Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Background: Para-valvular regurgitation (PVR) after transcatheter aortic valve (TAV) implantation is associated with increased mortality. Redo-TAVI may be applied to treat PVR, yet with unknown efficacy. We thought to assess redo-TAVI efficacy in reducing PVR using the Redo-TAVI registry (45 centers; 600 TAV-in-TAV cases). Methods: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation. Results: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR ≥ moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR ≥ moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV. Conclusions: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | International Journal of Cardiology |
| Vol/bind | 364 |
| Sider (fra-til) | 31-34 |
| ISSN | 0167-5273 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Dr. JG Webb: consultant to, and has received research funding from, Edwards Lifesciences, Abbott Vascular, Boston Scientific. Dr. WK Kim: proctor or speaker fees from Boston Scientific, Abbott, Edwards Lifesciences, Medtronic. Dr. Abdel-Wahab: Dr. Abdel-Wahab hospital received speaker's honoraria and/or consultancy fees on his behalf from Boston Scientific and Medtronic. Dr. M Barbanti: consultant for Edwards and is an advisory board member for Biotronik. Dr. L Sondergaard: consultant fees and institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic and Symetis. Dr. C Hamm: Advisory Board Medtronic. Dr. JM Sinning: speaker honoraria and research grants from Medtronic, Boston Scientific, and Edwards Lifesciences. Dr. J Sathananthan: consultant to Edwards Lifesciences. Dr. M Andreas: proctor/consultant/ speaker for Edwards, Abbott and Medtronic, received institutional grants (Edwards, Abbott, Medtronic, LSI). Dr. M Guerrero: research grant support from Abbott Vascular and Edwards Lifesciences. Dr. F Castriota: proctor for Medtronic, and Boston Scientific. Dr. T Nazif: consulting or honoraria from Edwards LifeSciences, Medtronic, and Boston Scientific, Biotrace and Baylis Medical. Consulting and equity with Venus medtech. Dr. T Pilgrim: research grants from Boston Scientific, Edwards Lifesciences and Biotronik; speaker fees from Boston Scientific and Biotronik. Dr. VC Babaliaros: consultant to Edwards Lifesciences and equity in transmural system. Dr. N Van Mieghem: institutional research grants and consulting fees from Abbott, Boston Sientific, Medtronic, Daiichi Sankyo, and PulseCath BV and institutional research grant support from Edwards Liefsciences. Dr. A Latib: institutional research/grant support from Abbott, Boston Scientific, Medtronic and Edwards Lifesciences; and personal consulting honoraria from Abbott, Edwards Lifesciences and Medtronic. Dr. D Hildick-Smith: proctor and advisory to Boston, Medtronic, Edwards. All other authors have no conflict of interest to report in relation with this manuscript.
Publisher Copyright:
© 2022 Elsevier B.V.
ID: 326017854