Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves
Author
Bleiziffer, SabineSimonato, Matheus
Webb, John G
Rodés-Cabau, Josep
Pibarot, Philippe
Kornowski, Ran
Windecker, Stephan
Erlebach, Magdalena
Duncan, Alison
Seiffert, Moritz
Unbehaun, Axel
Frerker, Christian
Conzelmann, Lars
Wijeysundera, Harindra
Kim, Won-Keun
Montorfano, Matteo
Latib, Azeem
Tchetche, Didier
Allali, Abdelhakim
Abdel-Wahab, Mohamed
Orvin, Katia
Stortecky, Stefan
Nissen, Henrik
Holzamer, Andreas
Urena, Marina
Testa, Luca
Agrifoglio, Marco
Whisenant, Brian
Sathananthan, Janarthanan
Napodano, Massimo
Landi, Antonio
Fiorina, Claudia
Zittermann, Armin
Veulemans, Verena
Sinning, Jan-Malte
Saia, Francesco
Brecker, Stephen
Presbitero, Patrizia
De Backer, Ole
Søndergaard, Lars
Bruschi, Giuseppe
Franco, Luis Nombela
Petronio, Anna Sonia
Barbanti, Marco
Cerillo, Alfredo
Spargias, Konstantinos
Schofer, Joachim
Cohen, Mauricio
Muñoz-Garcia, Antonio
Finkelstein, Ariel
Adam, Matti
Serra, Vicenç
Teles, Rui Campante
Champagnac, Didier
Iadanza, Alessandro
Chodor, Piotr
Eggebrecht, Holger
Welsh, Robert
Caixeta, Adriano
Salizzoni, Stefano
Dager, Antonio
Auffret, Vincent
Cheema, Asim
Ubben, Timm
Ancona, Marco
Rudolph, Tanja
Gummert, Jan
Tseng, Elaine
Noble, Stephane
Bunc, Matjaz
Roberts, David
Kass, Malek
Gupta, Anuj
Leon, Martin B
Dvir, Danny
Date
2020-08-01Journal
European Heart JournalPublisher
Oxford University PressType
Article
Metadata
Show full item recordAbstract
AIMS: Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. METHODS AND RESULTS: A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) ≤ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. CONCLUSIONS: The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020.Rights/Terms
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com.Identifier to cite or link to this item
http://hdl.handle.net/10713/13558ae974a485f413a2113503eed53cd6c53
10.1093/eurheartj/ehaa544
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