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Bleiziffer, Sabine; Simonato, 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; [...]

Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves

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  • Medientyp: E-Artikel
  • Titel: Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves
  • Beteiligte: Bleiziffer, Sabine; Simonato, 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; [...]
  • Erschienen: Oxford University Press (OUP), 2020
  • Erschienen in: European Heart Journal
  • Sprache: Englisch
  • DOI: 10.1093/eurheartj/ehaa544
  • ISSN: 0195-668X; 1522-9645
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Aims</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and results</jats:title> <jats:p>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 &amp;gt; 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)].</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> <jats:p /> </jats:sec>
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