Transapical implantation of a second-generation transcatheter heart valve in patients with noncalcified aortic regurgitation
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Transapical implantation of a second-generation transcatheter heart valve in patients with noncalcified aortic regurgitation. / Seiffert, Moritz; Diemert, Patrick; Koschyk, Dietmar; Schirmer, Johannes; Conradi, Lenard; Schnabel, Renate; Blankenberg, Stefan; Reichenspurner, Hermann; Baldus, Stephan; Treede, Hendrik.
In: JACC-CARDIOVASC INTE, Vol. 6, No. 6, 06.2013, p. 590-597.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Transapical implantation of a second-generation transcatheter heart valve in patients with noncalcified aortic regurgitation
AU - Seiffert, Moritz
AU - Diemert, Patrick
AU - Koschyk, Dietmar
AU - Schirmer, Johannes
AU - Conradi, Lenard
AU - Schnabel, Renate
AU - Blankenberg, Stefan
AU - Reichenspurner, Hermann
AU - Baldus, Stephan
AU - Treede, Hendrik
N1 - Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2013/6
Y1 - 2013/6
N2 - OBJECTIVES: This study sought to report on the feasibility and early results of transcatheter aortic valve implantation employing a second-generation device in a series of patients with pure aortic regurgitation.BACKGROUND: Efficacy and safety of transcatheter aortic valve implantation in patients with calcific aortic stenosis and high surgical risk has been demonstrated. However, experience with implantation for severe noncalcified aortic regurgitation has been limited due to increased risk for valve dislocation or annular rupture.METHODS: Five patients (mean age: 66.6 ± 7 years) underwent transapical implantation of a JenaValve (JenaValve Technology GmbH, Munich, Germany) transcatheter heart valve for moderate to severe, noncalcified aortic regurgitation. All patients were considered high risk for surgical aortic valve replacement after evaluation by an interdisciplinary heart team (logistic EuroSCORE [European System for Cardiac Operative Risk Evaluation] range 3.1% to 38.9%). Procedural and acute clinical outcomes were analyzed.RESULTS: Implantation was successful in all cases without relevant remaining aortic regurgitation or signs of stenosis in any of the patients. No major device- or procedure-related adverse events occurred and all 5 patients were alive with improved exercise tolerance at 3-month follow-up.CONCLUSIONS: Noncalcified aortic regurgitation continues to be a challenging pathology for transcatheter aortic valve implantation due to the risk for insufficient anchoring of the valve stent within the aortic annulus. This report provides first evidence that the JenaValve prosthesis may be a reasonable option in these specific patients due to its unique stent design, clipping the native aortic valve leaflets, and offering promising early results.
AB - OBJECTIVES: This study sought to report on the feasibility and early results of transcatheter aortic valve implantation employing a second-generation device in a series of patients with pure aortic regurgitation.BACKGROUND: Efficacy and safety of transcatheter aortic valve implantation in patients with calcific aortic stenosis and high surgical risk has been demonstrated. However, experience with implantation for severe noncalcified aortic regurgitation has been limited due to increased risk for valve dislocation or annular rupture.METHODS: Five patients (mean age: 66.6 ± 7 years) underwent transapical implantation of a JenaValve (JenaValve Technology GmbH, Munich, Germany) transcatheter heart valve for moderate to severe, noncalcified aortic regurgitation. All patients were considered high risk for surgical aortic valve replacement after evaluation by an interdisciplinary heart team (logistic EuroSCORE [European System for Cardiac Operative Risk Evaluation] range 3.1% to 38.9%). Procedural and acute clinical outcomes were analyzed.RESULTS: Implantation was successful in all cases without relevant remaining aortic regurgitation or signs of stenosis in any of the patients. No major device- or procedure-related adverse events occurred and all 5 patients were alive with improved exercise tolerance at 3-month follow-up.CONCLUSIONS: Noncalcified aortic regurgitation continues to be a challenging pathology for transcatheter aortic valve implantation due to the risk for insufficient anchoring of the valve stent within the aortic annulus. This report provides first evidence that the JenaValve prosthesis may be a reasonable option in these specific patients due to its unique stent design, clipping the native aortic valve leaflets, and offering promising early results.
KW - Aged
KW - Aortic Valve Insufficiency/diagnosis
KW - Cardiac Catheterization/instrumentation
KW - Echocardiography, Doppler, Color
KW - Feasibility Studies
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/instrumentation
KW - Humans
KW - Male
KW - Middle Aged
KW - Prosthesis Design
KW - Severity of Illness Index
KW - Tomography, X-Ray Computed
KW - Treatment Outcome
U2 - 10.1016/j.jcin.2013.01.138
DO - 10.1016/j.jcin.2013.01.138
M3 - SCORING: Journal article
C2 - 23683735
VL - 6
SP - 590
EP - 597
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 6
ER -
