; Fiorina, Claudia ; Zittermann, Armin ; Veulemans, Verena ; Sinning, Jan-Malte ; Saia, Francesco ; Brecker, Stephen ; Presbitero, Patrizia ; De Backer, Ole ; Søndergaard, Lars ; Bruschi, Giuseppe ; Franco, Luis Nombela ; Petronio, Anna Sonia ; Barbanti, Marco ; Cerillo, Alfredo ; Spargias, Konstantinos ; Schofer, Joachim ; Cohen, Mauricio ; Muñoz-Garcia, Antonio ; Finkelstein, Ariel ; Adam, Matti ; Serra, Vicenç ; Teles, Rui Campante ; Champagnac, Didier ; Iadanza, Alessandro ; Chodor, Piotr ; Eggebrecht, Holger ; Welsh, Robert ; Caixeta, Adriano ; Salizzoni, Stefano ; Dager, Antonio ; Auffret, Vincent ; Cheema, Asim ; Ubben, Timm ; Ancona, Marco ; Rudolph, Tanja ; Gummert, Jan ; Tseng, Elaine ; Noble, Stephane ; Bunc, Matjaz ; Roberts, David ; Kass, Malek ; Gupta, Anuj ; Leon, Martin B. ; Dvir, Danny | Dokumentenart: | Artikel | ||||
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| Titel eines Journals oder einer Zeitschrift: | European Heart Journal | ||||
| Verlag: | Oxford Univ. Press | ||||
| Ort der Veröffentlichung: | OXFORD | ||||
| Band: | 41 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 29 | ||||
| Seitenbereich: | S. 2731-2742 | ||||
| Datum: | 2020 | ||||
| Institutionen: | Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
| Identifikationsnummer: |
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| Stichwörter / Keywords: | PROSTHESIS-PATIENT MISMATCH; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; REPLACEMENT; RECOMMENDATIONS; TAVR; Aortic valve-in-valve; Reintervention; Severe prosthesis-patient mismatch; SAPIEN valve | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 49788 |
Zusammenfassung
Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods and results A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 +/- 9.7 years; ...

Zusammenfassung
Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods and results A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 +/- 9.7 years; 58.8% mate; median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreVatve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloo-nexpandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n=435, 43.2%), and other devices (n =48, 4.8%). Survival was tower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) < 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P= 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. Conclusions: The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV. [GRAPHICS] .
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