Early and Midterm Clinical Outcomes of Transcatheter Valve-in-Valve Implantation Versus Redo Surgical Aortic Valve Replacement for Aortic Bioprosthetic Valve Degeneration: Two Faces of the Same Medal

Dokollari, Aleksander; Cameli, Matteo; Mandoli, Giulia Elena; Poston, Robert; Çoku, Lindita; Pernoci, Marjela; Miri, Mirian; Bonacchi, Massimo; Gelsomino, Sandro

doi:10.1053/j.jvca.2021.05.029

Cited by 16 publications

(20 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The valve has grown in popularity mostly due to the reduced cardiopulmonary bypass (CPB) time ( 1 ), the improved myocardial recovery time and its application in minimally invasive cardiac surgery (MICS) procedures ( 2 ). In addition, the three PARTNER clinical trials' ( 3 – 5 ), the SURTAVI trial ( 6 ) and other observational cohort studies ( 7 , 8 ) have evidenced the non-inferiority of TAVR vs. SAVR. In this context, some reports of successful valve-in-valve TAVR in bioprostheses with structural valve deterioration (SVD) have generated enthusiasm particularly for future applications ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Benefits and Pitfalls of the Perceval Sutureless Bioprosthesis

Dokollari

Ramlawi

Torregrossa

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

Objective: To highlight the main target points covered by clinical studies on the Perceval sutureless valve for surgical aortic valve replacement (SAVR) and raise a point of discussion for further expansion of its use when compared with stented bioprostheses (SB) and transcatheter aortic valve replacement (TAVR).Methods: We reviewed clinical trials and retrospective studies published up to date and compared the outcomes in terms of mortality, myocardial infarction (MI) stroke, paravalvular leak (PVL), permanent pacemaker implantation (PPI), bleeding and long-term outcomes.Results: Clinical studies showed that 30-day mortality ranged from 0–4% for Perceval and 2.9–7% for TAVR. The incidence of PVL (Perceval 1.9–19.4 vs. TAVR 9–53.5%), PPI (Perceval 2–11.2 vs. TAVR 4.9–25.5%), stroke (Perceval 0 vs. TAVR 0–2.8%), MI (Perceval 0 vs. TAVR 0–3.5%), were all higher in the TAVR group. Compared to other SB, mortality ranged from 0–6.4% for Perceval and 0–5.9% for SB. The incidence of PVR (Perceval 1–19.4 vs. SB 0–1%), PPI (Perceval 2–10.7 vs. SB 1.8–8.5%), stroke (Perceval 0–3.7 vs. SB 1.8–7.3%) and MI (Perceval 0–7.8 vs. SB 0–4.3%) were comparable among the groups. In patients with a bicuspid aortic valve, mortality rate was (0–4%) and PVL incidence was (0–2.3%). However, there was a high incidence of PPI (0–20%), and stroke (0–8%). Long-term survival ranged between 96.7–98.6%.Conclusions: The Perceval bioprosthesis has proved to be a reliable prosthesis for surgical aortic valve replacement due to its implantation speed, the reduced cardiopulmonary bypass time, the reduced aortic cross-clamp time and the shorter intensive care unit and hospital length of stay.

show abstract

Section: Introductionmentioning

confidence: 99%

Benefits and Pitfalls of the Perceval Sutureless Bioprosthesis

Dokollari

Ramlawi

Torregrossa

et al. 2022

Front. Cardiovasc. Med.

Self Cite

View full text Add to dashboard Cite

show abstract

“…The overall OR for operative mortality (Supporting Information: Figure ) demonstrated a statistically significant difference favoring ViV‐TAVR over redo SAVR (random‐effects model: OR: 0.37; 95% CI: 0.27–0.49; p < .001) 6,9,12,14,15,17–19,22,24 . There was no evidence of heterogeneity among studies reporting on operative mortality.…”

Section: Resultsmentioning

confidence: 90%

“…The overall OR for operative mortality (Supporting Information: Figure 8A) demonstrated a statistically significant difference favoring ViV-TAVR over redo SAVR (random-effects model: OR: 0.37; 95% CI: 0.27-0.49; p < .001). 6,9,12,14,15,[17][18][19]22,24 There was no evidence of heterogeneity among studies reporting on operative mortality. The overall OR for 30-day mortality (Supporting Information: Figure 8B) showed no statistically significant difference between ViV-TAVR and redo SAVR (random-effects model: OR: 0.92; 95% CI: 0.53-1.60; p = .78).…”

Section: Operative Mortality and 30-day Mortalitymentioning

confidence: 97%

Renal outcomes in valve‐in‐valve transcatheter versus redo surgical aortic valve replacement: A systematic review and meta‐analysis

Rad

Naruka

Vardanyan

et al. 2022

Journal of Cardiac Surgery

View full text Add to dashboard Cite

Introduction Postoperative acute kidney injury (AKI) and the requirement for renal replacement therapy (RRT) remain common and significant complications of both transcatheter valve‐in‐valve aortic valve replacement (ViV‐TAVR) and redo surgical aortic valve replacement (SAVR). Nevertheless, the understanding of renal outcomes in the population undergoing either redo SAVR or ViV‐TAVR remains controversial. Methods A systematic database search with meta‐analysis was conducted of comparative original articles of ViV‐TAVR versus redo SAVR in EMBASE, MEDLINE, Cochrane database, and Google Scholar, from inception to September 2021. Primary outcomes were AKI and RRT. Secondary outcomes were stroke, major bleeding, pacemaker implantation rate, operative mortality, and 30‐day mortality. Results Our search yielded 5435 relevant studies. Eighteen studies met the inclusion criteria with a total of 11,198 patients. We found ViV‐TAVR to be associated with lower rates of AKI, postoperative RRT, major bleeding, pacemaker implantation, operative mortality, and 30‐day mortality. No significant difference was observed in terms of stroke rate. The mean incidence of AKI in ViV‐TAVR was 6.95% (±6%) and in redo SAVR was 15.2% (±9.6%). For RRT, our data showed that VIV‐TAVR to be 1.48% (±1.46%) and redo SAVR to be 8.54% (±8.06%). Conclusion Renoprotective strategies should be put into place to prevent and reduce AKI incidence regardless of the treatment modality. Patients undergoing re‐intervention for the aortic valve constitute a high‐risk and frail population in which ViV‐TAVR demonstrated it might be a feasible option for carefully selected patients. Long‐term follow‐up data and randomized control trials will be needed to evaluate mortality and morbidity outcomes between these 2 treatments.

show abstract

“…Multiple previous studies have shown ViV TAVI to be a less invasive approach with noninferior to superior outcomes compared with redo SAVR, despite generally higher risk patient populations. 19 , 20 , 21 , 22 , 23 The caveat to this is that most of these studies were retrospective with limited data on long-term outcomes. Clinical trials are needed to evaluate the safety and efficacy profile of each treatment modality thoroughly.…”

Section: Discussionmentioning

confidence: 99%