Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation
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Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation. / Yoon, Sung-Han; Schmidt, Tobias; Bleiziffer, Sabine; Schofer, Niklas; Fiorina, Claudia; Munoz-Garcia, Antonio J; Yzeiraj, Ermela; Amat-Santos, Ignacio J; Tchetche, Didier; Jung, Christian; Fujita, Buntaro; Mangieri, Antonio; Deutsch, Marcus-Andre; Ubben, Timm; Deuschl, Florian; Kuwata, Shingo; De Biase, Chiara; Williams, Timothy; Dhoble, Abhijeet; Kim, Won-Keun; Ferrari, Enrico; Barbanti, Marco; Vollema, E Mara; Miceli, Antonio; Giannini, Cristina; Attizzani, Guiherme F; Kong, William K F; Gutierrez-Ibanes, Enrique; Jimenez Diaz, Victor Alfonso; Wijeysundera, Harindra C; Kaneko, Hidehiro; Chakravarty, Tarun; Makar, Moody; Sievert, Horst; Hengstenberg, Christian; Prendergast, Bernard D; Vincent, Flavien; Abdel-Wahab, Mohamed; Nombela-Franco, Luis; Silaschi, Miriam; Tarantini, Giuseppe; Butter, Christian; Ensminger, Stephan M; Hildick-Smith, David; Petronio, Anna Sonia; Yin, Wei-Hsian; De Marco, Federico; Testa, Luca; Van Mieghem, Nicolas M; Whisenant, Brian K; Kuck, Karl-Heinz; Colombo, Antonio; Kar, Saibal; Moris, Cesar; Delgado, Victoria; Maisano, Francesco; Nietlispach, Fabian; Mack, Michael J; Schofer, Joachim; Schaefer, Ulrich; Bax, Jeroen J; Frerker, Christian; Latib, Azeem; Makkar, Raj R.
in: J AM COLL CARDIOL, Jahrgang 70, Nr. 22, 05.12.2017, S. 2752-2763.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Transcatheter Aortic Valve Replacement in Pure Native Aortic Valve Regurgitation
AU - Yoon, Sung-Han
AU - Schmidt, Tobias
AU - Bleiziffer, Sabine
AU - Schofer, Niklas
AU - Fiorina, Claudia
AU - Munoz-Garcia, Antonio J
AU - Yzeiraj, Ermela
AU - Amat-Santos, Ignacio J
AU - Tchetche, Didier
AU - Jung, Christian
AU - Fujita, Buntaro
AU - Mangieri, Antonio
AU - Deutsch, Marcus-Andre
AU - Ubben, Timm
AU - Deuschl, Florian
AU - Kuwata, Shingo
AU - De Biase, Chiara
AU - Williams, Timothy
AU - Dhoble, Abhijeet
AU - Kim, Won-Keun
AU - Ferrari, Enrico
AU - Barbanti, Marco
AU - Vollema, E Mara
AU - Miceli, Antonio
AU - Giannini, Cristina
AU - Attizzani, Guiherme F
AU - Kong, William K F
AU - Gutierrez-Ibanes, Enrique
AU - Jimenez Diaz, Victor Alfonso
AU - Wijeysundera, Harindra C
AU - Kaneko, Hidehiro
AU - Chakravarty, Tarun
AU - Makar, Moody
AU - Sievert, Horst
AU - Hengstenberg, Christian
AU - Prendergast, Bernard D
AU - Vincent, Flavien
AU - Abdel-Wahab, Mohamed
AU - Nombela-Franco, Luis
AU - Silaschi, Miriam
AU - Tarantini, Giuseppe
AU - Butter, Christian
AU - Ensminger, Stephan M
AU - Hildick-Smith, David
AU - Petronio, Anna Sonia
AU - Yin, Wei-Hsian
AU - De Marco, Federico
AU - Testa, Luca
AU - Van Mieghem, Nicolas M
AU - Whisenant, Brian K
AU - Kuck, Karl-Heinz
AU - Colombo, Antonio
AU - Kar, Saibal
AU - Moris, Cesar
AU - Delgado, Victoria
AU - Maisano, Francesco
AU - Nietlispach, Fabian
AU - Mack, Michael J
AU - Schofer, Joachim
AU - Schaefer, Ulrich
AU - Bax, Jeroen J
AU - Frerker, Christian
AU - Latib, Azeem
AU - Makkar, Raj R
N1 - Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2017/12/5
Y1 - 2017/12/5
N2 - BACKGROUND: Limited data exist about safety and efficacy of transcatheter aortic valve replacement (TAVR) in patients with pure native aortic regurgitation (AR).OBJECTIVES: This study sought to compare the outcomes of TAVR with early- and new-generation devices in symptomatic patients with pure native AR.METHODS: From the pure native AR TAVR multicenter registry, procedural and clinical outcomes were assessed according to VARC-2 criteria and compared between early- and new-generation devices.RESULTS: A total of 331 patients with a mean STS score of 6.7 ± 6.7 underwent TAVR. The early- and new-generation devices were used in 119 patients (36.0%) and 212 patients (64.0%), respectively. STS score tended to be lower in the new-generation device group (6.2 ± 6.7 vs. 7.6 ± 6.7; p = 0.08), but transfemoral access was more frequently used in the early-generation device group (87.4% vs. 60.8%; p < 0.001). Compared with the early-generation devices, the new-generation devices were associated with a significantly higher device success rate (81.1% vs. 61.3%; p < 0.001) due to lower rates of second valve implantation (12.7% vs. 24.4%; p = 0.007) and post-procedural AR ≥ moderate (4.2% vs. 18.8%; p < 0.001). There were no significant differences in major 30-day endpoints between the 2 groups. The cumulative rates of all-cause and cardiovascular death at 1-year follow-up were 24.1% and 15.6%, respectively. The 1-year all-cause mortality rate was significantly higher in the patients with post-procedural AR ≥ moderate compared with those with post-procedural AR ≤ mild (46.1% vs. 21.8%; log-rank p = 0.001). On multivariable analysis, post-procedural AR ≥ moderate was independently associated with 1-year all-cause mortality (hazard ratio: 2.85; 95% confidence interval: 1.52 to 5.35; p = 0.001).CONCLUSIONS: Compared with the early-generation devices, TAVR using the new-generation devices was associated with improved procedural outcomes in treating patients with pure native AR. In patients with pure native AR, significant post-procedural AR was independently associated with increased mortality.
AB - BACKGROUND: Limited data exist about safety and efficacy of transcatheter aortic valve replacement (TAVR) in patients with pure native aortic regurgitation (AR).OBJECTIVES: This study sought to compare the outcomes of TAVR with early- and new-generation devices in symptomatic patients with pure native AR.METHODS: From the pure native AR TAVR multicenter registry, procedural and clinical outcomes were assessed according to VARC-2 criteria and compared between early- and new-generation devices.RESULTS: A total of 331 patients with a mean STS score of 6.7 ± 6.7 underwent TAVR. The early- and new-generation devices were used in 119 patients (36.0%) and 212 patients (64.0%), respectively. STS score tended to be lower in the new-generation device group (6.2 ± 6.7 vs. 7.6 ± 6.7; p = 0.08), but transfemoral access was more frequently used in the early-generation device group (87.4% vs. 60.8%; p < 0.001). Compared with the early-generation devices, the new-generation devices were associated with a significantly higher device success rate (81.1% vs. 61.3%; p < 0.001) due to lower rates of second valve implantation (12.7% vs. 24.4%; p = 0.007) and post-procedural AR ≥ moderate (4.2% vs. 18.8%; p < 0.001). There were no significant differences in major 30-day endpoints between the 2 groups. The cumulative rates of all-cause and cardiovascular death at 1-year follow-up were 24.1% and 15.6%, respectively. The 1-year all-cause mortality rate was significantly higher in the patients with post-procedural AR ≥ moderate compared with those with post-procedural AR ≤ mild (46.1% vs. 21.8%; log-rank p = 0.001). On multivariable analysis, post-procedural AR ≥ moderate was independently associated with 1-year all-cause mortality (hazard ratio: 2.85; 95% confidence interval: 1.52 to 5.35; p = 0.001).CONCLUSIONS: Compared with the early-generation devices, TAVR using the new-generation devices was associated with improved procedural outcomes in treating patients with pure native AR. In patients with pure native AR, significant post-procedural AR was independently associated with increased mortality.
KW - Aged
KW - Aged, 80 and over
KW - Aortic Valve/surgery
KW - Aortic Valve Insufficiency/diagnosis
KW - Catheterization, Peripheral/methods
KW - Female
KW - Femoral Artery/surgery
KW - Heart Valve Prosthesis/adverse effects
KW - Humans
KW - International Cooperation
KW - Male
KW - Mortality
KW - Outcome and Process Assessment, Health Care
KW - Postoperative Complications/diagnosis
KW - Prosthesis Design/trends
KW - Quality Improvement
KW - Registries/statistics & numerical data
KW - Risk Assessment
KW - Severity of Illness Index
KW - Transcatheter Aortic Valve Replacement/adverse effects
U2 - 10.1016/j.jacc.2017.10.006
DO - 10.1016/j.jacc.2017.10.006
M3 - SCORING: Journal article
C2 - 29191323
VL - 70
SP - 2752
EP - 2763
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 22
ER -