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

Dvir, D; Webb, J; Brecker, S; Bleiziffer, S; Hildick-Smith, D; Colombo, A; Descoutures, F; Hengstenberg, C; Moat, NE; Bekeredjian, R; Napodano, M; Testa, L; Lefèvre, T; Guetta, V; Nissen, H; Hernández, JM; Roy, D; Teles, RC; Segev, A; Dumonteil, N; Fiorina, C; Gotzmann, M; Tchetche, D; Abdel-Wahab, M; De Marco, F; Baumbach, A; Laborde, JC; Kornowski, R

doi:10.1161/CIRCULATIONAHA.112.104505

journal article

Dokumenttyp:: Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't; Article
Autor(en):: Dvir, D; Webb, J; Brecker, S; Bleiziffer, S; Hildick-Smith, D; Colombo, A; Descoutures, F; Hengstenberg, C; Moat, NE; Bekeredjian, R; Napodano, M; Testa, L; Lefèvre, T; Guetta, V; Nissen, H; Hernández, JM; Roy, D; Teles, RC; Segev, A; Dumonteil, N; Fiorina, C; Gotzmann, M; Tchetche, D; Abdel-Wahab, M; De Marco, F; Baumbach, A; Laborde, JC; Kornowski, R
Titel:: Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry.
Abstract:: 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.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.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.
Zeitschriftentitel:: Circulation
Jahr:: 2012
Band / Volume:: 126
Heft / Issue:: 19
Seitenangaben Beitrag:: 2335-44
Sprache:: eng
Volltext / DOI:: doi:10.1161/CIRCULATIONAHA.112.104505
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/23052028
Print-ISSN:: 0009-7322
TUM Einrichtung:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2012