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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Sabine Bleiziffer
  • Matheus Simonato
  • John G. Webb
  • Josep Rodés-Cabau
  • Philippe Pibarot
  • Ran Kornowski
  • Stephan Windecker
  • Magdalena Erlebach
  • Alison Duncan
  • Moritz Seiffert
  • Axel Unbehaun
  • Christian Frerker
  • Lars Conzelmann
  • Harindra Wijeysundera
  • Won Keun Kim
  • Matteo Montorfano
  • Azeem Latib
  • Didier Tchetche
  • Abdelhakim Allali
  • Mohamed Abdel-Wahab
  • Katia Orvin
  • Stefan Stortecky
  • Henrik Nissen
  • Andreas Holzamer
  • Marina Urena
  • Luca Testa
  • Marco Agrifoglio
  • Brian Whisenant
  • Janarthanan Sathananthan
  • Massimo Napodano
  • Antonio Landi
  • Claudia Fiorina
  • Armin Zittermann
  • Verena Veulemans
  • Jan Malte Sinning
  • Francesco Saia
  • Stephen Brecker
  • Patrizia Presbitero
  • Giuseppe Bruschi
  • Luis Nombela Franco
  • Anna Sonia Petronio
  • Marco Barbanti
  • Alfredo Cerillo
  • Konstantinos Spargias
  • Joachim Schofer
  • Mauricio Cohen
  • Antonio Muñoz-Garcia
  • Ariel Finkelstein
  • Matti Adam
  • Vicenç Serra
  • Rui Campante Teles
  • Didier Champagnac
  • Alessandro Iadanza
  • Piotr Chodor
  • Holger Eggebrecht
  • Robert Welsh
  • Adriano Caixeta
  • Stefano Salizzoni
  • Antonio Dager
  • Vincent Auffret
  • Asim Cheema
  • Timm Ubben
  • Marco Ancona
  • Tanja Rudolph
  • Jan Gummert
  • Elaine Tseng
  • Stephane Noble
  • Matjaz Bunc
  • David Roberts
  • Malek Kass
  • Anuj Gupta
  • Martin B. Leon
  • Danny Dvir

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 A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; and results 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.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind41
Udgave nummer29
Sider (fra-til)2731-2742
Antal sider12
ISSN0195-668X
DOI
StatusUdgivet - 2020

ID: 261524549