Long-Term Outcome of Patients With Moderate and Severe Prosthetic Aortic Valve Regurgitation After Transcatheter Aortic Valve Implantation

Gotzmann, Michael; Korten, Michael; Bojara, Waldemar; Lindstaedt, Michael; Rahlmann, Pia; Mügge, Andreas; Ewers, Aydan

doi:10.1016/j.amjcard.2012.07.010

Cited by 98 publications

(59 citation statements)

References 26 publications

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“…Recently, moderate and significant valvular regurgitation have been identified as independent risk factors for short and medium-term mortality after transcatheter aortic valve implantation [19,23]. The same can be observed in the long-term, with mortality being 21% in cases of moderate and significant regurgitation and 6% in cases of discrete or absent regurgitation [24]. In the present series, none of the patients developed total atrioventricular block or needed definitive pacemaker implant.…”

Section: Discussionsupporting

confidence: 60%

“…The patients had mean EuroScore of 39.30% and mean STS score of 30.28%, which means that higher mortality rates than the ones described in major studies worldwide [20][21][22][23][24][25][26] can be explained by greater patient severity. A recent study in Italy [29] evaluated 165 patients who had undergone transcatheter aortic valve implantation.…”

Section: Discussionmentioning

confidence: 76%

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Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Pontes¹,

Duarte²,

Silva³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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208Rev Bras Cir Cardiovasc | Braz J Cardiovasc SurgRev Bras Cir Cardiovasc 2013;28(2):208-16 Pontes JCDV, et al. -Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery RBCCV 44205-1459 DOI: 10.5935/1678 Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery Abstract Objective: This paper demonstrates the initial and pioneering experience implant of the Inovare prosthesis implant through transfemoral or iliac artery route.Methods: Six patients underwent transcatheter aortic valve implantation. The access was femoral or iliac through which the delivery device, a latex balloon catheter with the crimped prosthesis, was inserted. Through the femoral introducer 24 Fr Gore ® DrySeal sheath, an extra stiff guide wire with non-traumatic tip was positioned in the left ventricle by passing through the valve ring. After balloon valvuloplasty, in cases of native valve stenosis, the prosthesis implantation was performed after hypotension induced by tachycardia and controlled by temporary pacemaker. The valve positioning was guided by TEE (transesophageal ecocardiography) and fluoroscopy, aiming to position a third of the length of the prosthesis into the left ventricle cavity.Results: The successful valve implantation was possible in six cases. There was no need of conversion to open surgery due to inability to access or graft migration. There were no intraoperative or hospital deaths. We observed a significant reduction in the mean gradient of 66.84±15.46 mmHg to 19.74±10.61 mm Hg postoperatively (P=0.002), a reduction of 70.46%.Conclusion: Inovare prosthesis, implanted by femoral or iliac artery was feasible, and determined adequate hemodynamic performance in the postoperative follow-up, showing no mortality in this small series.Descriptors: Heart valve diseases. Stents. Heart catheterization. Heart valve prosthesis implantation/methods. Aortic valve/surgery. ORIGINAL ARTICLE 209Rev Bras Cir Cardiovasc | Braz J Cardiovasc Surg Bras Cir Cardiovasc 2013;28(2):208- Rev INTRODUCTIONDegenerative calcification of normal or congenital bicuspid aortic valve is the leading cause of aortic valve stenosis in adults in developed countries [1][2][3]. Prevalence of severe aortic stenosis increases with age and may affect up to 2% of individuals over 65 years of age [4]. The onset of symptoms constitutes poor prognosis and survival after that is as low as 60% in 1 year and 32% in 5 years [5]. Death in patients with heart failure usually occurs 2 years after the onset of symptoms, and after 3 and 5 years for patients with syncope and angina, respectively [6]. In such cases, surgical intervention alters the natural course of the disease, since surgical mortality, at about 4%, is considered low [7]. However, 33% of patients who are candidates for surgical treatment are not accepted to undergo the procedure, especially due to advanced age and ventricular dysfunction [8]. Other conditions, such as associated comorbidit...

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 76%

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Pontes¹,

Duarte²,

Silva³

et al. 2013

Revista Brasileira De Cirurgia Cardiovascular

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“…Moderate-severe PVL is an independent predictor of mortality in the postoperative period to 30 days, at 1 year, and at 2 years [5][6][7][8][9][10][11]13 (Table 2). Recently, Kodali et al from the Placement of AoRTic TraNscathetER (PARTNER) valve trial high-risk cohort suggested that any PVL regurgitation (mild-moderatesevere) was associated with increased mortality at 2 years, although this association was not analyzed in multivariate fashion.…”

Section: Clinical Impact Of Paravalvular Leakmentioning

confidence: 99%

“…Most importantly, PVL has been associated with increased short-and long-term mortality post-TAVR, and is seen as a barrier to more widespread use of this promising technique. [5][6][7][8][9][10][11][12][13] This article describes the incidence, causes, and predictors of PVL, as well as its impact on clinical outcomes. Methods of prevention, diagnosis, and treatment of PVL are also reviewed.…”

mentioning

confidence: 99%

Paravalvular Aortic Leak After Transcatheter Aortic Valve Replacement

Lerakis

Hayek²,

Douglas³

2013

Circulation

200

128

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“…[5][6][7][8][12][13][14][15][16][18][19][20]24,25,30,33 One-year mortality of men and women was 22.0% and 16.9%, respectively. Pooled analysis using a random-effects model showed that men had significantly higher 1-year mortality (pooled RR, 1.30; 95% CI, 1.14-1.49; Figure 7).…”

Section: One-year Mortalitymentioning

confidence: 99%

Sex-Related Differences in Outcomes After Transcatheter Aortic Valve Implantation

Zhang

Liao

Peng

et al. 2013

Circ: Cardiovascular Interventions

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Studies were initially screened at the level of title and abstract, and then full-length reports were retrieved for detailed evaluation. Two authors independently selected articles according to prespecified inclusion and exclusion criteria. Articles were included if they (1) reported Background-There were considerable discrepancies with regard to sex-related differences in complications and prognosis after transcatheter aortic valve implantation. Methods and Results-The Cochrane library and PubMed online databases were searched. Articles reporting sex-specific post-transcatheter aortic valve implantation complications and mortality were identified. Two authors selected studies and extracted data independently. Random-and fixed-effects models were used depending on between-study heterogeneity. There were 27 articles, a total of 9118 patients, enrolled in our systematic review and meta-analysis, including 4176 men and 4942 women. Pooled analyses suggested considerable sex-related differences in complications and early as well as midterm outcomes after transcatheter aortic valve implantation. The difference in the risk for heart block requiring permanent pacemaker implantation was noted to be significant only in the subgroup of the CoreValve-dominating studies (pooled risk ratio [RR, men versus women], 1.29; 95% confidence interval [CI], 1.13-1.47). Although men had significantly lower risks for major/life-threatening bleeding (pooled RR, 0.81; 95% CI, 0.68-0.96) and major vascular complications (pooled RR, 0.49; 95% CI, 0.37-0.66), they had poorer prognosis. In fact, male sex was associated with significantly higher risks for deaths at both 30 days (RR, 1.37; 95% CI, 1.07-1.76) and 1 year (RR, 1.30; 95% CI, 1.14-1.49). Conclusions-Although men had lower risks for major/life-threatening bleeding and major vascular complications after transcatheter aortic valve implantation, they had less favorable short-term and midterm survival. (Circ Cardiovasc Interv. 2013;6:543-551.)

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Long-Term Outcome of Patients With Moderate and Severe Prosthetic Aortic Valve Regurgitation After Transcatheter Aortic Valve Implantation

Cited by 98 publications

References 26 publications

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Initial and pioneer experience of transcatheter aortic valve implantation (Inovare) through femoral or iliac artery

Paravalvular Aortic Leak After Transcatheter Aortic Valve Replacement

Sex-Related Differences in Outcomes After Transcatheter Aortic Valve Implantation

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