Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry.

Détails

ID Serval
serval:BIB_9E5146490475
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry.
Périodique
Circulation
Auteur(s)
Dvir D., Webb J., Brecker S., Bleiziffer S., Hildick-Smith D., Colombo A., Descoutures F., Hengstenberg C., Moat N.E., Bekeredjian R., Napodano M., Testa L., Lefevre T., Guetta V., Nissen H., Hernández J.M., Roy D., Teles R.C., Segev A., Dumonteil N., Fiorina C., Gotzmann M., Tchetche D., Abdel-Wahab M., De Marco F., Baumbach A., Laborde J.C., Kornowski R.
ISSN
1524-4539 (Electronic)
ISSN-L
0009-7322
Statut éditorial
Publié
Date de publication
2012
Peer-reviewed
Oui
Volume
126
Numéro
19
Pages
2335-2344
Langue
anglais
Notes
Publication types: Evaluation Studies ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND: Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry.
METHODS AND RESULTS: The Global Valve-in-Valve Registry included 202 patients with degenerated bioprosthetic valves (aged 77.7±10.4 years; 52.5% men) from 38 cardiac centers. Bioprosthesis mode of failure was stenosis (n=85; 42%), regurgitation (n=68; 34%), or combined stenosis and regurgitation (n=49; 24%). Implanted devices included CoreValve (n=124) and Edwards SAPIEN (n=78). Procedural success was achieved in 93.1% of cases. Adverse procedural outcomes included initial device malposition in 15.3% of cases and ostial coronary obstruction in 3.5%. After the procedure, valve maximum/mean gradients were 28.4±14.1/15.9±8.6 mm Hg, and 95% of patients had ≤+1 degree of aortic regurgitation. At 30-day follow-up, all-cause mortality was 8.4%, and 84.1% of patients were at New York Heart Association functional class I/II. One-year follow-up was obtained in 87 patients, with 85.8% survival of treated patients.
CONCLUSIONS: The valve-in-valve procedure is clinically effective in the vast majority of patients with degenerated bioprosthetic valves. Safety and efficacy concerns include device malposition, ostial coronary obstruction, and high gradients after the procedure.
Mots-clé
Aged, Aged, 80 and over, Aortic Valve/surgery, Aortic Valve Insufficiency/epidemiology, Aortic Valve Insufficiency/etiology, Aortic Valve Stenosis/epidemiology, Aortic Valve Stenosis/etiology, Bioprosthesis/adverse effects, Cardiac Catheterization/adverse effects, Cardiac Catheterization/methods, Equipment Failure/statistics & numerical data, Female, Follow-Up Studies, Heart Valve Prosthesis/adverse effects, Heart Valve Prosthesis Implantation/adverse effects, Heart Valve Prosthesis Implantation/methods, Humans, Incidence, Male, Registries, Reoperation, Retrospective Studies, Treatment Outcome, World Health/statistics & numerical data
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/03/2014 22:49
Dernière modification de la notice
20/08/2019 15:04
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