Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses
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Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses. / Landes, Uri; Sathananthan, Janarthanan; Witberg, Guy; De Backer, Ole; Sondergaard, Lars; Abdel-Wahab, Mohamed; Holzhey, David; Kim, Won-Keun; Hamm, Christian; Buzzatti, Nicola; Montorfano, Matteo; Ludwig, Sebastian; Conradi, Lenard; Seiffert, Moritz; Guerrero, Mayra; El Sabbagh, Abdallah; Rodés-Cabau, Josep; Guimaraes, Leonardo; 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; 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; Godfrey, Rebecca; Hildick-Smith, David; Chuang, Ming-Yu A; Blanke, Philipp; Leipsic, Jonathon; Wood, David A; Nazif, Tamim M; Kodali, Susheel; Barbanti, Marco; Kornowski, Ran; Leon, Martin B; Webb, John G.
in: J AM COLL CARDIOL, Jahrgang 77, Nr. 1, 05.01.2021, S. 1-14.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses
AU - Landes, Uri
AU - Sathananthan, Janarthanan
AU - Witberg, Guy
AU - De Backer, Ole
AU - Sondergaard, Lars
AU - Abdel-Wahab, Mohamed
AU - Holzhey, David
AU - Kim, Won-Keun
AU - Hamm, Christian
AU - Buzzatti, Nicola
AU - Montorfano, Matteo
AU - Ludwig, Sebastian
AU - Conradi, Lenard
AU - Seiffert, Moritz
AU - Guerrero, Mayra
AU - El Sabbagh, Abdallah
AU - Rodés-Cabau, Josep
AU - Guimaraes, Leonardo
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 - 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 - Godfrey, Rebecca
AU - Hildick-Smith, David
AU - Chuang, Ming-Yu A
AU - Blanke, Philipp
AU - Leipsic, Jonathon
AU - Wood, David A
AU - Nazif, Tamim M
AU - Kodali, Susheel
AU - Barbanti, Marco
AU - Kornowski, Ran
AU - Leon, Martin B
AU - Webb, John G
N1 - Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2021/1/5
Y1 - 2021/1/5
N2 - BACKGROUND: Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) are now both used to treat aortic stenosis in patients in whom life expectancy may exceed valve durability. The choice of initial bioprosthesis should therefore consider the relative safety and efficacy of potential subsequent interventions.OBJECTIVES: The aim of this study was to compare TAVR in failed transcatheter aortic valves (TAVs) versus surgical aortic valves (SAVs).METHODS: Data were collected on 434 TAV-in-TAV and 624 TAV-in-SAV consecutive procedures performed at centers participating in the Redo-TAVR international registry. Propensity score matching was applied, and 330 matched (165:165) patients were analyzed. Principal endpoints were procedural success, procedural safety, and mortality at 30 days and 1 year.RESULTS: For TAV-in-TAV versus TAV-in-SAV, procedural success was observed in 120 (72.7%) versus 103 (62.4%) patients (p = 0.045), driven by a numerically lower frequency of residual high valve gradient (p = 0.095), ectopic valve deployment (p = 0.081), coronary obstruction (p = 0.091), and conversion to open heart surgery (p = 0.082). Procedural safety was achieved in 116 (70.3%) versus 119 (72.1%) patients (p = 0.715). Mortality at 30 days was 5 (3%) after TAV-in-TAV and 7 (4.4%) after TAV-in-SAV (p = 0.570). At 1 year, mortality was 12 (11.9%) and 10 (10.2%), respectively (p = 0.633). Aortic valve area was larger (1.55 ± 0.5 cm2 vs. 1.37 ± 0.5 cm2; p = 0.040), and the mean residual gradient was lower (12.6 ± 5.2 mm Hg vs. 14.9 ± 5.2 mm Hg; p = 0.011) after TAV-in-TAV. The rate of moderate or greater residual aortic regurgitation was similar, but mild aortic regurgitation was more frequent after TAV-in-TAV (p = 0.003).CONCLUSIONS: In propensity score-matched cohorts of TAV-in-TAV versus TAV-in-SAV patients, TAV-in-TAV was associated with higher procedural success and similar procedural safety or mortality.
AB - BACKGROUND: Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) are now both used to treat aortic stenosis in patients in whom life expectancy may exceed valve durability. The choice of initial bioprosthesis should therefore consider the relative safety and efficacy of potential subsequent interventions.OBJECTIVES: The aim of this study was to compare TAVR in failed transcatheter aortic valves (TAVs) versus surgical aortic valves (SAVs).METHODS: Data were collected on 434 TAV-in-TAV and 624 TAV-in-SAV consecutive procedures performed at centers participating in the Redo-TAVR international registry. Propensity score matching was applied, and 330 matched (165:165) patients were analyzed. Principal endpoints were procedural success, procedural safety, and mortality at 30 days and 1 year.RESULTS: For TAV-in-TAV versus TAV-in-SAV, procedural success was observed in 120 (72.7%) versus 103 (62.4%) patients (p = 0.045), driven by a numerically lower frequency of residual high valve gradient (p = 0.095), ectopic valve deployment (p = 0.081), coronary obstruction (p = 0.091), and conversion to open heart surgery (p = 0.082). Procedural safety was achieved in 116 (70.3%) versus 119 (72.1%) patients (p = 0.715). Mortality at 30 days was 5 (3%) after TAV-in-TAV and 7 (4.4%) after TAV-in-SAV (p = 0.570). At 1 year, mortality was 12 (11.9%) and 10 (10.2%), respectively (p = 0.633). Aortic valve area was larger (1.55 ± 0.5 cm2 vs. 1.37 ± 0.5 cm2; p = 0.040), and the mean residual gradient was lower (12.6 ± 5.2 mm Hg vs. 14.9 ± 5.2 mm Hg; p = 0.011) after TAV-in-TAV. The rate of moderate or greater residual aortic regurgitation was similar, but mild aortic regurgitation was more frequent after TAV-in-TAV (p = 0.003).CONCLUSIONS: In propensity score-matched cohorts of TAV-in-TAV versus TAV-in-SAV patients, TAV-in-TAV was associated with higher procedural success and similar procedural safety or mortality.
U2 - 10.1016/j.jacc.2020.10.053
DO - 10.1016/j.jacc.2020.10.053
M3 - SCORING: Journal article
C2 - 33413929
VL - 77
SP - 1
EP - 14
JO - J AM COLL CARDIOL
JF - J AM COLL CARDIOL
SN - 0735-1097
IS - 1
ER -