Edwards Sapien XT valve placement as treatment option for aortic regurgitation after transfemoral CoreValve implantation: a multicenter experience
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Edwards Sapien XT valve placement as treatment option for aortic regurgitation after transfemoral CoreValve implantation: a multicenter experience. / Diemert, Patrick; Lange, Philipp; Greif, Martin; Seiffert, Moritz; Conradi, Lenard; Massberg, Steffen; Blankenberg, Stefan; Reichenspurner, Hermann; Hagl, Christian; Schmitz, Christoph; Schröfel, Holger; Treede, Hendrik; Schymik, Gerhard; Kupatt, Christian.
in: CLIN RES CARDIOL, Jahrgang 103, Nr. 3, 03.2014, S. 183-190.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Edwards Sapien XT valve placement as treatment option for aortic regurgitation after transfemoral CoreValve implantation: a multicenter experience
AU - Diemert, Patrick
AU - Lange, Philipp
AU - Greif, Martin
AU - Seiffert, Moritz
AU - Conradi, Lenard
AU - Massberg, Steffen
AU - Blankenberg, Stefan
AU - Reichenspurner, Hermann
AU - Hagl, Christian
AU - Schmitz, Christoph
AU - Schröfel, Holger
AU - Treede, Hendrik
AU - Schymik, Gerhard
AU - Kupatt, Christian
PY - 2014/3
Y1 - 2014/3
N2 - UNLABELLED: Transcatheter aortic valve replacement (TAVI), though a preferred treatment option in the elderly population carrying increased risks for open heart surgery, may result in prognosis-limiting moderate or severe aortic regurgitation. Here, we report a series of 11 patients from 3 German TAVI centers, suffering from moderate- to high-grade aortic regurgitation after CoreValve implantation, who were subsequently treated by Edwards Sapien XT implantation.METHODS: The patients were 79.5 ± 4.2 years of age and presented between November 2009 and February 2013 with a symptomatic high-grade aortic stenosis (mean maximum gradient 57 ± 22 mmHg) and EuroSCORE of 16 ± 7%. Initial implantation of a Medtronic CoreValve resulted in moderate-to-severe aortic regurgitation (grade 2.64 ± 0.37) although postdilatation was attempted in eight cases and snare repositioning was attempted in one case.RESULTS: All 11 patients were treated by a Sapien XT (Edwards) valve implanted into the initially deployed CoreValve: four via transfemoral, one via transaortical and six via transapical approaches. Successful implantation was possible in all 11 patients resulting in a reduction of aortic regurgitation to mean grade 0.23 ± 0.39. Two patients required permanent pacemaker. After 30 days, ten patients were alive, whereas one patient succumbed to pneumonia complicating advanced chronic obstructive pulmonary disease.CONCLUSION: In the instance of moderate or severe aortic regurgitation after TAVI of a CoreValve, transfemoral or transapical Sapien XT valve-in-valve deployment is an excellent option to reduce residual regurgitation to none or mild.
AB - UNLABELLED: Transcatheter aortic valve replacement (TAVI), though a preferred treatment option in the elderly population carrying increased risks for open heart surgery, may result in prognosis-limiting moderate or severe aortic regurgitation. Here, we report a series of 11 patients from 3 German TAVI centers, suffering from moderate- to high-grade aortic regurgitation after CoreValve implantation, who were subsequently treated by Edwards Sapien XT implantation.METHODS: The patients were 79.5 ± 4.2 years of age and presented between November 2009 and February 2013 with a symptomatic high-grade aortic stenosis (mean maximum gradient 57 ± 22 mmHg) and EuroSCORE of 16 ± 7%. Initial implantation of a Medtronic CoreValve resulted in moderate-to-severe aortic regurgitation (grade 2.64 ± 0.37) although postdilatation was attempted in eight cases and snare repositioning was attempted in one case.RESULTS: All 11 patients were treated by a Sapien XT (Edwards) valve implanted into the initially deployed CoreValve: four via transfemoral, one via transaortical and six via transapical approaches. Successful implantation was possible in all 11 patients resulting in a reduction of aortic regurgitation to mean grade 0.23 ± 0.39. Two patients required permanent pacemaker. After 30 days, ten patients were alive, whereas one patient succumbed to pneumonia complicating advanced chronic obstructive pulmonary disease.CONCLUSION: In the instance of moderate or severe aortic regurgitation after TAVI of a CoreValve, transfemoral or transapical Sapien XT valve-in-valve deployment is an excellent option to reduce residual regurgitation to none or mild.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve Insufficiency/diagnosis
KW - Aortic Valve Stenosis/diagnosis
KW - Cardiac Catheterization/adverse effects
KW - Echocardiography, Doppler, Color
KW - Female
KW - Femoral Artery
KW - Germany
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Humans
KW - Male
KW - Prosthesis Design
KW - Retrospective Studies
KW - Severity of Illness Index
KW - Time Factors
KW - Treatment Outcome
U2 - 10.1007/s00392-013-0632-8
DO - 10.1007/s00392-013-0632-8
M3 - SCORING: Journal article
C2 - 24249313
VL - 103
SP - 183
EP - 190
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 3
ER -