Outcomes of Redo Transcatheter Aortic Valve Replacement According to the Initial and Subsequent Valve Type
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Outcomes of Redo Transcatheter Aortic Valve Replacement According to the Initial and Subsequent Valve Type. / Landes, Uri; Richter, Ilan; Danenberg, Haim; Kornowski, Ran; Sathananthan, Janarthanan; De Backer, Ole; Søndergaard, Lars; Abdel-Wahab, Mohamed; Yoon, Sung-Han; Makkar, Raj R; Thiele, Holger; Kim, Won-Keun; Hamm, Christian; Buzzatti, Nicola; Montorfano, Matteo; Ludwig, Sebastian; Schofer, Niklas; Voigtlaender, Lisa; Guerrero, Mayra; El Sabbagh, Abdallah; Rodés-Cabau, Josep; Mesnier, Jules; Okuno, Taishi; Pilgrim, Thomas; Fiorina, Claudia; Colombo, Antonio; Mangieri, Antonio; Eltchaninoff, Helene; Nombela-Franco, Luis; Van Wiechen, Maarten P H; Van Mieghem, Nicolas M; Tchétché, Didier; Schoels, Wolfgang H; Kullmer, Matthias; Barbanti, Marco; Tamburino, Corrado; Sinning, Jan-Malte; Al-Kassou, Baravan; Perlman, Gidon Y; Ielasi, Alfonso; Fraccaro, Chiara; Tarantini, Giuseppe; De Marco, Federico; Witberg, Guy; Redwood, Simon R; Lisko, John C; Babaliaros, Vasilis C; Laine, Mika; Nerla, Roberto; Finkelstein, Ariel; Eitan, Amnon; Jaffe, Ronen; Ruile, Philipp; Neumann, Franz J; Piazza, Nicolo; Sievert, Horst; Sievert, Kolja; Russo, Marco; Andreas, Martin; Bunc, Matjaz; Latib, Azeem; Bruoha, Sharon; Godfrey, Rebecca; Hildick-Smith, David; Barbash, Israel; Segev, Amit; Maurovich-Horvat, Pál; Szilveszter, Balint; Spargias, Konstantinos; Aravadinos, Dionisis; Nazif, Tamim M; Leon, Martin B; Webb, John G; Redo-TAVR Registry.
in: JACC-CARDIOVASC INTE, Jahrgang 15, Nr. 15, 08.08.2022, S. 1543-1554.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes of Redo Transcatheter Aortic Valve Replacement According to the Initial and Subsequent Valve Type
AU - Landes, Uri
AU - Richter, Ilan
AU - Danenberg, Haim
AU - Kornowski, Ran
AU - Sathananthan, Janarthanan
AU - De Backer, Ole
AU - Søndergaard, Lars
AU - Abdel-Wahab, Mohamed
AU - Yoon, Sung-Han
AU - Makkar, Raj R
AU - Thiele, Holger
AU - Kim, Won-Keun
AU - Hamm, Christian
AU - Buzzatti, Nicola
AU - Montorfano, Matteo
AU - Ludwig, Sebastian
AU - Schofer, Niklas
AU - Voigtlaender, Lisa
AU - Guerrero, Mayra
AU - El Sabbagh, Abdallah
AU - Rodés-Cabau, Josep
AU - Mesnier, Jules
AU - Okuno, Taishi
AU - Pilgrim, Thomas
AU - Fiorina, Claudia
AU - Colombo, Antonio
AU - Mangieri, Antonio
AU - Eltchaninoff, Helene
AU - Nombela-Franco, Luis
AU - Van Wiechen, Maarten P H
AU - Van Mieghem, Nicolas M
AU - Tchétché, Didier
AU - Schoels, Wolfgang H
AU - Kullmer, Matthias
AU - Barbanti, Marco
AU - Tamburino, Corrado
AU - Sinning, Jan-Malte
AU - Al-Kassou, Baravan
AU - Perlman, Gidon Y
AU - Ielasi, Alfonso
AU - Fraccaro, Chiara
AU - Tarantini, Giuseppe
AU - De Marco, Federico
AU - Witberg, Guy
AU - Redwood, Simon R
AU - Lisko, John C
AU - Babaliaros, Vasilis C
AU - Laine, Mika
AU - Nerla, Roberto
AU - Finkelstein, Ariel
AU - Eitan, Amnon
AU - Jaffe, Ronen
AU - Ruile, Philipp
AU - Neumann, Franz J
AU - Piazza, Nicolo
AU - Sievert, Horst
AU - Sievert, Kolja
AU - Russo, Marco
AU - Andreas, Martin
AU - Bunc, Matjaz
AU - Latib, Azeem
AU - Bruoha, Sharon
AU - Godfrey, Rebecca
AU - Hildick-Smith, David
AU - Barbash, Israel
AU - Segev, Amit
AU - Maurovich-Horvat, Pál
AU - Szilveszter, Balint
AU - Spargias, Konstantinos
AU - Aravadinos, Dionisis
AU - Nazif, Tamim M
AU - Leon, Martin B
AU - Webb, John G
AU - Redo-TAVR Registry
N1 - Copyright © 2022. Published by Elsevier Inc.
PY - 2022/8/8
Y1 - 2022/8/8
N2 - BACKGROUND: As transcatheter aortic valve (TAV) replacement is increasingly used in patients with longer life expectancy, a sizable proportion will require redo TAV replacement (TAVR). The unique configuration of balloon-expandable TAV (bTAV) vs a self-expanding TAV (sTAV) potentially affects TAV-in-TAV outcome.OBJECTIVES: The purpose of this study was to better inform prosthesis selection, TAV-in-TAV outcomes were assessed according to the type of initial and subsequent TAV.METHODS: Patients from the Redo-TAVR registry were analyzed using propensity weighting according to their initial valve type (bTAV [n = 115] vs sTAV [n = 106]) and subsequent valve type (bTAV [n = 130] vs sTAV [n = 91]).RESULTS: Patients with failed bTAVs presented later (vs sTAV) (4.9 ± 2.1 years vs 3.7 ± 2.3 years; P < 0.001), with smaller effective orifice area (1.0 ± 0.7 cm2 vs 1.3 ± 0.8 cm2; P = 0.018) and less frequent dominant regurgitation (16.2% vs 47.3%; P < 0.001). Mortality at 30 days was 2.3% (TAV-in-bTAV) vs 0% (TAV-in-sTAV) (P = 0.499) and 1.7% (bTAV-in-TAV) vs 1.0% (sTAV-in-TAV) (P = 0.612); procedural safety was 72.6% (TAV-in-bTAV) vs 71.2% (TAV-in-sTAV) (P = 0.817) and 73.2% (bTAV-in-TAV) vs 76.5% (sTAV-in-TAV) (P = 0.590). Device success was similar according to initial valve type but higher with subsequent sTAV vs bTAV (77.2% vs 64.3%; P = 0.045), primarily because of lower residual gradients (10.3 mm Hg [8.9-11.7 mm Hg] vs 15.2 mm Hg [13.2-17.1 mm Hg]; P < 0.001). Residual regurgitation (moderate or greater) was similar after bTAV-in-TAV and sTAV-in-TAV (5.7%) and nominally higher after TAV-in-bTAV (9.1%) vs TAV-in-sTAV (4.4%) (P = 0.176).CONCLUSIONS: In selected patients, no association was observed between TAV type and redo TAVR safety or mortality, yet subsequent sTAV was associated with higher device success because of lower redo gradients. These findings are preliminary, and more data are needed to guide valve choice for redo TAVR.
AB - BACKGROUND: As transcatheter aortic valve (TAV) replacement is increasingly used in patients with longer life expectancy, a sizable proportion will require redo TAV replacement (TAVR). The unique configuration of balloon-expandable TAV (bTAV) vs a self-expanding TAV (sTAV) potentially affects TAV-in-TAV outcome.OBJECTIVES: The purpose of this study was to better inform prosthesis selection, TAV-in-TAV outcomes were assessed according to the type of initial and subsequent TAV.METHODS: Patients from the Redo-TAVR registry were analyzed using propensity weighting according to their initial valve type (bTAV [n = 115] vs sTAV [n = 106]) and subsequent valve type (bTAV [n = 130] vs sTAV [n = 91]).RESULTS: Patients with failed bTAVs presented later (vs sTAV) (4.9 ± 2.1 years vs 3.7 ± 2.3 years; P < 0.001), with smaller effective orifice area (1.0 ± 0.7 cm2 vs 1.3 ± 0.8 cm2; P = 0.018) and less frequent dominant regurgitation (16.2% vs 47.3%; P < 0.001). Mortality at 30 days was 2.3% (TAV-in-bTAV) vs 0% (TAV-in-sTAV) (P = 0.499) and 1.7% (bTAV-in-TAV) vs 1.0% (sTAV-in-TAV) (P = 0.612); procedural safety was 72.6% (TAV-in-bTAV) vs 71.2% (TAV-in-sTAV) (P = 0.817) and 73.2% (bTAV-in-TAV) vs 76.5% (sTAV-in-TAV) (P = 0.590). Device success was similar according to initial valve type but higher with subsequent sTAV vs bTAV (77.2% vs 64.3%; P = 0.045), primarily because of lower residual gradients (10.3 mm Hg [8.9-11.7 mm Hg] vs 15.2 mm Hg [13.2-17.1 mm Hg]; P < 0.001). Residual regurgitation (moderate or greater) was similar after bTAV-in-TAV and sTAV-in-TAV (5.7%) and nominally higher after TAV-in-bTAV (9.1%) vs TAV-in-sTAV (4.4%) (P = 0.176).CONCLUSIONS: In selected patients, no association was observed between TAV type and redo TAVR safety or mortality, yet subsequent sTAV was associated with higher device success because of lower redo gradients. These findings are preliminary, and more data are needed to guide valve choice for redo TAVR.
KW - Aortic Valve/diagnostic imaging
KW - Aortic Valve Stenosis/diagnostic imaging
KW - Heart Valve Prosthesis
KW - Humans
KW - Prosthesis Design
KW - Registries
KW - Risk Factors
KW - Transcatheter Aortic Valve Replacement
KW - Treatment Outcome
U2 - 10.1016/j.jcin.2022.05.016
DO - 10.1016/j.jcin.2022.05.016
M3 - SCORING: Journal article
C2 - 35926921
VL - 15
SP - 1543
EP - 1554
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 15
ER -