Hemodynamic Performances and Clinical Outcomes in Patients Undergoing Valve-in-Valve Versus Native Transcatheter Aortic Valve Implantation

Akodad, Mariama; Meilhac, Alexandra; Lefèvre, Thierry; Cayla, Guillaume; Lattuca, Benoît; Autissier, Cécile; Gandet, Thomas; Macia, Jean‐Christophe; Delseny, Delphine; Roubille, François; Maupas, Eric; Schmutz, Laurent; Piot, Christophe; Targosz, Frédéric; Robert, Gabriel; Rivalland, François; Albat, Bernard; Chevalier, Bernard; Leclercq, Florence

doi:10.1016/j.amjcard.2019.04.009

Cited by 13 publications

(15 citation statements)

References 28 publications

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“…A total of 125 patients were included (redo-SAVR; 84, ViV-TAVI; 41). Median age was 74 [63-80] years, 58% of the patients were male and the median logistic EuroSCORE was 15 [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]%. Median follow-up was 4.2 (2.2-6.8) years; redo-SAVR: 4.9 (2.1-7.8) years, ViV-TAVI: 3.5 (2.2-4.6) years.…”

Section: Resultsmentioning

confidence: 99%

“…As confirmed by our experience, early residual paravalvular leak after ViV-TAVI has a low prevalence and limited to mild degrees of regurgitation which usually does not worsen. 7,20,22 Conversely, post-procedure trans-prosthetic gradients are often elevated after valve-in-valve procedures and significantly higher than in transcatheter implantation in a native aortic valve. 22,23 At discharge echocardiogram, we found significantly higher peak and mean trans-prosthetic gradients after ViV-TAVI compared with redo-SAVR.…”

Section: Discussionmentioning

confidence: 99%

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Early- and mid-term outcomes of reinterventions for aortic bioprosthesis failure

Malvindi

Luthra

Santarpino

et al. 2022

Asian Cardiovasc Thorac Ann

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Background The aim of this study was to evaluate early- and mid-term results of our actual practice embedding redo aortic valve replacement and transcatheter procedures for aortic bioprosthetic failure. Methods Data for aortic valve reinterventions (redo surgical aortic valve replacement, isolated redo aortic valve replacement, and valve-in-valve transcatheter aortic valve implantation, transcatheter valve-in-valve procedure) were collected (2010–2019). Logistic regression analysis was performed to identify predictors favouring the choice of transcatheter against redo surgery. Cox analysis was used to study the association of preoperative variables with survival. Survival probabilities were calculated with Kaplan-Meier analysis and compared using a log-rank test. Results A total of 125 patients were included (redo surgical aortic valve replacement: 84 patients, valve-in-valve transcatheter aortic valve implantation: 41 patients). Median age was 74 [63–80] years, 58% of the patients were male and the median logistic EuroSCORE was 15 [8–26] %. There was no early mortality. Eighteen patients (redo surgical aortic valve replacement: 15, valve-in-valve transcatheter aortic valve implantation: 3) sustained at least one postoperative complication. At pre-discharge transthoracic echocardiogram, valve-in-valve transcatheter aortic valve implantation had significantly higher trans-prosthetic gradients (mean gradient: valve-in-valve transcatheter aortic valve implantation 18 mmHg vs. redo surgical aortic valve replacement 14 mmHg, p < 0.001). Overall survival probabilities were 94% and 73% at 1 year and 5 years, respectively. Previous coronary artery bypass surgery operation and age were independently associated with lower survival probabilities during the follow-up. Conclusions Redo surgical aortic valve replacement and valve-in-valve transcatheter aortic valve implantation are both safe and effective for aortic bioprosthetic failure. Further valve-in-valve data are needed to determine the haemodynamic performance of transcatheter prostheses and its impact on long-term outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early- and mid-term outcomes of reinterventions for aortic bioprosthesis failure

Malvindi

Luthra

Santarpino

et al. 2022

Asian Cardiovasc Thorac Ann

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“…Given the publication bias, CO mortality was lower in the present study than in real-world studies. It is noteworthy that patients were younger but had higher STS scores and Logistic Euro-SCORE in VIV-TAVR than in the native-TAVR; 24,25) therefore, it is not surprising that patients who underwent VIV had a higher mortality. In the present study, we could infer from the CO mortality description that those who were treated by PCI were more likely to survive the complica- tion.…”

Section: Discussionmentioning

confidence: 99%

“…Urgent percutaneous coronary intervention (PCI) was performed in 39 (79.4%) subjects and succeed in 27(69.2%). 26) *** ** ** Akodad, et al 24) *** * ** Camboni, et al 27) *** * ** Ye, et al 28) *** ** ** Grubitzsch, et al 29) **** * *** Schneider , et al 30) *** ** ** Tchétché, et al 31) *** ** ** Miller, et al 14) *** * ** Adamo, et al 13) *** * *** Wernly, et al 32) **** * ** Mosquera, et al 33) *** * *** Ribeiro, et al 10) *** ** ** Webb, et al 34) **** ** **…”

Section: Outcomes Of Co Post-viv-tavrmentioning

confidence: 99%

Incidence, Risk Factors, and Outcomes of Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement

et al. 2021

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There is scant information about the incidence, risk factors, and outcomes of coronary obstruction (CO) following valve-in-valve transcatheter aortic valve replacement (VIV-TAVR). A meta-analysis of the published studies from January 2000 to April 2020 was conducted, and the endpoint was CO. A total of 2858 patients were enrolled in this study. The mean age was 77.7 ± 9.8, and 39.9% of them were female. The Society of Thoracic Surgeons (STS) score, European System for Cardiac Operative Risk Evaluation (EuroSCORE), and Logistic EuroSCORE were 8.9 ± 7.8, 16.0 ± 10.9, and 26.3 ± 16.3, respectively. The overall incidence of CO was 2.58%. CO incidence between patients with prior stented and stentless valves were significantly different (1.67% versus 7.17%), with an odds ratio (OR) of 0.25 and a 95% confidence interval (CI) of 0.14-0.44 (P < 0.00001). The first-generation valves were significantly associated with higher CO incidence compared with the second-generation valves (7.09% versus 2.03%; OR, 2.44; 95%CI, 1.06-5.62; P = 0.04), while no statistical difference was found between self-expandable valves and balloon-expandable valves (2.45% versus 2.60%; OR, 0.99; 95%CI, 0.55-1.79; P = 0.98). Virtual transcatheter to coronary ostia (VTC) distance (3.3 ± 2.1 mm, n = 29 versus 5.8 ± 2.4 mm, n = 169; mean difference, −2.70; 95%CI, −3.46 to −1.95; P < 0.00001) and the sinus of Valsalva (SOV) diameter (27.5 ± 3.8 mm, n = 23 versus 32.3 ± 4.0 mm, n = 101; mean difference, −3.80; 95%CI, −6.55 to −1.05; P = 0.007) were enormously shorter in patients with CO. The 24-hour, in-hospital, and 30-day mortality of patients with CO were 10.5%, 30.8%, and 37.1%, respectively. In conclusion, device selections, VTC distances, and SOV diameters may be important factors in assessing the CO risk in VIV-TAVR.

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“…16,19,[22][23][24][25][26] Como preditores dessa melhora, foram identificados a ausência de calcificação anular mitral, 17,27 a RM funcional (ao invés da degenerativa), 6,21,27 a ausência de hipertensão pulmonar, 17,21,27 a ausência de fibrilação atrial, 21,24,27 bloqueio de ramo esquerdo persistente, 27 gradientes transaórticos iniciais mais altos, 17 válvula-em-válvula é tão seguro e viável quanto o TAVI na EAo nativa, sem influência significativa no acompanhamento destes pacientes. 32 Tal achado indica que a inclusão de um pequeno número de biopróteses cirúrgicas degeneradas não deve afetar os nossos resultados e conclusões.…”

Section: Discussionunclassified

A Relação entre Regurgitação Mitral e Implante Transcateter de Válvula Aórtica: um Estudo de Acompanhamento Multi-Institucional

Cunha¹,

Guérios²,

Cunha³

et al. 2021

Arquivos Brasileiros De Cardiologia

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Fundamento: A regurgitação mitral (RM) é prevalente em pacientes submetidos a implante transcateter de válvula aórtica (TAVI). Há algumas controvérsias sobre o impacto prognóstico da RM na sobrevida de pacientes submetidos a TAVI. Objetivo: Examinar a relação entre TAVI e RM em uma população de pacientes do Registro Brasileiro de TAVI. Métodos: Setecentos e noventa e cinco pacientes do Registro Brasileiro de TAVI foram divididos na linha de base, alta e acompanhamento de acordo com o grau da RM da maneira seguinte: ausente/leve (RMAL) ou moderado/grave (RMMG). Eles foram subsequentemente reagrupados de acordo com as mudanças imediatas e tardias na gravidade da RM após TAVI da maneira seguinte: RM sem mudança, melhora ou piora. Foram analisados os preditores e o impacto prognóstico na linha de base, bem como as mudanças na gravidade da RM. A significância estatística foi estabelecida em p < 0,05.Resultados: RMMG basal estava presente em 19,3% dos pacientes e foi um preditor de aumento da mortalidade tardia. Imediatamente após o TAVI, 47,4% dos casos melhoraram para RMAL, previsto por uma pontuação mais alta da Society of Thoracic Surgeons e um grau mais alto de regurgitação aórtica basal. No acompanhamento, 9,2% dos casos de RMAL pioraram para RMMG, enquanto 36,8% dos casos de RMMG melhoraram para RMAL. Fração de ejeção do ventrículo esquerdo (FEVE) mais baixa na linha de base e melhora na FEVE durante o acompanhamento foram preditores de melhora da RM. Piora progressiva da RM no acompanhamento foi um preditor independente de maior mortalidade tardia após TAVI (p = 0,005).Conclusões: A RMMG na linha de base é um preditor de mortalidade tardia após TAVI. FEVE mais baixa e melhora na FEVE durante o acompanhamento são preditores de melhora da RM após TAVI. A pior progressiva da gravidade da RM durante o acompanhamento é um preditor independente de mortalidade tardia; isto é um achado raro na literatura.

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Hemodynamic Performances and Clinical Outcomes in Patients Undergoing Valve-in-Valve Versus Native Transcatheter Aortic Valve Implantation

Cited by 13 publications

References 28 publications

Early- and mid-term outcomes of reinterventions for aortic bioprosthesis failure

Early- and mid-term outcomes of reinterventions for aortic bioprosthesis failure

Incidence, Risk Factors, and Outcomes of Coronary Obstruction Following Valve-in-Valve Transcatheter Aortic Valve Replacement

A Relação entre Regurgitação Mitral e Implante Transcateter de Válvula Aórtica: um Estudo de Acompanhamento Multi-Institucional

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