Transcatheter aortic valve‐in‐valve implantation in failed stentless bioprostheses

Huczek, Zenon; Grodecki, Kajetan; Ścisło, Piotr; Wilczek, Krzysztof; Jagielak, Dariusz; Fil, Wojciech; Kübler, Piotr; Olszówka, Piotr; Dąbrowski, M; Frank, Marek; Grygier, Marek; Kidawa, Michał; Wilimski, Radosław; Żelazowska, Katarzyna; Witkowski, Adam; Kochman, Janusz; Zembala, Marian; Opolski, Grzegorz; Dvir, Danny; Wojakowski, Wojciech

doi:10.1111/joic.12540

Cited by 16 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Again, however, this assumption was derived from a mix of patients with both degenerated stented and stentless aortic bioprostheses. Residual mean transvalvular pressure gradient of 10.1±3.1 mmHg in the present study using balloon-expandable Edwards valves was very similar to the residual pressure gradient after ViV TAVI with selfexpandable Medtronic CoreValve valves as described previously by Wai Sang and colleagues (11±8 mmHg) and Huczek and colleagues [14.7 (11.7-18.3) mmHg] (12,18).…”

Section: Discussionsupporting

confidence: 89%

Outcomes after transcatheter valve-in-valve implantation using a balloon-expandable Edwards Sapien valve in patients with degenerated Freestyle aortic bioprosthesis

Burgdorf¹,

Momchilovska²,

Remppis³

2021

Ann Cardiothorac Surg

View full text Add to dashboard Cite

Background: Transcatheter aortic valve-in-valve implantation (ViV TAVI) in degenerated Medtronic Freestyle aortic bioprosthesis (FSB) has been reported as being technically challenging. This study sought to evaluate procedural data and outcomes after ViV TAVI using a balloon-expandable Edwards valve in patients with failed FSB.Methods: Between August 2014 and December 2020, twenty-seven consecutive patients underwent ViV TAVI for symptomatic FSB failure at our institution using a Sapien XT (n=1) and Sapien 3 (n=26) valve, respectively. Endpoints were defined according to the Valve Academic Research Consortium-2 (VARC-2) criteria and were retrospectively analyzed.Results: Mean patient age was 75.7±8.2 years (female n=5, male n=22); Society of Thoracic Surgeons Predicted Risk of Mortality score was 7.3%±6.2%. ViV implantation with correct positioning of the Edwards Sapien valve within the FSB was successful in all cases. Intraprocedural transesophageal echocardiography revealed none/trace paravalvular regurgitation in twenty-five patients (92.6%), mild paravalvular regurgitation was present in two patients (7.4%). Neither of the patients had a mean gradient ≥20.0 mmHg excluding significant patient-prosthesis mismatch. Three early deaths (≤ thirty days) occurred resulting in a device success rate of 88.8%. One-year and three-year survival rates for patients alive beyond day thirty after ViV TAVI were 95.8% and 70.0%, respectively. Conclusions:ViV TAVI with Edwards Sapien valves lead to acceptable functional results in high-risk patients with degenerated FSB but early complications must be considered particularly during hospital stay.

show abstract

Section: Discussionsupporting

confidence: 89%

Outcomes after transcatheter valve-in-valve implantation using a balloon-expandable Edwards Sapien valve in patients with degenerated Freestyle aortic bioprosthesis

Burgdorf¹,

Momchilovska²,

Remppis³

2021

Ann Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…Coronary obstruction, which has also been described in a different case series of eight patients with degenerated FSB during VIV TAVI is a severe complication and is often associated with fatal outcome 13 . Using VARC‐2 composite endpoints, Huczek and colleagues 14 previously documented a device success of only 50% in a heterogeneous cohort of 20 patients with degenerated stentless bioprosthesis (including 8 patients with FSB) and an early safety rate of 74% at 30 days after intervention. Very similar to Grubitzsch and colleagues 15 who found a 30‐day mortality rate of 11% in a cohort of 27 patients with stentless bioprosthesis degradation (thereof none were FSB), our present study indicates a 30‐day mortality rate of 12% in the ViV TAVI cohort versus 0% in the redo SAVR cohort.…”

Section: Discussionmentioning

confidence: 86%

Transcatheter valve‐in‐valve implantation versus surgical redo aortic root replacement in patients with degenerated freestyle aortic bioprosthesis

Vukadinovikj

Baumgartner

Bohmann

et al. 2021

Cathet Cardio Intervent

View full text Add to dashboard Cite

Background Transcatheter aortic valve‐in‐valve implantation (ViV TAVI) represents a new treatment option for patients with degenerated aortic bioprosthesis. Comparative data to redo surgical aortic valve replacement (redo SAVR) are limited. Objective We investigated feasibility and outcome of ViV TAVI versus redo SAVR in patients with symptomatic degenerated Medtronic Freestyle aortic bioprosthesis (FSB). Methods Between January 2002 and February 2020, 25 patients with failed FSB underwent ViV TAVI and 10 patients with failed FSB underwent redo SAVR. Endpoints were defined according to the Valve Academic Research Consortium‐2 (VARC‐2) criteria. Results Age and logistic EuroSCORE II were higher in patients with ViV TAVI (75.4 ± 1.7 vs. 62.9 ± 5.1 years, p = .019; 11.5 ± 1.6 vs. 5.6 ± 5.6%, p = .007). Valve implantation was successful in all cases. Mean transvalvular pressure gradients were significantly lower in patients with redo SAVR than ViV TAVI (7.6 ± 1.0 vs. 10.3 ± 0.8 mmHg, p = .037). Aortic valve regurgitation was absent in 91% and 100% of patients with ViV TAVI and redo SAVR, respectively. Thirty‐day mortality rates were 12% in the ViV TAVI cohort versus 0% in the redo SAVR cohort (p = .542). Within the first year after hospital discharge, one patient after ViV TAVI had redo surgical intervention. Conclusions ViV TAVI and redo SAVR lead to excellent functional results in patients with degenerated FSB. Post‐procedural early complications must be considered particularly in patients with ViV TAVI because of higher clinical risk profiles.

show abstract

“…The most catastrophic complications are coronary obstruction and valve malpositioning, especially in stentless bioprostheses. [16][17][18] To preclude these complications in the present study, the details of the aortic complex including coronary height and size of the sinus of Valsalva will be collected in all cases, and the percutaneous coronary intervention team and extracorporeal membrane oxygenation will be available at all times for emergency intervention. To treat the migration of the implanted THV promptly, the heart team members were trained via the protocol of the AORTIC VIV study before starting to perform the valve-…”

Section: Discussionmentioning

confidence: 99%

Study Protocol for Transcatheter Aortic Valve Replacement for a Degenerated Aortic Bioprosthesis in a Japanese Cohort

et al. 2019

View full text Add to dashboard Cite

Background: The valve-in-valve (VIV) procedure is being increasingly performed in high-risk patients with a degenerated bioprosthesis in an aortic position in Western countries. The early safety and efficacy of the VIV procedure, however, remain unclear in Japanese patients with a small aortic annulus. We present the protocol for a study designed to evaluate the early safety and efficacy of the VIV procedure in the aortic position in Japanese patients. Methods and Results: The prospective, single-center, non-comparative, clinical study of the VIV procedure for the aortic position (AORTIC VIV study) commenced in August 2016 and will end in March 2020. Patients will be monitored for ≥1 month after the VIV procedure. The targeted number of patients is 11. Eligible patients are those who have undergone transcatheter aortic valve replacement for a surgical valve (including stented or stentless bioprosthetic valves), or for a transcatheter heart valve. The VIV procedure is performed in high-operative-risk patients with substantial prosthetic valve stenosis, and regurgitation and heart failure resistant to medical treatment (unless the patient meets an exclusion criterion). The safety and efficacy of the VIV procedure will be evaluated in accordance with the Valve Academic Research Consortium-2 initiative. Conclusions: The AORTIC VIV study will clarify the early safety and efficacy of the VIV procedure in Japanese patients.

show abstract

Transcatheter aortic valve‐in‐valve implantation in failed stentless bioprostheses

Abstract: Despite technical challenges and a lower device success, ViV-TAVI in stentless aortic bioprostheses achieves similar safety, efficacy, and functional improvement as in stented or degenerated native valves.

Cited by 16 publications

References 15 publications

Outcomes after transcatheter valve-in-valve implantation using a balloon-expandable Edwards Sapien valve in patients with degenerated Freestyle aortic bioprosthesis

Outcomes after transcatheter valve-in-valve implantation using a balloon-expandable Edwards Sapien valve in patients with degenerated Freestyle aortic bioprosthesis

Transcatheter valve‐in‐valve implantation versus surgical redo aortic root replacement in patients with degenerated freestyle aortic bioprosthesis

Study Protocol for Transcatheter Aortic Valve Replacement for a Degenerated Aortic Bioprosthesis in a Japanese Cohort

Contact Info

Product

Resources

About