
Item type: | Article | ||||
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Journal or Publication Title: | European Heart Journal | ||||
Publisher: | OXFORD UNIV PRESS | ||||
Place of Publication: | OXFORD | ||||
Volume: | 41 | ||||
Number of Issue or Book Chapter: | 29 | ||||
Page Range: | pp. 2731-2742 | ||||
Date: | 2020 | ||||
Institutions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
Identification Number: |
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Keywords: | PROSTHESIS-PATIENT MISMATCH; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; REPLACEMENT; RECOMMENDATIONS; TAVR; Aortic valve-in-valve; Reintervention; Severe prosthesis-patient mismatch; SAPIEN valve | ||||
Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
Status: | Published | ||||
Refereed: | Yes, this version has been refereed | ||||
Created at the University of Regensburg: | Yes | ||||
Item ID: | 49788 |
Abstract
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; ...

Abstract
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] .
Metadata last modified: 07 Apr 2022 09:07