Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI. / Landes, Uri; Morelli, Olga; Danenberg, Haim; Sathananthan, Janarthanan; Backer, Ole De; Sondergaard, Lars; Abdel-Wahab, Mohamed; Yoon, Sung Han; Makkar, Raj R.; Thiele, Holger; Kim, Won Keun; Hamm, Christian; Guerrero, Mayra; Rodés-Cabau, Josep; Okuno, Taishi; Pilgrim, Thomas; Mangieri, Antonio; Van Mieghem, Nicolas M.; Tchétché, Didier; Schoels, Wolfgang H.; Barbanti, Marco; Sinning, Jan Malte; Ielasi, Alfonso; Tarantini, Giuseppe; De Marco, Federico; Finkelstein, Ariel; Sievert, Horst; Andreas, Martin; Latib, Azeem; Godfrey, Rebecca; Hildick-Smith, David; Manevich, Lisa; Kornowski, Ran; Nazif, Tamim M.; Leon, Martin B.; Webb, John G.
I: International Journal of Cardiology, Bind 364, 2022, s. 31-34.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI
AU - Landes, Uri
AU - Morelli, Olga
AU - Danenberg, Haim
AU - Sathananthan, Janarthanan
AU - Backer, Ole De
AU - Sondergaard, Lars
AU - Abdel-Wahab, Mohamed
AU - Yoon, Sung Han
AU - Makkar, Raj R.
AU - Thiele, Holger
AU - Kim, Won Keun
AU - Hamm, Christian
AU - Guerrero, Mayra
AU - Rodés-Cabau, Josep
AU - Okuno, Taishi
AU - Pilgrim, Thomas
AU - Mangieri, Antonio
AU - Van Mieghem, Nicolas M.
AU - Tchétché, Didier
AU - Schoels, Wolfgang H.
AU - Barbanti, Marco
AU - Sinning, Jan Malte
AU - Ielasi, Alfonso
AU - Tarantini, Giuseppe
AU - De Marco, Federico
AU - Finkelstein, Ariel
AU - Sievert, Horst
AU - Andreas, Martin
AU - Latib, Azeem
AU - Godfrey, Rebecca
AU - Hildick-Smith, David
AU - Manevich, Lisa
AU - Kornowski, Ran
AU - Nazif, Tamim M.
AU - Leon, Martin B.
AU - Webb, John G.
N1 - Publisher Copyright: © 2022 Elsevier B.V.
PY - 2022
Y1 - 2022
N2 - Background: Para-valvular regurgitation (PVR) after transcatheter aortic valve (TAV) implantation is associated with increased mortality. Redo-TAVI may be applied to treat PVR, yet with unknown efficacy. We thought to assess redo-TAVI efficacy in reducing PVR using the Redo-TAVI registry (45 centers; 600 TAV-in-TAV cases). Methods: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation. Results: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR ≥ moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR ≥ moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV. Conclusions: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.
AB - Background: Para-valvular regurgitation (PVR) after transcatheter aortic valve (TAV) implantation is associated with increased mortality. Redo-TAVI may be applied to treat PVR, yet with unknown efficacy. We thought to assess redo-TAVI efficacy in reducing PVR using the Redo-TAVI registry (45 centers; 600 TAV-in-TAV cases). Methods: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation. Results: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR ≥ moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR ≥ moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV. Conclusions: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.
KW - Para-valvular aortic regurgitation
KW - Para-valvular leak
KW - Redo-TAVI
KW - TAVI
KW - Valve-in-valve
U2 - 10.1016/j.ijcard.2022.06.014
DO - 10.1016/j.ijcard.2022.06.014
M3 - Journal article
C2 - 35700856
AN - SCOPUS:85133344979
VL - 364
SP - 31
EP - 34
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -
ID: 326017854