Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Luca Testa
  • Mauro Agnifili
  • Nicolas M. Van Mieghem
  • Didier Tchétché
  • Anita W. Asgar
  • Azeem Latib
  • Bernhard Reimers
  • Giulio Stefanini
  • Carlo Trani
  • Antonio Colombo
  • Francesco Giannini
  • Antonio Bartorelli
  • Wojtek Wojakowski
  • MacIej Dabrowski
  • Dariusz Jagielak
  • Adrian P. Banning
  • Rajesh Kharbanda
  • Raul Moreno
  • Joachim Schofer
  • Niels Van Royen
  • Duane Pinto
  • Antoni Serra
  • Amit Segev
  • Arturo Giordano
  • Nedy Brambilla
  • Antonio Popolo Rubbio
  • Matteo Casenghi
  • Jacopo Oreglia
  • Federico De Marco
  • Rudolph Tanja
  • James M. McCabe
  • Alexander Abizaid
  • Michiel Voskuil
  • Rui Teles
  • Giuseppe Biondi Zoccai
  • Giovanni Bianchi
  • Francesco Bedogni

Background: Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR. Methods: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%. Results: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded. Conclusions: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population.

OriginalsprogEngelsk
Artikelnummere010440
TidsskriftCirculation: Cardiovascular Interventions
Vol/bind14
Udgave nummer6
Sider (fra-til)628-638
Antal sider11
ISSN1941-7640
DOI
StatusUdgivet - 2021

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