Benutzer: Gast  Login
Mehr Felder
Einfache Suche
Titel:

Safety and efficacy of minimalist transcatheter aortic valve implantation using a new-generation balloon-expandable transcatheter heart valve in bicuspid and tricuspid aortic valves.

Dokumenttyp:
Article; Journal Article
Autor(en):
Michel, Jonathan M; Frangieh, Antonio H; Giacoppo, Daniele; Alvarez-Covarrubias, Hector A; Pellegrini, Costanza; Rheude, Tobias; Deutsch, Oliver; Mayr, N Patrick; Rumpf, P Moritz; Stähli, Barbara E; Kastrati, Adnan; Schunkert, Heribert; Xhepa, Erion; Joner, Michael; Kasel, A Markus
Abstract:
BACKGROUND: Bicuspid aortic valve may be associated with increased complications during transcatheter aortic valve implantation (TAVI). AIMS: Compare balloon-expandable transcatheter heart valve (THV) safety and efficacy in severe tricuspid (TAV) and bicuspid (BAV) aortic stenosis. METHODS: Transfemoral TAVI was performed in 743 patients (Jan 2014-June 2019) using the SAPIEN 3 THV. Aortic valve morphology was determined using computed tomography. Valve Academic Research Consortium-2 (VARC-2) derived safety and efficacy endpoints at 1 year were evaluated. RESULTS: BAV patients (n = 78), were younger (77 [72, 81] vs. 81 [78, 85] years, p < 0.001) with lower surgical risk (EuroSCORE II 2.96% vs. 4.51% p < 0.001). Bicuspid valves were more calcified (BAV 1308mm3, TAV 848mm3 p < 0.001) with more asymmetric calcification (BAV 63/78 (81%), TAV 239/665 (36%), p < 0.001). Device success (BAV 94%, TAV 90%, p = 0.45) and major vascular complications (BAV 6%, TAV 9%, p = 0.66) were comparable. At 1 year, there was a trend toward lower combined all-cause mortality and rehospitalization for congestive heart failure in BAV patients (BAV 7%, TAV 13%, p = 0.08) with significantly lower all-cause mortality in this cohort (BAV 1%, TAV 9%, p = 0.020). VARC-2 time-related valve safety (BAV 22%, TAV 20%, p = 0.60) was comparable; however, bioprosthetic valve thrombosis remained more common in BAV patients (BAV 7%, TAV 2%, p = 0.010, Hazard ratio 3.57 [95% confidence interval 1.26, 10.10]). After propensity score matching, only bioprosthetic valve thrombosis remained significantly different. CONCLUSIONS: Safety and efficacy of the SAPIEN 3 balloon-expandable THV in BAV is comparable with TAV. Higher rates of bioprosthetic valve thrombosis require further investigation.
Zeitschriftentitel:
Clin Res Cardiol
Jahr:
2021
Band / Volume:
110
Heft / Issue:
12
Seitenangaben Beitrag:
1993-2006
Volltext / DOI:
doi:10.1007/s00392-021-01935-7
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/34505192
Print-ISSN:
1861-0684
TUM Einrichtung:
Fachgebiet Kardioanästhesie (Prof. Tassani-Prell); Klinik für Herz- und Gefäßchirurgie (Prof. Lange); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
 BibTeX