Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic review and meta-analysis

Giordana, Francesca; Bruno, Francesco; Conrotto, Federico; Saglietto, Andrea; D’Ascenzo, Fabrizio; Marra, Walter Grosso; Dvir, Danny; Webb, John G.; D’Onofrio, Augusto; Camboni, Daniele; Grubitzsch, Herko; Duncan, Alison; Kaneko, Tsuyoshi; Toggweiler, Stefan; Latib, Azeem; Nerla, Roberto; Salizzoni, Stefano; Torre, Michele La; Trompeo, Anna Chiara; D’Amico, Maurizio; Ferrari, G

doi:10.1016/j.ijcard.2020.05.058

Cited by 13 publications

(17 citation statements)

References 38 publications

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“…A recent meta-analysis of mostly small observational studies (<50 patients each) analyzed the predictors of 30-day and 1year mortality in patients undergoing ViV-TAVI. The authors concluded that the independent predictors of 30-day mortality included study year (indicating improving operator experience), logistic EuroSCORE, and valve size < 21 mm, while stenosis as a reason for the surgical valve failure was the only independent predictor of mortality at 1 year (17).…”

Section: Discussionmentioning

confidence: 99%

“…We are not aware of a ViV-TAVI study that evaluated the impact of age on procedural success. The aforementioned meta-analysis did not analyze the predictors for procedural success but did not identify age as an independent predictor for either 30-day or 1-year mortality after ViV-TAVI (17). For native valve TAVI, two studies by Buellesfeld et al and Yamamoto et al reported similar procedural success and short-term mortality outcomes in younger and older age groups (18,19).…”

Section: Discussionmentioning

confidence: 99%

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Predictors of Procedural Success in Patients With Degenerated Surgical Valves Undergoing Transcatheter Aortic Valve-in-Valve Implantation

Abushouk

Abdelfattah

Saad

et al. 2021

Front. Cardiovasc. Med.

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Background: Valve-in-Valve transcatheter aortic valve implantation (ViV-TAVI) is a growing alternative for redo-surgery in patients with degenerated surgical valves. To our knowledge, data are lacking on the determinants on ViV-TAVI procedural success in patients with degenerated surgical valves.Methods: All consecutive patients undergoing ViV-TAVI for degenerated surgical valves at the Cleveland Clinic were analyzed. Data were extracted from our patient registry on baseline patient characteristics, echocardiographic parameters, and procedural details. To identify possible predictors of ViV-TAVI procedural success, we employed a multivariate logistic regression model.Results: A total of 186 patients who underwent ViV-TAVI were analyzed, with procedural success (VARC-2 device success and absence of periprocedural MACCE) reported in 165 (88.7%) patients. Patients with successful ViV-TAVI were significantly younger and had more frequent utilization of the transfemoral access than those with failed procedure. Other baseline and procedural characteristics were comparable between both groups. In terms of echocardiographic parameters, the procedural success group had a significantly lower AV peak pressure gradient (62.1 ± 24.7 vs. 74.1 ± 34.6 mmHg; p = 0.04) and lower incidence of moderate-to-severe aortic regurgitation [AR] (30.4 vs. 55%; p = 0.04). However, no significant differences between both groups were noted in terms of AV mean pressure gradient and left ventricular measurements. In multivariate analysis, lower AV peak pressure gradient (OR = 0.97, 95% CI: 0.95–0.99) and absence of moderate-to-severe AR (OR = 0.65, 95% CI: 0.44–0.95) at baseline emerged as independent predictors of ViV-TAVI procedural success.Conclusion: Valve-in-Valve TAVI for degenerated surgical valves is a feasible approach with high success rates, especially in those with lower AV peak pressure gradient and absence of moderate-to-severe AR. Studies with larger sample size and longer follow-up are required to further characterize the predictors of ViV-TAVI success and other clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predictors of Procedural Success in Patients With Degenerated Surgical Valves Undergoing Transcatheter Aortic Valve-in-Valve Implantation

Abushouk

Abdelfattah

Saad

et al. 2021

Front. Cardiovasc. Med.

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“…Critical issues in achieving a successful valve-in-valve procedure include an understanding of the manufacturer sizing and labelling of surgical bioprostheses and correct positioning of the valve in the valve. Early experience suggests that TAVI will be an important option for the treatment of patients with failed bioprostheses [70].…”

Section: Management Of Aortic Regurgitationmentioning

confidence: 99%

Aortic Valve Disease: State of the Art

Gamel¹

2021

Advances in Complex Valvular Disease

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Aortic valve replacement is the most commonly performed valve operation. It has been shown to be an effective therapy in all age groups, including the very elderly (age > 90 years). The most common etiologies for aortic stenosis are calcific degeneration, rheumatic disease, and congenital bicuspid valves. The most common causes of pure aortic regurgitation include annuloaortic ectasia and associated dilation of the aortic root, endocarditis, aortic dissection, and rheumatic disease. The indications for surgery depend on the pathophysiology and symptoms. The choice of the prosthesis can be difficult and depends on multiple clinical and lifestyle considerations. Early and late outcomes are generally quite good, even in high-risk patients.

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“…Sudden malfunction of an aortic bioprosthesis will cause congestive heart failure and requires urgent reoperation with valve replacement or more recently in some cases can be treated by transcatheter aortic valve implantation (TAVI). 2 COVID-19 patients can present with acute heart failure. 3 In our patient, initial symptoms of aortic bioprosthesis failure mimicked COVID-19 infection, pulmonary emboli, or septicemia that delayed assessment of the correct diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Late leaflet dehiscence in a bovine bioprosthesis-mimicked COVID-19 infection

Ivert

Dalén

2021

SAGE Open Medical Case Reports

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Symptoms mimicking COVID-19 infection, pulmonary emboli, or septicemia delayed diagnosis of aortic bioprosthesis failure. A 71-year-old man was admitted emergently with shortness of breath, fever, cough, and chest pain. Echocardiography performed after 2 days showed diastolic regurgitation in an aortic perimount pericardial bioprosthesis implanted 12 years previously. An urgent reoperation disclosed that one pericardial cusp was torn from the stent of the valve. We have not previously encountered sudden pericardial leaflet dehiscence of an internally mounted pericardial valve that caused heart failure and found no literature report like our finding.

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Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic review and meta-analysis

Cited by 13 publications

References 38 publications

Predictors of Procedural Success in Patients With Degenerated Surgical Valves Undergoing Transcatheter Aortic Valve-in-Valve Implantation

Predictors of Procedural Success in Patients With Degenerated Surgical Valves Undergoing Transcatheter Aortic Valve-in-Valve Implantation

Aortic Valve Disease: State of the Art

Late leaflet dehiscence in a bovine bioprosthesis-mimicked COVID-19 infection

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