Outcomes of valve-in-valve transcatheter aortic valve implantation with and without bioprosthetic valve fracture
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Outcomes of valve-in-valve transcatheter aortic valve implantation with and without bioprosthetic valve fracture. / Brinkmann, Christina; Abdel-Wahab, Mohamed; Bedogni, Francesco; Bhadra, Oliver Daniel; Charbonnier, Gaetan; Conradi, Lenard; Hildick-Smith, David; Kargoli, Faraj; Latib, Azeem; Van Mieghem, Nicolas M; Mylotte, Darren; Landes, Uri; Pilgrim, Thomas; Stripling, Jan; Taramasso, Maurizio; Tchétché, Didier; Testa, Luca; Thiele, Holger; Webb, John; Windecker, Stephan; Witt, Julian; Wohlmuth, Peter; Schofer, Joachim.
in: EUROINTERVENTION, Jahrgang 17, Nr. 10, 19.11.2021, S. 848-855.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes of valve-in-valve transcatheter aortic valve implantation with and without bioprosthetic valve fracture
AU - Brinkmann, Christina
AU - Abdel-Wahab, Mohamed
AU - Bedogni, Francesco
AU - Bhadra, Oliver Daniel
AU - Charbonnier, Gaetan
AU - Conradi, Lenard
AU - Hildick-Smith, David
AU - Kargoli, Faraj
AU - Latib, Azeem
AU - Van Mieghem, Nicolas M
AU - Mylotte, Darren
AU - Landes, Uri
AU - Pilgrim, Thomas
AU - Stripling, Jan
AU - Taramasso, Maurizio
AU - Tchétché, Didier
AU - Testa, Luca
AU - Thiele, Holger
AU - Webb, John
AU - Windecker, Stephan
AU - Witt, Julian
AU - Wohlmuth, Peter
AU - Schofer, Joachim
PY - 2021/11/19
Y1 - 2021/11/19
N2 - BACKGROUND: Bioprosthetic valve fracture (BVF) is a technique to reduce gradients in valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) procedures. The outcome of VIV-TAVI with BVF has not been compared with VIV-TAVI without BVF.AIMS: The aim of this study was to evaluate the outcome of VIV-TAVI with BVF compared to VIV-TAVI without BVF.METHODS: In total, 81 cases of BVF VIV-TAVI (BVF group) from 14 centres were compared to 79 cases of VIV-TAVI without BVF (control group).RESULTS: VARC-2-defined device success was 93% in the BVF group and 68.4% in the control group (p<0.001). The mean transvalvular gradient decreased from 37±13 mmHg to 10.8±5.9 mmHg (p<0.001) in the BVF group and from 35±16 mmHg to 15.8±6.8 mmHg (p<0.001) in the control group with a significantly higher final gradient in the control group (p<0.001). The transvalvular gradients did not change significantly over time. In-hospital major adverse events occurred in 3.7% in the BVF group and 7.6% in the control group (p=0.325). A linear mixed model identified BVF, self-expanding transcatheter heart valves (THVs) and other surgical aortic valve (SAV) types other than Mitroflow as predictors of lower transvalvular gradients.CONCLUSIONS: Compared to VIV-TAVI alone, VIV-TAVI with BVF resulted in a significantly lower transvalvular gradient acutely and at follow-up. Independent predictors of lower gradients were the use of self-expanding THVs and the treatment of SAVs other than Mitroflow, irrespective of BVF performance. BVF significantly reduced the gradient independently from transcatheter or surgical valve type.
AB - BACKGROUND: Bioprosthetic valve fracture (BVF) is a technique to reduce gradients in valve-in-valve transcatheter aortic valve implantation (VIV-TAVI) procedures. The outcome of VIV-TAVI with BVF has not been compared with VIV-TAVI without BVF.AIMS: The aim of this study was to evaluate the outcome of VIV-TAVI with BVF compared to VIV-TAVI without BVF.METHODS: In total, 81 cases of BVF VIV-TAVI (BVF group) from 14 centres were compared to 79 cases of VIV-TAVI without BVF (control group).RESULTS: VARC-2-defined device success was 93% in the BVF group and 68.4% in the control group (p<0.001). The mean transvalvular gradient decreased from 37±13 mmHg to 10.8±5.9 mmHg (p<0.001) in the BVF group and from 35±16 mmHg to 15.8±6.8 mmHg (p<0.001) in the control group with a significantly higher final gradient in the control group (p<0.001). The transvalvular gradients did not change significantly over time. In-hospital major adverse events occurred in 3.7% in the BVF group and 7.6% in the control group (p=0.325). A linear mixed model identified BVF, self-expanding transcatheter heart valves (THVs) and other surgical aortic valve (SAV) types other than Mitroflow as predictors of lower transvalvular gradients.CONCLUSIONS: Compared to VIV-TAVI alone, VIV-TAVI with BVF resulted in a significantly lower transvalvular gradient acutely and at follow-up. Independent predictors of lower gradients were the use of self-expanding THVs and the treatment of SAVs other than Mitroflow, irrespective of BVF performance. BVF significantly reduced the gradient independently from transcatheter or surgical valve type.
KW - Aortic Valve/diagnostic imaging
KW - Aortic Valve Stenosis/diagnostic imaging
KW - Bioprosthesis
KW - Heart Valve Prosthesis
KW - Humans
KW - Prosthesis Design
KW - Prosthesis Failure
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Treatment Outcome
U2 - 10.4244/EIJ-D-21-00254
DO - 10.4244/EIJ-D-21-00254
M3 - SCORING: Journal article
C2 - 34031022
VL - 17
SP - 848
EP - 855
JO - EUROINTERVENTION
JF - EUROINTERVENTION
SN - 1774-024X
IS - 10
ER -