Balloon-Expandable vs Self-Expanding Valves for Transcatheter Treatment of Sievers Type 1 Bicuspid Aortic Stenosis

被引：5

作者：

Buono, Andrea ^{[1
]}

Zito, Andrea ^{[2
]}

Kim, Won-Keun ^{[3
,4
]}

Fabris, Tommaso ^{[5
]}

De Biase, Chiara ^{[6
]}

Bellamoli, Michele ^{[1
]}

Montarello, Nicholas ^{[7
]}

Costa, Giuliano ^{[8
,18
]}

Alfadhel, Mesfer ^{[9
]}

Koren, Ofir ^{[10
]}

Fezzi, Simone ^{[11
]}

Bellini, Barbara ^{[12
,13
]}

Massussi, Mauro ^{[14
]}

Scotti, Andrea ^{[15
]}

Bai, Lin ^{[16
]}

Costa, Giulia ^{[17
]}

Mazzapicchi, Alessandro ^{[19
]}

Giacomin, Enrico ^{[20
]}

Gorla, Riccardo ^{[21
]}

Hug, Karsten ^{[22
]}

Briguori, Carlo ^{[23
]}

Bettari, Luca ^{[1
]}

Messina, Antonio ^{[1
]}

Boiago, Mauro

Villa, Emmanuel ^{[1
]}

Renker, Matthias

Gomez, Mario Garcia ^{[24
]}

Fraccaro, Chiara

Rosa, Maria Luisa De ^{[1
]}

Patel, Vivek

Trani, Carlo

De Carlo, Marco

Laterra, Giulia ^{[25
]}

Latini, Alessia

Pellegrini, Dario ^{[27
,28
]}

Ielasi, Alfonso ^{[26
,27
,28
]}

Orbach, Ady ^{[29
]}

Landes, Uri ^{[29
]}

Rheude, Tobias ^{[22
]}

Testa, Luca

Santos, Ignacio Amat

Mangieri, Antonio

Saia, Francesco

Favero, Luca

Chen, Mao

Adamo, Marianna

Latib, Azeem

Petronio, Anna Sonia

Montorfano, Matteo ^{[30
,31
]}

Makkar, Raj R.

机构：

[1] Fdn Poliambulanza Ist Osped, Valve Ctr, Brescia, Italy

[2] Univ Cattolica Sacro Cuore, Dept Cardiovasc & Pul monary Sci, Rome, Italy

[3] Kerckhoff Heart Ctr, Bad Nauheim, Germany

[4] Justus Liebig Univ Giessen, Dept Cardiol & Angiol, Med Clin 1, Giessen, Germany

[5] Univ Padua, Med Sch, Dept Cardiac Thorac & Vasc Sci & Publ Hlth, Padua, Italy

[6] Clin Pasteur, Grp Cardiovasc Intervent, Toulouse, France

[7] Copenhagen Univ Hosp, Rigshospitalet, Heart Ctr, Copenhagen, Denmark

[8] Univ Catania, AOU Policlin.Emanuele 5, Ctr Alte Special & Trapianti, POG Rodol,UOC Cardiol, Catania, Italy

[9] Leeds Teaching Hosp NHS Trust, Dept Cardiol, Leeds, England

[10] Cedars Sinai Med Ctr, Smidt Heart Inst, Dept Cardiol, Los Angeles, CA USA

[11] Univ Hosp Galway, Dept Cardiol, Galway, Ireland

[12] IRCCS San Raffaele Sci Inst, Intervent Cardiol Unit, Milan, Italy

[13] Civil Hosp Brescia, Brescia, Italy

[14] Univ Brescia, Brescia, Italy

[15] Montefiore Med Ctr, New York, NY USA

[16] Sichuan Univ, West China Hosp, Dept Cardiol, Chengdu, Peoples R China

[17] Univ Pisa, Cardiac Catheterizat Lab, Pisa, Italy

[18] Azienda Osped Univ Pisana, Pisa, Italy

[19] Univ Bologna, IRCCS Azienda Osped, Cardiol Unit, Cardiac Thorac & Vasc Dept, Bologna, Italy

[20] Ca Foncello Hosp Azienda, Marca Trevigiana N2, Cardiol Unit, Cardioneurovasc Dept, Treviso, Italy

[21] IRCCS Policlin San Donato, Dept Cardiol, Milan, San Donato Mila, Italy

[22] Tech Univ Munich, Dept Cardiovasc Dis, German Heart Ctr Munich, Munich, Germany

[23] Intervent Cardiol Unit, Mediterranea Cardioctr, Naples, Italy

[24] Hosp Clin Univ Valladolid, CIBERCV, Div Cardiol, Valladolid, Spain

[25] Univ Enna Kore, Enna, Italy

[26] IRCCS Humanitas Res Hosp, Cardio Ctr, Milan, Italy

[27] Edith Wolfson Med Ctr, Cardiol Dept, Holon, Israel

[28] Tel Aviv Univ, Tel Aviv, Israel

[29] IRCCS, Hosp Galeazzi St Ambrogio, Div Cardiol, Milan, Italy

[30] Univ Vita Salute San Raffaele, Sch Med, Milan, Italy

[31] IRCCS San Raffaele Sci Inst, Intervent Cardiol Unit, Milan, Italy

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2024年 / 17卷 / 22期

关键词：

balloon expandable; bicuspid aortic valve; raphe; self-expanding; transcatheter aortic valve replacement; OUTCOMES; REPLACEMENT; CLASSIFICATION;

D O I：

10.1016/j.jcin.2024.07.031

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) have different features that may impact the outcomes of patients with Sievers type 1 bicuspid aortic valve (BAV) stenosis undergoing transcatheter aortic valve replacement. OBJECTIVES This study sought to compare procedural and clinical outcomes of BEVs and SEVs in Sievers type 1 BAV stenosis. METHODS AD-HOC (Characteristics, Sizing, and Outcomes of Stenotic Raphe-Type Bicuspid Aortic Valves Treated With Transcatheter Device Implantation) is an observational registry enrolling patients with Sievers type 1 BAV stenosis undergoing transcatheter aortic valve replacement with current-generation BEVs and SEVs at 24 international centers. A 1:1 propensity score matching analysis was performed to adjust for baseline imbalances. The primary endpoint was midterm major adverse events, defined as a composite of all-cause death, neurologic events, or hospitalization for heart failure. RESULTS Among 955 eligible patients, propensity score matching resulted in 301 pairs. At a median follow-up of 1.3 years, BEVs and SEVs had a similar risk of major adverse events (BEV vs SEV: HR: 0.75; 95% CI: 0.49-1.16; P = 0.200). Technical success was similar (OR: 1.38; 95% CI: 0.63-3.04; P = 0.421). At 30 days, BEVs were associated with a lower risk of new permanent pacemaker implantation (OR: 0.42; 95% CI: 0.24-0.72; P = 0.002) and moderate or greater paravalvular regurgitation (OR: 0.16; 95% CI: 0.05-0.48; P = 0.001) but a higher risk of severe patient-prosthesis mismatch (OR: 3.03; 95% CI 1.02-8.95; P = 0.045). CONCLUSIONS Current-generation BEVs and SEVs proved similar technical success and midterm clinical efficacy in Sievers type 1 BAV stenosis. Compared to SEVs, BEVs were associated with less permanent pacemaker implantation and moderate or greater paravalvular regurgitation but with more severe patient-prosthesis mismatch. (JACC Cardiovasc Interv. 2024;17:2596-2608) (c) 2024 by the American College of Cardiology Foundation.

引用

页码：2596 / 2608

页数：13

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