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Titel:

Usefulness of Transcatheter Aortic Valve Implantation for Treatment of Pure Native Aortic Valve Regurgitation.

Dokumenttyp:
Journal Article; Article
Autor(en):
De Backer, Ole; Pilgrim, Thomas; Simonato, Matheus; Mackensen, G Burkhard; Fiorina, Claudia; Veulemanns, Verena; Cerillo, Alfredo; Schofer, Joachim; Amabile, Nicolas; Achkouty, Guy; Schäfer, Ulrich; Deutsch, Marcus-André; Sinning, Jan-Malte; Rahman, Mohammed S; Sawaya, Fadi J; Hildick-Smith, David; Hernandez, Jose Maria; Kim, Won-Keun; Lefèvre, Thierry; Seiffert, Moritz; Bleiziffer, Sabine; Petronio, Anna Sonia; Van Mieghem, Nicolas; Taramasso, Maurizio; Søndergaard, Lars; Windecker, Stephan; La...     »
Abstract:
Patients with pure native aortic valve regurgitation (NAVR) and increased surgical risk are often denied surgery. This retrospective study aimed to evaluate the "off-label" use of transcatheter heart valves (THV) for the treatment of NAVR. A total of 254 high surgical risk patients with NAVR (age 74 ± 12 years, Society of Thoracic Surgeons risk score 6.6 ± 6.2%) underwent transcatheter aortic valve implantation (TAVI) with early generation (43%) or newer generation (57%) devices at 46 different sites. Device success was significantly higher in patients treated with newer as compared with early generation THV (82% vs 47%, p <0.001). The difference was driven by lower rates of device malpositioning (9% vs 33%) and aortic regurgitation (AR) >= moderate (4% vs 31%) and translated into higher clinical efficacy at 30 days in patients treated with newer as compared with early generation THV (72% vs 56%, p = 0.041). Both THV under- and oversizing were associated with an increased risk of THV malpositioning. In conclusion, TAVI is a feasible treatment strategy in selected high-risk patients with NAVR but is associated with a considerable risk of THV malpositioning and residual AR. Although newer-generation THV are associated with better outcomes, novel devices for the treatment of NAVR are warranted.
Zeitschriftentitel:
Am J Cardiol
Jahr:
2018
Band / Volume:
122
Heft / Issue:
6
Seitenangaben Beitrag:
1028-1035
Sprache:
eng
Volltext / DOI:
doi:10.1016/j.amjcard.2018.05.044
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/30072124
Print-ISSN:
0002-9149
TUM Einrichtung:
Klinik für Herz- und Gefäßchirurgie (Prof. Lange)
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