Reintervention and Survival After Transcatheter Pulmonary Valve Replacement
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Reintervention and Survival After Transcatheter Pulmonary Valve Replacement. / McElhinney, Doff B.; Zhang, Yulin; Levi, Daniel S.; Georgiev, Stanimir; Biernacka, Elzbieta Katarzyna; Goldstein, Bryan H.; Shahanavaz, Shabana; Qureshi, Athar M.; Cabalka, Allison K.; Bauser-Heaton, Holly; Torres, Alejandro J.; Morray, Brian H.; Armstrong, Aimee K.; Millan-Iturbe, Oscar; Peng, Lynn F.; Aboulhosn, Jamil A.; Ruzyllo, Witold; Berger, Felix; Sondergaard, Lars; Schranz, Dietmar; Cheatham, John P.; Jones, Thomas K.; Ewert, Peter; Schubert, Stephan.
I: Journal of the American College of Cardiology, Bind 79, Nr. 1, 2022, s. 18-32.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Reintervention and Survival After Transcatheter Pulmonary Valve Replacement
AU - McElhinney, Doff B.
AU - Zhang, Yulin
AU - Levi, Daniel S.
AU - Georgiev, Stanimir
AU - Biernacka, Elzbieta Katarzyna
AU - Goldstein, Bryan H.
AU - Shahanavaz, Shabana
AU - Qureshi, Athar M.
AU - Cabalka, Allison K.
AU - Bauser-Heaton, Holly
AU - Torres, Alejandro J.
AU - Morray, Brian H.
AU - Armstrong, Aimee K.
AU - Millan-Iturbe, Oscar
AU - Peng, Lynn F.
AU - Aboulhosn, Jamil A.
AU - Ruzyllo, Witold
AU - Berger, Felix
AU - Sondergaard, Lars
AU - Schranz, Dietmar
AU - Cheatham, John P.
AU - Jones, Thomas K.
AU - Ewert, Peter
AU - Schubert, Stephan
PY - 2022
Y1 - 2022
N2 - BACKGROUND Transcatheter pulmonary valve (TPV) replacement (TPVR) has become the standard therapy for postoperative pulmonary outflow tract dysfunction in patients with a prosthetic conduit/valve, but there is limited information about risk factors for death or reintervention after this procedure.OBJECTIVES This study sought to evaluate mid- and long-term outcomes after TPVR in a large multicenter cohort.METHODS International registry focused on time-related outcomes after TPVR.RESULTS Investigators submitted data for 2,476 patients who underwent TPVR and were followed up for 8,475 patient-years. A total of 95 patients died after TPVR, most commonly from heart failure (n = 24). The cumulative incidence of death was 8.9% (95% CI: 6.9%-11.5%) 8 years after TPVR. On multivariable analysis, age at TPVR (HR: 1.04 per year; 95% CI: 1.03-1.06 per year; P < 0.001), a prosthetic valve in other positions (HR: 2.1; 95% CI: 1.2-3.7; P = 0.014), and an existing transvenous pacemaker/implantable cardioverter-defibrillator (HR: 2.1; 95% CI: 1.3-3.4; P = 0.004) were associated with death. A total of 258 patients underwent TPV reintervention. At 8 years, the cumulative incidence of any TPV reintervention was 25.1% (95% CI: 21.8%-28.5%) and of surgical TPV reintervention was 14.4% (95% CI: 11.9%-17.2%). Risk factors for surgical reintervention included age (0.95 per year [95% CI: 0.93-0.97 per year]; P < 0.001), prior endocarditis (2.5 [95% CI: 1.4-4.3]; P = 0.001), TPVR into a stented bioprosthetic valve (1.7 [95% CI: 1.2-2.5]; P = 0.007), and postimplant gradient (1.4 per 10 mm Hg [95% CI: 1.2-1.7 per 10 mm Hg]: P < 0.001).CONCLUSIONS These findings support the conclusion that survival and freedom from reintervention or surgery after TPVR are generally comparable to outcomes of surgical conduit/valve replacement across a wide age range. (C) 2022 by the American College of Cardiology Foundation.
AB - BACKGROUND Transcatheter pulmonary valve (TPV) replacement (TPVR) has become the standard therapy for postoperative pulmonary outflow tract dysfunction in patients with a prosthetic conduit/valve, but there is limited information about risk factors for death or reintervention after this procedure.OBJECTIVES This study sought to evaluate mid- and long-term outcomes after TPVR in a large multicenter cohort.METHODS International registry focused on time-related outcomes after TPVR.RESULTS Investigators submitted data for 2,476 patients who underwent TPVR and were followed up for 8,475 patient-years. A total of 95 patients died after TPVR, most commonly from heart failure (n = 24). The cumulative incidence of death was 8.9% (95% CI: 6.9%-11.5%) 8 years after TPVR. On multivariable analysis, age at TPVR (HR: 1.04 per year; 95% CI: 1.03-1.06 per year; P < 0.001), a prosthetic valve in other positions (HR: 2.1; 95% CI: 1.2-3.7; P = 0.014), and an existing transvenous pacemaker/implantable cardioverter-defibrillator (HR: 2.1; 95% CI: 1.3-3.4; P = 0.004) were associated with death. A total of 258 patients underwent TPV reintervention. At 8 years, the cumulative incidence of any TPV reintervention was 25.1% (95% CI: 21.8%-28.5%) and of surgical TPV reintervention was 14.4% (95% CI: 11.9%-17.2%). Risk factors for surgical reintervention included age (0.95 per year [95% CI: 0.93-0.97 per year]; P < 0.001), prior endocarditis (2.5 [95% CI: 1.4-4.3]; P = 0.001), TPVR into a stented bioprosthetic valve (1.7 [95% CI: 1.2-2.5]; P = 0.007), and postimplant gradient (1.4 per 10 mm Hg [95% CI: 1.2-1.7 per 10 mm Hg]: P < 0.001).CONCLUSIONS These findings support the conclusion that survival and freedom from reintervention or surgery after TPVR are generally comparable to outcomes of surgical conduit/valve replacement across a wide age range. (C) 2022 by the American College of Cardiology Foundation.
KW - pediatric
KW - pulmonary atresia
KW - pulmonary valve
KW - Ross procedure
KW - tetralogy of Fallot
KW - FOLLOW-UP
KW - BIOPROSTHETIC VALVES
KW - OUTCOMES
KW - IMPLANTATION
KW - ADULTS
KW - DURABILITY
KW - TETRALOGY
KW - VENTRICLE
KW - HOMOGRAFT
KW - OPERATION
U2 - 10.1016/j.jacc.2021.10.031
DO - 10.1016/j.jacc.2021.10.031
M3 - Journal article
C2 - 34991785
VL - 79
SP - 18
EP - 32
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 1
ER -
ID: 314147706