Matched Comparison of Self-Expanding Transcatheter Heart Valves for the Treatment of Failed Aortic Surgical Bioprosthesis Insights From the Valve-in-Valve International Data Registry (VIVID)

被引：30

作者：

Alnasser, Sami ^{[1
]}

Cheema, Asim N. ^{[1
]}

Simonato, Matheus ^{[2
]}

Barbanti, Marco ^{[3
]}

Edwards, Jeremy ^{[1
]}

Kornowski, Ran ^{[4
]}

Horlick, Eric ^{[5
]}

Wijeysundera, Harindra C. ^{[6
]}

Testa, Luca ^{[7
]}

Bedogni, Francesco ^{[7
]}

Amrane, Hafid ^{[8
]}

Walther, Thomas ^{[9
]}

Pelletier, Marc ^{[10
]}

Latib, Azeem ^{[11
]}

laborde, Jean-Claude ^{[12
]}

Hildick-Smith, David ^{[13
]}

Kim, Won-Keun ^{[9
]}

Tchetche, Didier ^{[14
]}

Agrifoglio, Marco ^{[15
]}

Sinning, Jan-Malte ^{[16
]}

van Boven, Ad J. ^{[8
]}

Kefer, Joelle ^{[17
]}

Frerker, Christian ^{[18
]}

van Mieghem, Nicolas M. ^{[19
]}

Linke, Axel ^{[20
]}

Worthley, Stephen ^{[21
]}

Asgar, Anita ^{[22
]}

Sgroi, Carmelo ^{[3
]}

Aziz, Mina ^{[2
]}

Danenberg, Haim D. ^{[23
]}

Labinaz, Marino ^{[24
]}

Manoharan, Ganesh ^{[25
]}

Cheung, Anson ^{[2
]}

Webb, John G. ^{[2
]}

Dvir, Danny ^{[2
]}

机构：

[1] St Michaels Hosp, 30 Bond St, Toronto, ON M5B 1W8, Canada

[2] St Pauls Hosp, 1081 Burrard St, Vancouver, BC V6Z 1Y6, Canada

[3] Univ Catania, Ferrarotto Hosp, Catania, Italy

[4] Rabin Med Ctr, Tel Aviv, Israel

[5] Peter Munk Cardiac Ctr, Toronto, ON, Canada

[6] Sunnybrook Hlth Sci Ctr, Div Cardiol, Schulich Heart Ctr, Toronto, ON, Canada

[7] IRCCS Pol S Donato, Dept Cardiol, Milan, Italy

[8] Med Ctr Leeuwarden, Leeuwarden, Netherlands

[9] Kerckhoff Klin Bad Nauheim, Bad Nauheim, Germany

[10] New Brunswick Heart Ctr, St John, NB, Canada

[11] Ist Sci San Raffaele, Milan, Italy

[12] St George Hosp, London, England

[13] Sussex Cardiac Ctr, Brighton, E Sussex, England

[14] Clin Pasteur, Toulouse, France

[15] Ctr Cardiol Monzino, Milan, Italy

[16] Univ Hosp Bonn, Heart Ctr, Bonn, Germany

[17] Clin Univ St Luc, Brussels, Belgium

[18] Asklepios Klin St Georg Hosp, Hamburg, Germany

[19] Erasmus Univ, Med Ctr, Rotterdam, Netherlands

[20] Univ Leipzig, Heart Ctr, Leipzig, Germany

[21] Royal Adelaide Hosp, Adelaide, SA, Australia

[22] Montreal Heart Inst, Montreal, PQ, Canada

[23] Hadassah Hebrew Univ Med Ctr, Jerusalem, Israel

[24] Ottawa Heart Inst, Ottawa, ON, Canada

[25] Royal Victoria Hosp, Belfast, Antrim, North Ireland

来源：

CIRCULATION-CARDIOVASCULAR INTERVENTIONS | 2017年 / 10卷 / 04期

关键词：

aortic valve; bioprosthesis; hemodynamic; transcatheter aortic valve replacement; JUDE MEDICAL PORTICO; IMPLANTATION; REPLACEMENT; COREVALVE; BALLOON; SAFETY; LEAK;

D O I：

10.1161/CIRCINTERVENTIONS.116.004392

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-Transcatheter valve-in-valve implantation is an established therapy for high-risk patients with failed surgical aortic bioprosthesis. There are limited data comparing outcomes of valve-in-valve implantation using different transcatheter heart valves (THV). Methods and Results-Patients included in the Valve-in-Valve International Data registry (VIVID) and treated with self-expanding THV devices were analyzed using centralized core laboratory blinded to clinical events. St. Jude Medical Portico versus Medtronic CoreValve were compared in a 1: 2 fashion after propensity score matching. A total of 162 patients, Portico- (n=54) and CoreValve-(n=108) based valve-in-valve procedures comprised the study population with no significant difference in baseline characteristics (age, 79 +/- 8.2 years; 60% women; mean STS [Society of Thoracic Surgery] score 8.1 +/- 5.5%). Postimplantation, CoreValve was associated with a larger effective orifice area (1.67 versus 1.31 cm(2); P=0.001), lower mean gradient (14 +/- 7.5 versus 17 +/- 7.5 mm Hg; P=0.02), and lower core laboratory-adjudicated moderate-to-severe aortic insufficiency (4.2% versus 13.7%; P=0.04), compared with Portico. Procedural complications including THV malpositioning, second THV requirement, or coronary obstruction were not significantly different between the 2 groups. Survival and stroke rates at 30 days were similar, but overall mortality at 1 year was higher among patients treated with Portico compared with CoreValve (22.6% versus 9.1%; P=0.03). Conclusions-In this first matched comparison of THVs for valve-in-valve implantations, Portico and CoreValve demonstrated differences in postprocedural hemodynamics and long-term clinical outcomes. Although this could be related to THV design characteristics, the impact of other procedural factors cannot be excluded and require further evaluation.

引用

页数：7

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