Predictors of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation for Aortic Stenosis Using New-Generation Balloon-Expandable SAPIEN 3

Kaneko, Hidehiro; Hoelschermann, Frank; Tambor, Grit; Yoon, Sung‐Han; Neuß, Michael; Butter, Christian

doi:10.1016/j.amjcard.2016.10.047

Cited by 15 publications

(7 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, annular calcifications remain the more frequent factor associated with PVL [ 24 ]. In our cohort, higher pre-TAVI gradients (likely related to severely calcified AS) and the type of TAVI device were associated with PVL ≥ 2.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Deharo

Leroux

Théron

et al. 2022

JCM

View full text Add to dashboard Cite

Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusion: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.

show abstract

Section: Discussionmentioning

confidence: 99%

Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Deharo

Leroux

Théron

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Myocardial hypertrophy such as left ventricular outlet tract bulging has been described to be a risk factor of malpositioning 19 . In terms of the ratio of the aortic annulus to THV size, a smaller ratio of the aortic annulus to THV size may not be related with malpositioning or stuck valve since the difference between the two groups was clinically modest and the use of appropriately oversized THV is needed for a successful THV implantation 20,21 …”

Section: Discussionmentioning

confidence: 99%

Midterm outcomes after the rescue THV‐in‐THV procedure: Insights from the multicenter prospective OCEAN‐TAVI registry

Hibino¹,

Tabata²,

Ito³

et al. 2020

Cathet Cardio Intervent

View full text Add to dashboard Cite

Objectives To confirm whether the rescue transcatheter heart valve in the transcatheter heart valve (THV‐in‐THV) procedure is effective and feasible, we aimed to assess the midterm outcomes following rescue THV‐in‐THV procedures. The trends in the usage of the rescue THV‐in‐THV procedure at the time of transcatheter aortic valve implantation (TAVI) have also been explored. Background Midterm outcomes of the rescue THV‐in‐THV procedure have been poorly defined, though it is popular as an effective method to bail‐out some complications in TAVI. Methods We reviewed data from the Optimized transCathEter vAlvular iNtervention‐Transcatheter Aortic Valve Implantation (OCEAN‐TAVI) registry and compared the outcomes of TAVI with rescue THV‐in‐THV and TAVI without rescue THV‐in‐THV. We also examined the annual rates of rescue THV‐in‐THV procedures in all the TAVI procedures between 2013 and 2017. Results Among 2,588 patients who underwent TAVI, 26 patients have required rescue THV‐in‐THV for valve malposition (n = 23) or severe transvalvular regurgitation because of stuck THV leaflets (n = 3). Three cases needed an open conversion, and two died in the hospital. The rates of new permanent pacemaker implantation, acute kidney injury, and stroke were higher in the THV‐in‐THV group. A two‐year cumulative survival and echocardiographic outcomes succeeding rescue THV‐in‐THV procedure were comparable to non‐THV‐in‐THV cases. The rate of rescue THV‐in‐THV procedure lessened from 2.6% in 2013 to 0.6% in 2017. Conclusions The rescue THV‐in‐THV procedure is an effective and feasible option for THV malpositioning and stuck valve. It has given a comparable survival and a stable valve function over midterm observation periods.

show abstract

“…57 Optimal valve sizing and lower degree of valve calcification have been associated with lower degrees of regurgitation. 58 An oval shape of the annulus and annular eccentricity are further predictors of PVR. 57 Furthermore, there is a direct correlation between undersizing of the THV and severity of PVR.…”

Section: Aortic Regurgitation ≥ II Degreesmentioning

confidence: 99%

Valve-Related Complications in TAVI Leading to Emergent Cardiac Surgery

Conzelmann

Grotherr

et al. 2022

Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Transcatheter aortic valve implantation (TAVI) is now a standard procedure for the treatment of symptomatic aortic valve stenosis in many patients. In Germany, according to the annual reports from the German Institute for Quality Assurance and Transparency in Healthcare (Institut für Qualitätssicherung und Transparenz im Gesundheitswesen), the rate of serious intraprocedural complications, such as valve malpositioning or embolization, coronary obstruction, aortic dissection, annular rupture, pericardial tamponade, or severe aortic regurgitation requiring emergency cardiac surgery has decreased markedly in recent years from more than 5.5% in 2012 to 2.0% in 2019. However, with increased use, the total number of adverse events remains about 500 per year, about 100 of which require conversion to sternotomy. These, sometimes, fatal events can occur at any time and are still challenging. Therefore, the interdisciplinary TAVI heart team should be prepared and aware of possible rescue strategies.

show abstract

Predictors of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation for Aortic Stenosis Using New-Generation Balloon-Expandable SAPIEN 3

Cited by 15 publications

References 26 publications

Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry

Midterm outcomes after the rescue THV‐in‐THV procedure: Insights from the multicenter prospective OCEAN‐TAVI registry

Valve-Related Complications in TAVI Leading to Emergent Cardiac Surgery

Contact Info

Product

Resources

About