Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction
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Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction. / Landes, Uri; Webb, John G; De Backer, Ole; Sondergaard, Lars; Abdel-Wahab, Mohamed; Crusius, Lisa; Kim, Won-Keun; Hamm, Christian; Buzzatti, Nicola; Montorfano, Matteo; Ludwig, Sebastian; Schofer, Niklas; Voigtlaender, Lisa; Guerrero, Mayra; El Sabbagh, Abdallah; Rodés-Cabau, Josep; Guimaraes, Leonardo; Kornowski, Ran; Codner, Pablo; 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; Tamburino, Corrado; Sinning, Jan-Malte; Al-Kassou, Baravan; Perlman, Gidon Y; Danenberg, Haim; Ielasi, Alfonso; Fraccaro, Chiara; Tarantini, Giuseppe; De Marco, Federico; Witberg, Guy; Redwood, Simon R; Lisko, John C; Babaliaros, Vasilis C; Laine, Mika; Nerla, Roberto; Castriota, Fausto; Finkelstein, Ariel; Loewenstein, Itamar; Eitan, Amnon; Jaffe, Ronen; Ruile, Philipp; Neumann, Franz J; Piazza, Nicolo; Alosaimi, Hind; Sievert, Horst; Sievert, Kolja; Russo, Marco; Andreas, Martin; Bunc, Matjaz; Latib, Azeem; Govdfrey, Rebecca; Hildick-Smith, David; Sathananthan, Janarthanan; Hensey, Mark; Alkhodair, Abdullah; Blanke, Philipp; Leipsic, Jonathon; Wood, David A; Nazif, Tamim M; Kodali, Susheel; Leon, Martin B; Barbanti, Marco; Redo-TAVR Registry.
in: J AM COLL CARDIOL, Jahrgang 75, Nr. 16, 28.04.2020, S. 1882-1893.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction
AU - Landes, Uri
AU - Webb, John G
AU - De Backer, Ole
AU - Sondergaard, Lars
AU - Abdel-Wahab, Mohamed
AU - Crusius, Lisa
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 - Guimaraes, Leonardo
AU - Kornowski, Ran
AU - Codner, Pablo
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 - Tamburino, Corrado
AU - Sinning, Jan-Malte
AU - Al-Kassou, Baravan
AU - Perlman, Gidon Y
AU - Danenberg, Haim
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 - Castriota, Fausto
AU - Finkelstein, Ariel
AU - Loewenstein, Itamar
AU - Eitan, Amnon
AU - Jaffe, Ronen
AU - Ruile, Philipp
AU - Neumann, Franz J
AU - Piazza, Nicolo
AU - Alosaimi, Hind
AU - Sievert, Horst
AU - Sievert, Kolja
AU - Russo, Marco
AU - Andreas, Martin
AU - Bunc, Matjaz
AU - Latib, Azeem
AU - Govdfrey, Rebecca
AU - Hildick-Smith, David
AU - Sathananthan, Janarthanan
AU - Hensey, Mark
AU - Alkhodair, Abdullah
AU - Blanke, Philipp
AU - Leipsic, Jonathon
AU - Wood, David A
AU - Nazif, Tamim M
AU - Kodali, Susheel
AU - Leon, Martin B
AU - Barbanti, Marco
AU - Redo-TAVR Registry
N1 - Copyright © 2020. Published by Elsevier Inc.
PY - 2020/4/28
Y1 - 2020/4/28
N2 - BACKGROUND: Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail.OBJECTIVES: The authors sought to examine outcomes following redo-TAVR.METHODS: The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively.RESULTS: Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm2 and 1.51 ± 0.57 cm2; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively.CONCLUSIONS: Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern.
AB - BACKGROUND: Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail.OBJECTIVES: The authors sought to examine outcomes following redo-TAVR.METHODS: The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively.RESULTS: Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm2 and 1.51 ± 0.57 cm2; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively.CONCLUSIONS: Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern.
KW - Aged
KW - Aortic Valve/surgery
KW - Aortic Valve Insufficiency/diagnosis
KW - Aortic Valve Stenosis/surgery
KW - Equipment Failure Analysis
KW - Female
KW - Global Health
KW - Heart Valve Prosthesis/adverse effects
KW - Humans
KW - Male
KW - Outcome Assessment, Health Care
KW - Postoperative Complications/diagnosis
KW - Registries/statistics & numerical data
KW - Reoperation/instrumentation
KW - Survival Analysis
KW - Symptom Assessment/statistics & numerical data
KW - Transcatheter Aortic Valve Replacement/adverse effects
U2 - 10.1016/j.jacc.2020.02.051
DO - 10.1016/j.jacc.2020.02.051
M3 - SCORING: Journal article
C2 - 32327098
VL - 75
SP - 1882
EP - 1893
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 16
ER -