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Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes

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Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes. / Simonato, Matheus; Webb, John; Bleiziffer, Sabine; Abdel-Wahab, Mohamed; Wood, David; Seiffert, Moritz; Schäfer, Ulrich; Wöhrle, Jochen; Jochheim, David; Woitek, Felix; Latib, Azeem; Barbanti, Marco; Spargias, Konstantinos; Kodali, Susheel; Jones, Tara; Tchetche, Didier; Coutinho, Rafael; Napodano, Massimo; Garcia, Santiago; Veulemans, Verena; Siqueira, Dimytri; Windecker, Stephan; Cerillo, Alfredo; Kempfert, Jörg; Agrifoglio, Marco; Bonaros, Nikolaos; Schoels, Wolfgang; Baumbach, Hardy; Schofer, Joachim; Gaia, Diego Felipe; Dvir, Danny.

in: JACC-CARDIOVASC INTE, Jahrgang 12, Nr. 16, 26.08.2019, S. 1606-1617.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Simonato, M, Webb, J, Bleiziffer, S, Abdel-Wahab, M, Wood, D, Seiffert, M, Schäfer, U, Wöhrle, J, Jochheim, D, Woitek, F, Latib, A, Barbanti, M, Spargias, K, Kodali, S, Jones, T, Tchetche, D, Coutinho, R, Napodano, M, Garcia, S, Veulemans, V, Siqueira, D, Windecker, S, Cerillo, A, Kempfert, J, Agrifoglio, M, Bonaros, N, Schoels, W, Baumbach, H, Schofer, J, Gaia, DF & Dvir, D 2019, 'Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes', JACC-CARDIOVASC INTE, Jg. 12, Nr. 16, S. 1606-1617. https://doi.org/10.1016/j.jcin.2019.05.057

APA

Simonato, M., Webb, J., Bleiziffer, S., Abdel-Wahab, M., Wood, D., Seiffert, M., Schäfer, U., Wöhrle, J., Jochheim, D., Woitek, F., Latib, A., Barbanti, M., Spargias, K., Kodali, S., Jones, T., Tchetche, D., Coutinho, R., Napodano, M., Garcia, S., ... Dvir, D. (2019). Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes. JACC-CARDIOVASC INTE, 12(16), 1606-1617. https://doi.org/10.1016/j.jcin.2019.05.057

Vancouver

Simonato M, Webb J, Bleiziffer S, Abdel-Wahab M, Wood D, Seiffert M et al. Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes. JACC-CARDIOVASC INTE. 2019 Aug 26;12(16):1606-1617. https://doi.org/10.1016/j.jcin.2019.05.057

Bibtex

@article{f19fe0d86ab74700b657af88b4df0a6a,
title = "Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes",
abstract = "OBJECTIVES: This study sought to evaluate SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) positioning using different strategies.BACKGROUND: Aortic valve-in-valve (ViV) is associated with high risk of elevated gradients.METHODS: S3 aortic ViV procedures in stented bioprostheses were studied. Transcatheter heart valve (THV) positioning was analyzed in a centralized core lab blinded to clinical outcomes. A combined endpoint of severely elevated mean gradient (≥30 mm Hg) or pacemaker need was established. Two positioning strategies were compared: central marker method and top of S3 method. Optimal final depth was defined as S3 depth ≤20%.RESULTS: A total of 113 patients met inclusion criteria and were analyzed (76.5 ± 9.7 years of age, 65.8% male, STS score 8 ± 7.6%). THVs had incomplete shortening in comparison to fully expanded valves (92 ± 3.4%), and expansion was more complete in optimal positioning cases compared with others (93.2 ± 2.7% vs. 91.5 ± 3.5%; p = 0.027). The central marker method demonstrated greater correlation with final implantation depth than the top of S3 method (R2 of 0.48 and 0.14; p < 0.001 and p = 0.001, respectively). The combined endpoint rate was 4.3% in the optimal (higher than 3 mm) implantation group, 12% in the intermediate group, and 50% in the low group (p < 0.001). There were no cases of THV embolization. In cases with central marker higher than 3 mm, 72.4% had optimal final depth. In those with central marker higher than 6 mm, 90% had optimal final depth.CONCLUSIONS: Optimal S3 positioning in aortic ViV is associated with better outcomes. Central marker positioning is more reliable than top of S3 positioning. Central marker bottom position should be 3 mm to 6 mm above the ring.",
keywords = "Aged, Aged, 80 and over, Aortic Valve/diagnostic imaging, Aortic Valve Insufficiency/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Balloon Valvuloplasty/adverse effects, Bioprosthesis, Female, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/adverse effects, Humans, Male, Prosthesis Design, Prosthesis Failure, Risk Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome",
author = "Matheus Simonato and John Webb and Sabine Bleiziffer and Mohamed Abdel-Wahab and David Wood and Moritz Seiffert and Ulrich Sch{\"a}fer and Jochen W{\"o}hrle and David Jochheim and Felix Woitek and Azeem Latib and Marco Barbanti and Konstantinos Spargias and Susheel Kodali and Tara Jones and Didier Tchetche and Rafael Coutinho and Massimo Napodano and Santiago Garcia and Verena Veulemans and Dimytri Siqueira and Stephan Windecker and Alfredo Cerillo and J{\"o}rg Kempfert and Marco Agrifoglio and Nikolaos Bonaros and Wolfgang Schoels and Hardy Baumbach and Joachim Schofer and Gaia, {Diego Felipe} and Danny Dvir",
note = "Copyright {\textcopyright} 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2019",
month = aug,
day = "26",
doi = "10.1016/j.jcin.2019.05.057",
language = "English",
volume = "12",
pages = "1606--1617",
journal = "JACC-CARDIOVASC INTE",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "16",

}

RIS

TY - JOUR

T1 - Current Generation Balloon-Expandable Transcatheter Valve Positioning Strategies During Aortic Valve-in-Valve Procedures and Clinical Outcomes

AU - Simonato, Matheus

AU - Webb, John

AU - Bleiziffer, Sabine

AU - Abdel-Wahab, Mohamed

AU - Wood, David

AU - Seiffert, Moritz

AU - Schäfer, Ulrich

AU - Wöhrle, Jochen

AU - Jochheim, David

AU - Woitek, Felix

AU - Latib, Azeem

AU - Barbanti, Marco

AU - Spargias, Konstantinos

AU - Kodali, Susheel

AU - Jones, Tara

AU - Tchetche, Didier

AU - Coutinho, Rafael

AU - Napodano, Massimo

AU - Garcia, Santiago

AU - Veulemans, Verena

AU - Siqueira, Dimytri

AU - Windecker, Stephan

AU - Cerillo, Alfredo

AU - Kempfert, Jörg

AU - Agrifoglio, Marco

AU - Bonaros, Nikolaos

AU - Schoels, Wolfgang

AU - Baumbach, Hardy

AU - Schofer, Joachim

AU - Gaia, Diego Felipe

AU - Dvir, Danny

N1 - Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2019/8/26

Y1 - 2019/8/26

N2 - OBJECTIVES: This study sought to evaluate SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) positioning using different strategies.BACKGROUND: Aortic valve-in-valve (ViV) is associated with high risk of elevated gradients.METHODS: S3 aortic ViV procedures in stented bioprostheses were studied. Transcatheter heart valve (THV) positioning was analyzed in a centralized core lab blinded to clinical outcomes. A combined endpoint of severely elevated mean gradient (≥30 mm Hg) or pacemaker need was established. Two positioning strategies were compared: central marker method and top of S3 method. Optimal final depth was defined as S3 depth ≤20%.RESULTS: A total of 113 patients met inclusion criteria and were analyzed (76.5 ± 9.7 years of age, 65.8% male, STS score 8 ± 7.6%). THVs had incomplete shortening in comparison to fully expanded valves (92 ± 3.4%), and expansion was more complete in optimal positioning cases compared with others (93.2 ± 2.7% vs. 91.5 ± 3.5%; p = 0.027). The central marker method demonstrated greater correlation with final implantation depth than the top of S3 method (R2 of 0.48 and 0.14; p < 0.001 and p = 0.001, respectively). The combined endpoint rate was 4.3% in the optimal (higher than 3 mm) implantation group, 12% in the intermediate group, and 50% in the low group (p < 0.001). There were no cases of THV embolization. In cases with central marker higher than 3 mm, 72.4% had optimal final depth. In those with central marker higher than 6 mm, 90% had optimal final depth.CONCLUSIONS: Optimal S3 positioning in aortic ViV is associated with better outcomes. Central marker positioning is more reliable than top of S3 positioning. Central marker bottom position should be 3 mm to 6 mm above the ring.

AB - OBJECTIVES: This study sought to evaluate SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) positioning using different strategies.BACKGROUND: Aortic valve-in-valve (ViV) is associated with high risk of elevated gradients.METHODS: S3 aortic ViV procedures in stented bioprostheses were studied. Transcatheter heart valve (THV) positioning was analyzed in a centralized core lab blinded to clinical outcomes. A combined endpoint of severely elevated mean gradient (≥30 mm Hg) or pacemaker need was established. Two positioning strategies were compared: central marker method and top of S3 method. Optimal final depth was defined as S3 depth ≤20%.RESULTS: A total of 113 patients met inclusion criteria and were analyzed (76.5 ± 9.7 years of age, 65.8% male, STS score 8 ± 7.6%). THVs had incomplete shortening in comparison to fully expanded valves (92 ± 3.4%), and expansion was more complete in optimal positioning cases compared with others (93.2 ± 2.7% vs. 91.5 ± 3.5%; p = 0.027). The central marker method demonstrated greater correlation with final implantation depth than the top of S3 method (R2 of 0.48 and 0.14; p < 0.001 and p = 0.001, respectively). The combined endpoint rate was 4.3% in the optimal (higher than 3 mm) implantation group, 12% in the intermediate group, and 50% in the low group (p < 0.001). There were no cases of THV embolization. In cases with central marker higher than 3 mm, 72.4% had optimal final depth. In those with central marker higher than 6 mm, 90% had optimal final depth.CONCLUSIONS: Optimal S3 positioning in aortic ViV is associated with better outcomes. Central marker positioning is more reliable than top of S3 positioning. Central marker bottom position should be 3 mm to 6 mm above the ring.

KW - Aged

KW - Aged, 80 and over

KW - Aortic Valve/diagnostic imaging

KW - Aortic Valve Insufficiency/diagnostic imaging

KW - Aortic Valve Stenosis/diagnostic imaging

KW - Balloon Valvuloplasty/adverse effects

KW - Bioprosthesis

KW - Female

KW - Heart Valve Prosthesis

KW - Heart Valve Prosthesis Implantation/adverse effects

KW - Humans

KW - Male

KW - Prosthesis Design

KW - Prosthesis Failure

KW - Risk Factors

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

U2 - 10.1016/j.jcin.2019.05.057

DO - 10.1016/j.jcin.2019.05.057

M3 - SCORING: Journal article

C2 - 31439340

VL - 12

SP - 1606

EP - 1617

JO - JACC-CARDIOVASC INTE

JF - JACC-CARDIOVASC INTE

SN - 1936-8798

IS - 16

ER -