Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis
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Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis. / Yoon, Sung-Han; Bleiziffer, Sabine; De Backer, Ole; Delgado, Victoria; Arai, Takahide; Ziegelmueller, Johannes; Barbanti, Marco; Sharma, Rahul; Perlman, Gidon Y; Khalique, Omar K; Holy, Erik W; Saraf, Smriti; Deuschl, Florian; Fujita, Buntaro; Ruile, Philipp; Neumann, Franz-Josef; Pache, Gregor; Takahashi, Masao; Kaneko, Hidehiro; Schmidt, Tobias; Ohno, Yohei; Schofer, Niklas; Kong, William K F; Tay, Edgar; Sugiyama, Daisuke; Kawamori, Hiroyuki; Maeno, Yoshio; Abramowitz, Yigal; Chakravarty, Tarun; Nakamura, Mamoo; Kuwata, Shingo; Yong, Gerald; Kao, Hsien-Li; Lee, Michael; Kim, Hyo-Soo; Modine, Thomas; Wong, S Chiu; Bedgoni, Francesco; Testa, Luca; Teiger, Emmanuel; Butter, Christian; Ensminger, Stephan M; Schaefer, Ulrich; Dvir, Danny; Blanke, Philipp; Leipsic, Jonathon; Nietlispach, Fabian; Abdel-Wahab, Mohamed; Chevalier, Bernard; Tamburino, Corrado; Hildick-Smith, David; Whisenant, Brian K; Park, Seung-Jung; Colombo, Antonio; Latib, Azeem; Kodali, Susheel K; Bax, Jeroen J; Søndergaard, Lars; Webb, John G; Lefèvre, Thierry; Leon, Martin B; Makkar, Raj.
in: J AM COLL CARDIOL, Jahrgang 69, Nr. 21, 30.05.2017, S. 2579-2589.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis
AU - Yoon, Sung-Han
AU - Bleiziffer, Sabine
AU - De Backer, Ole
AU - Delgado, Victoria
AU - Arai, Takahide
AU - Ziegelmueller, Johannes
AU - Barbanti, Marco
AU - Sharma, Rahul
AU - Perlman, Gidon Y
AU - Khalique, Omar K
AU - Holy, Erik W
AU - Saraf, Smriti
AU - Deuschl, Florian
AU - Fujita, Buntaro
AU - Ruile, Philipp
AU - Neumann, Franz-Josef
AU - Pache, Gregor
AU - Takahashi, Masao
AU - Kaneko, Hidehiro
AU - Schmidt, Tobias
AU - Ohno, Yohei
AU - Schofer, Niklas
AU - Kong, William K F
AU - Tay, Edgar
AU - Sugiyama, Daisuke
AU - Kawamori, Hiroyuki
AU - Maeno, Yoshio
AU - Abramowitz, Yigal
AU - Chakravarty, Tarun
AU - Nakamura, Mamoo
AU - Kuwata, Shingo
AU - Yong, Gerald
AU - Kao, Hsien-Li
AU - Lee, Michael
AU - Kim, Hyo-Soo
AU - Modine, Thomas
AU - Wong, S Chiu
AU - Bedgoni, Francesco
AU - Testa, Luca
AU - Teiger, Emmanuel
AU - Butter, Christian
AU - Ensminger, Stephan M
AU - Schaefer, Ulrich
AU - Dvir, Danny
AU - Blanke, Philipp
AU - Leipsic, Jonathon
AU - Nietlispach, Fabian
AU - Abdel-Wahab, Mohamed
AU - Chevalier, Bernard
AU - Tamburino, Corrado
AU - Hildick-Smith, David
AU - Whisenant, Brian K
AU - Park, Seung-Jung
AU - Colombo, Antonio
AU - Latib, Azeem
AU - Kodali, Susheel K
AU - Bax, Jeroen J
AU - Søndergaard, Lars
AU - Webb, John G
AU - Lefèvre, Thierry
AU - Leon, Martin B
AU - Makkar, Raj
N1 - Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.
PY - 2017/5/30
Y1 - 2017/5/30
N2 - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS).OBJECTIVES: This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry.METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria.RESULTS: Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28).CONCLUSIONS: Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices.
AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS).OBJECTIVES: This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry.METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria.RESULTS: Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28).CONCLUSIONS: Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices.
KW - Aged
KW - Aortic Valve/abnormalities
KW - Aortic Valve Stenosis/mortality
KW - Bicuspid Aortic Valve Disease
KW - Female
KW - Global Health
KW - Heart Valve Diseases/surgery
KW - Heart Valve Prosthesis
KW - Humans
KW - Male
KW - Retrospective Studies
KW - Survival Rate/trends
KW - Transcatheter Aortic Valve Replacement/methods
KW - Treatment Outcome
KW - Tricuspid Valve/abnormalities
U2 - 10.1016/j.jacc.2017.03.017
DO - 10.1016/j.jacc.2017.03.017
M3 - SCORING: Journal article
C2 - 28330793
VL - 69
SP - 2579
EP - 2589
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 21
ER -