Transcatheter aortic valve implantation in patients with extra-small aortic annuli
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Transcatheter aortic valve implantation in patients with extra-small aortic annuli. / Tirado-Conte, Gabriela; Rodés-Cabau, Josep; Oteo, Juan F.; Pan, Manuel; Muñoz, Erika; Witberg, Guy; Cheema, Asim; Alpieri, Alberto; Lopez, Diego; Amat-Santos, Ignacio; Akodad, Mariama; Ojeda, Soledad; Serra, Vicenç; Garcia-Blas, Sergio; Alfonso, Fernando; De Backer, Ole; Asmarats, Luis; Muñoz, Antonio; Hamdan, Ashraf; Toggweiler, Stefan; del Valle, Raquel; Salido, Luisa; Cruz-González, Ignacio; Estevez-Loureiro, Rodrigo; Alfaro, Luis Enrique Martin; Gheorghe, Livia; Dabrowski, Maciec; Berenguer, Alberto; Arzamendi, Dabit; Saia, Francesco; Webb, John; Søndergaard, Lars; Nombela-Franco, Luis.
I: EuroIntervention, Bind 19, Nr. 4, 2023, s. E340-E351.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Transcatheter aortic valve implantation in patients with extra-small aortic annuli
AU - Tirado-Conte, Gabriela
AU - Rodés-Cabau, Josep
AU - Oteo, Juan F.
AU - Pan, Manuel
AU - Muñoz, Erika
AU - Witberg, Guy
AU - Cheema, Asim
AU - Alpieri, Alberto
AU - Lopez, Diego
AU - Amat-Santos, Ignacio
AU - Akodad, Mariama
AU - Ojeda, Soledad
AU - Serra, Vicenç
AU - Garcia-Blas, Sergio
AU - Alfonso, Fernando
AU - De Backer, Ole
AU - Asmarats, Luis
AU - Muñoz, Antonio
AU - Hamdan, Ashraf
AU - Toggweiler, Stefan
AU - del Valle, Raquel
AU - Salido, Luisa
AU - Cruz-González, Ignacio
AU - Estevez-Loureiro, Rodrigo
AU - Alfaro, Luis Enrique Martin
AU - Gheorghe, Livia
AU - Dabrowski, Maciec
AU - Berenguer, Alberto
AU - Arzamendi, Dabit
AU - Saia, Francesco
AU - Webb, John
AU - Søndergaard, Lars
AU - Nombela-Franco, Luis
N1 - Publisher Copyright: © Europa Digital & Publishing 2023. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: A small aortic annulus (SAA) is a risk factor for prosthesis-patient mismatch (PPM) in patients undergoing surgical or transcatheter aortic valve implantation (TAVI). Data regarding TAVI in patients with extra-SAA are scarce. Aims: The aim of this study was to analyse the safety and efficacy of TAVI in patients with extra-SAA. Methods: A multicentre registry study including patients with extra-SAA (defined as an aortic annulus area <280 mm2 and/or perimeter <60 mm) undergoing TAVI was established. Primary efficacy and safety endpoints were defined as device success and early safety at 30 days, respectively, using the Valve Academic Research Consortium-3 criteria, and were analysed according to valve type: self-expanding (SEV) versus balloon-expandable (BEV). Results: A total of 150 patients were included, of which 139 (92.7%) were women, and 110 (73.3%) received an SEV. Intraprocedural technical success was 91.3%, with a higher rate in patients receiving an SEV (96.4% vs 77.5% with BEV; p=0.001). Overall, 30-day device success was 81.3%, (85.5% with SEV vs 70.0% with BEV; p=0.032). The primary safety endpoint occurred in 72.0% of patients (with no difference between groups; p=0.118). Severe PPM occurred in 12% (9.0% with SEV and 24.0% with BEV; p=0.039), with no impact on all-cause mortality, cardiovascular mortality, or heart failure readmission at 2-year follow-up. Conclusions: TAVI is a safe and feasible treatment in patients with extra-SAA with a high rate of technical success. The use of SEV was associated with a lower rate of intraprocedural complications, higher device success at 30 days and better haemodynamic outcomes compared to BEV.
AB - Background: A small aortic annulus (SAA) is a risk factor for prosthesis-patient mismatch (PPM) in patients undergoing surgical or transcatheter aortic valve implantation (TAVI). Data regarding TAVI in patients with extra-SAA are scarce. Aims: The aim of this study was to analyse the safety and efficacy of TAVI in patients with extra-SAA. Methods: A multicentre registry study including patients with extra-SAA (defined as an aortic annulus area <280 mm2 and/or perimeter <60 mm) undergoing TAVI was established. Primary efficacy and safety endpoints were defined as device success and early safety at 30 days, respectively, using the Valve Academic Research Consortium-3 criteria, and were analysed according to valve type: self-expanding (SEV) versus balloon-expandable (BEV). Results: A total of 150 patients were included, of which 139 (92.7%) were women, and 110 (73.3%) received an SEV. Intraprocedural technical success was 91.3%, with a higher rate in patients receiving an SEV (96.4% vs 77.5% with BEV; p=0.001). Overall, 30-day device success was 81.3%, (85.5% with SEV vs 70.0% with BEV; p=0.032). The primary safety endpoint occurred in 72.0% of patients (with no difference between groups; p=0.118). Severe PPM occurred in 12% (9.0% with SEV and 24.0% with BEV; p=0.039), with no impact on all-cause mortality, cardiovascular mortality, or heart failure readmission at 2-year follow-up. Conclusions: TAVI is a safe and feasible treatment in patients with extra-SAA with a high rate of technical success. The use of SEV was associated with a lower rate of intraprocedural complications, higher device success at 30 days and better haemodynamic outcomes compared to BEV.
KW - degenerative valve
KW - elderly (>75 years)
KW - TAVI
U2 - 10.4244/EIJ-D-23-00011
DO - 10.4244/EIJ-D-23-00011
M3 - Journal article
C2 - 37334654
AN - SCOPUS:85164977535
VL - 19
SP - E340-E351
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 4
ER -
ID: 366501953