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Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings

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Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings. / Yoon, Sung-Han; Whisenant, Brian K; Bleiziffer, Sabine; Delgado, Victoria; Schofer, Niklas; Eschenbach, Lena; Fujita, Buntaro; Sharma, Rahul; Ancona, Marco; Yzeiraj, Ermela; Cannata, Stefano; Barker, Colin; Davies, James E; Frangieh, Antonio H; Deuschl, Florian; Podlesnikar, Tomaz; Asami, Masahiko; Dhoble, Abhijeet; Chyou, Anthony; Masson, Jean-Bernard; Wijeysundera, Harindra C; Blackman, Daniel J; Rampat, Rajiv; Taramasso, Maurizio; Gutierrez-Ibanes, Enrique; Chakravarty, Tarun; Attizzani, Guiherme F; Kaneko, Tsuyoshi; Wong, S Chiu; Sievert, Horst; Nietlispach, Fabian; Hildick-Smith, David; Nombela-Franco, Luis; Conradi, Lenard; Hengstenberg, Christian; Reardon, Michael J; Kasel, Albert Markus; Redwood, Simon; Colombo, Antonio; Kar, Saibal; Maisano, Francesco; Windecker, Stephan; Pilgrim, Thomas; Ensminger, Stephan M; Prendergast, Bernard D; Schofer, Joachim; Schaefer, Ulrich; Bax, Jeroen J; Latib, Azeem; Makkar, Raj R.

In: J AM COLL CARDIOL, Vol. 70, No. 9, 29.08.2017, p. 1121-1131.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Yoon, S-H, Whisenant, BK, Bleiziffer, S, Delgado, V, Schofer, N, Eschenbach, L, Fujita, B, Sharma, R, Ancona, M, Yzeiraj, E, Cannata, S, Barker, C, Davies, JE, Frangieh, AH, Deuschl, F, Podlesnikar, T, Asami, M, Dhoble, A, Chyou, A, Masson, J-B, Wijeysundera, HC, Blackman, DJ, Rampat, R, Taramasso, M, Gutierrez-Ibanes, E, Chakravarty, T, Attizzani, GF, Kaneko, T, Wong, SC, Sievert, H, Nietlispach, F, Hildick-Smith, D, Nombela-Franco, L, Conradi, L, Hengstenberg, C, Reardon, MJ, Kasel, AM, Redwood, S, Colombo, A, Kar, S, Maisano, F, Windecker, S, Pilgrim, T, Ensminger, SM, Prendergast, BD, Schofer, J, Schaefer, U, Bax, JJ, Latib, A & Makkar, RR 2017, 'Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings', J AM COLL CARDIOL, vol. 70, no. 9, pp. 1121-1131. https://doi.org/10.1016/j.jacc.2017.07.714

APA

Yoon, S-H., Whisenant, B. K., Bleiziffer, S., Delgado, V., Schofer, N., Eschenbach, L., Fujita, B., Sharma, R., Ancona, M., Yzeiraj, E., Cannata, S., Barker, C., Davies, J. E., Frangieh, A. H., Deuschl, F., Podlesnikar, T., Asami, M., Dhoble, A., Chyou, A., ... Makkar, R. R. (2017). Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings. J AM COLL CARDIOL, 70(9), 1121-1131. https://doi.org/10.1016/j.jacc.2017.07.714

Vancouver

Yoon S-H, Whisenant BK, Bleiziffer S, Delgado V, Schofer N, Eschenbach L et al. Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings. J AM COLL CARDIOL. 2017 Aug 29;70(9):1121-1131. https://doi.org/10.1016/j.jacc.2017.07.714

Bibtex

@article{2a12cca588374fe09d73bd767cbe65e8,
title = "Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings",
abstract = "BACKGROUND: Limited data exist regarding transcatheter mitral valve replacement (TMVR) for patients with failed mitral valve replacement and repair.OBJECTIVES: This study sought to evaluate the outcomes of TMVR in patients with failed mitral bioprosthetic valves (valve-in-valve [ViV]) and annuloplasty rings (valve-in-ring [ViR]).METHODS: From the TMVR multicenter registry, procedural and clinical outcomes of mitral ViV and ViR were compared according to Mitral Valve Academic Research Consortium criteria.RESULTS: A total of 248 patients with mean Society of Thoracic Surgeons score of 8.9 ± 6.8% underwent TMVR. Transseptal access and the balloon-expandable valve were used in 33.1% and 89.9%, respectively. Compared with 176 patients undergoing ViV, 72 patients undergoing ViR had lower left ventricular ejection fraction (45.6 ± 17.4% vs. 55.3 ± 11.1%; p < 0.001). Overall technical and device success rates were acceptable, at 92.3% and 85.5%, respectively. However, compared with the ViV group, the ViR group had lower technical success (83.3% vs. 96.0%; p = 0.001) due to more frequent second valve implantation (11.1% vs. 2.8%; p = 0.008), and lower device success (76.4% vs. 89.2%; p = 0.009) due to more frequent reintervention (16.7% vs. 7.4%; p = 0.03). Mean mitral valve gradients were similar between groups (6.4 ± 2.3 mm Hg vs. 5.8 ± 2.7 mm Hg; p = 0.17), whereas the ViR group had more frequent post-procedural mitral regurgitation moderate or higher (19.4% vs. 6.8%; p = 0.003). Furthermore, the ViR group had more frequent life-threatening bleeding (8.3% vs. 2.3%; p = 0.03), acute kidney injury (11.1% vs. 4.0%; p = 0.03), and subsequent lower procedural success (58.3% vs. 79.5%; p = 0.001). The 1-year all-cause mortality rate was significantly higher in the ViR group compared with the ViV group (28.7% vs. 12.6%; log-rank test, p = 0.01). On multivariable analysis, failed annuloplasty ring was independently associated with all-cause mortality (hazard ratio: 2.70; 95% confidence interval: 1.34 to 5.43; p = 0.005).CONCLUSIONS: The TMVR procedure provided acceptable outcomes in high-risk patients with degenerated bioprostheses or failed annuloplasty rings, but mitral ViR was associated with higher rates of procedural complications and mid-term mortality compared with mitral ViV.",
keywords = "Aged, Bioprosthesis/adverse effects, Cardiac Catheterization/methods, Europe/epidemiology, Female, Heart Valve Diseases/surgery, Heart Valve Prosthesis Implantation/methods, Humans, Male, Mitral Valve/surgery, Mitral Valve Annuloplasty/adverse effects, North America/epidemiology, Prosthesis Design, Prosthesis Failure, Reoperation, Retrospective Studies, Survival Rate/trends, Treatment Outcome",
author = "Sung-Han Yoon and Whisenant, {Brian K} and Sabine Bleiziffer and Victoria Delgado and Niklas Schofer and Lena Eschenbach and Buntaro Fujita and Rahul Sharma and Marco Ancona and Ermela Yzeiraj and Stefano Cannata and Colin Barker and Davies, {James E} and Frangieh, {Antonio H} and Florian Deuschl and Tomaz Podlesnikar and Masahiko Asami and Abhijeet Dhoble and Anthony Chyou and Jean-Bernard Masson and Wijeysundera, {Harindra C} and Blackman, {Daniel J} and Rajiv Rampat and Maurizio Taramasso and Enrique Gutierrez-Ibanes and Tarun Chakravarty and Attizzani, {Guiherme F} and Tsuyoshi Kaneko and Wong, {S Chiu} and Horst Sievert and Fabian Nietlispach and David Hildick-Smith and Luis Nombela-Franco and Lenard Conradi and Christian Hengstenberg and Reardon, {Michael J} and Kasel, {Albert Markus} and Simon Redwood and Antonio Colombo and Saibal Kar and Francesco Maisano and Stephan Windecker and Thomas Pilgrim and Ensminger, {Stephan M} and Prendergast, {Bernard D} and Joachim Schofer and Ulrich Schaefer and Bax, {Jeroen J} and Azeem Latib and Makkar, {Raj R}",
note = "Copyright {\textcopyright} 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2017",
month = aug,
day = "29",
doi = "10.1016/j.jacc.2017.07.714",
language = "English",
volume = "70",
pages = "1121--1131",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",

}

RIS

TY - JOUR

T1 - Transcatheter Mitral Valve Replacement for Degenerated Bioprosthetic Valves and Failed Annuloplasty Rings

AU - Yoon, Sung-Han

AU - Whisenant, Brian K

AU - Bleiziffer, Sabine

AU - Delgado, Victoria

AU - Schofer, Niklas

AU - Eschenbach, Lena

AU - Fujita, Buntaro

AU - Sharma, Rahul

AU - Ancona, Marco

AU - Yzeiraj, Ermela

AU - Cannata, Stefano

AU - Barker, Colin

AU - Davies, James E

AU - Frangieh, Antonio H

AU - Deuschl, Florian

AU - Podlesnikar, Tomaz

AU - Asami, Masahiko

AU - Dhoble, Abhijeet

AU - Chyou, Anthony

AU - Masson, Jean-Bernard

AU - Wijeysundera, Harindra C

AU - Blackman, Daniel J

AU - Rampat, Rajiv

AU - Taramasso, Maurizio

AU - Gutierrez-Ibanes, Enrique

AU - Chakravarty, Tarun

AU - Attizzani, Guiherme F

AU - Kaneko, Tsuyoshi

AU - Wong, S Chiu

AU - Sievert, Horst

AU - Nietlispach, Fabian

AU - Hildick-Smith, David

AU - Nombela-Franco, Luis

AU - Conradi, Lenard

AU - Hengstenberg, Christian

AU - Reardon, Michael J

AU - Kasel, Albert Markus

AU - Redwood, Simon

AU - Colombo, Antonio

AU - Kar, Saibal

AU - Maisano, Francesco

AU - Windecker, Stephan

AU - Pilgrim, Thomas

AU - Ensminger, Stephan M

AU - Prendergast, Bernard D

AU - Schofer, Joachim

AU - Schaefer, Ulrich

AU - Bax, Jeroen J

AU - Latib, Azeem

AU - Makkar, Raj R

N1 - Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2017/8/29

Y1 - 2017/8/29

N2 - BACKGROUND: Limited data exist regarding transcatheter mitral valve replacement (TMVR) for patients with failed mitral valve replacement and repair.OBJECTIVES: This study sought to evaluate the outcomes of TMVR in patients with failed mitral bioprosthetic valves (valve-in-valve [ViV]) and annuloplasty rings (valve-in-ring [ViR]).METHODS: From the TMVR multicenter registry, procedural and clinical outcomes of mitral ViV and ViR were compared according to Mitral Valve Academic Research Consortium criteria.RESULTS: A total of 248 patients with mean Society of Thoracic Surgeons score of 8.9 ± 6.8% underwent TMVR. Transseptal access and the balloon-expandable valve were used in 33.1% and 89.9%, respectively. Compared with 176 patients undergoing ViV, 72 patients undergoing ViR had lower left ventricular ejection fraction (45.6 ± 17.4% vs. 55.3 ± 11.1%; p < 0.001). Overall technical and device success rates were acceptable, at 92.3% and 85.5%, respectively. However, compared with the ViV group, the ViR group had lower technical success (83.3% vs. 96.0%; p = 0.001) due to more frequent second valve implantation (11.1% vs. 2.8%; p = 0.008), and lower device success (76.4% vs. 89.2%; p = 0.009) due to more frequent reintervention (16.7% vs. 7.4%; p = 0.03). Mean mitral valve gradients were similar between groups (6.4 ± 2.3 mm Hg vs. 5.8 ± 2.7 mm Hg; p = 0.17), whereas the ViR group had more frequent post-procedural mitral regurgitation moderate or higher (19.4% vs. 6.8%; p = 0.003). Furthermore, the ViR group had more frequent life-threatening bleeding (8.3% vs. 2.3%; p = 0.03), acute kidney injury (11.1% vs. 4.0%; p = 0.03), and subsequent lower procedural success (58.3% vs. 79.5%; p = 0.001). The 1-year all-cause mortality rate was significantly higher in the ViR group compared with the ViV group (28.7% vs. 12.6%; log-rank test, p = 0.01). On multivariable analysis, failed annuloplasty ring was independently associated with all-cause mortality (hazard ratio: 2.70; 95% confidence interval: 1.34 to 5.43; p = 0.005).CONCLUSIONS: The TMVR procedure provided acceptable outcomes in high-risk patients with degenerated bioprostheses or failed annuloplasty rings, but mitral ViR was associated with higher rates of procedural complications and mid-term mortality compared with mitral ViV.

AB - BACKGROUND: Limited data exist regarding transcatheter mitral valve replacement (TMVR) for patients with failed mitral valve replacement and repair.OBJECTIVES: This study sought to evaluate the outcomes of TMVR in patients with failed mitral bioprosthetic valves (valve-in-valve [ViV]) and annuloplasty rings (valve-in-ring [ViR]).METHODS: From the TMVR multicenter registry, procedural and clinical outcomes of mitral ViV and ViR were compared according to Mitral Valve Academic Research Consortium criteria.RESULTS: A total of 248 patients with mean Society of Thoracic Surgeons score of 8.9 ± 6.8% underwent TMVR. Transseptal access and the balloon-expandable valve were used in 33.1% and 89.9%, respectively. Compared with 176 patients undergoing ViV, 72 patients undergoing ViR had lower left ventricular ejection fraction (45.6 ± 17.4% vs. 55.3 ± 11.1%; p < 0.001). Overall technical and device success rates were acceptable, at 92.3% and 85.5%, respectively. However, compared with the ViV group, the ViR group had lower technical success (83.3% vs. 96.0%; p = 0.001) due to more frequent second valve implantation (11.1% vs. 2.8%; p = 0.008), and lower device success (76.4% vs. 89.2%; p = 0.009) due to more frequent reintervention (16.7% vs. 7.4%; p = 0.03). Mean mitral valve gradients were similar between groups (6.4 ± 2.3 mm Hg vs. 5.8 ± 2.7 mm Hg; p = 0.17), whereas the ViR group had more frequent post-procedural mitral regurgitation moderate or higher (19.4% vs. 6.8%; p = 0.003). Furthermore, the ViR group had more frequent life-threatening bleeding (8.3% vs. 2.3%; p = 0.03), acute kidney injury (11.1% vs. 4.0%; p = 0.03), and subsequent lower procedural success (58.3% vs. 79.5%; p = 0.001). The 1-year all-cause mortality rate was significantly higher in the ViR group compared with the ViV group (28.7% vs. 12.6%; log-rank test, p = 0.01). On multivariable analysis, failed annuloplasty ring was independently associated with all-cause mortality (hazard ratio: 2.70; 95% confidence interval: 1.34 to 5.43; p = 0.005).CONCLUSIONS: The TMVR procedure provided acceptable outcomes in high-risk patients with degenerated bioprostheses or failed annuloplasty rings, but mitral ViR was associated with higher rates of procedural complications and mid-term mortality compared with mitral ViV.

KW - Aged

KW - Bioprosthesis/adverse effects

KW - Cardiac Catheterization/methods

KW - Europe/epidemiology

KW - Female

KW - Heart Valve Diseases/surgery

KW - Heart Valve Prosthesis Implantation/methods

KW - Humans

KW - Male

KW - Mitral Valve/surgery

KW - Mitral Valve Annuloplasty/adverse effects

KW - North America/epidemiology

KW - Prosthesis Design

KW - Prosthesis Failure

KW - Reoperation

KW - Retrospective Studies

KW - Survival Rate/trends

KW - Treatment Outcome

U2 - 10.1016/j.jacc.2017.07.714

DO - 10.1016/j.jacc.2017.07.714

M3 - SCORING: Journal article

C2 - 28838360

VL - 70

SP - 1121

EP - 1131

JO - J AM COLL CARDIOL

JF - J AM COLL CARDIOL

SN - 0735-1097

IS - 9

ER -