Transcatheter Replacement of Transcatheter Versus Surgically Implanted Aortic Valve Bioprostheses

被引：71

作者：

Landes, Uri ^{[1
,2
]}

Sathananthan, Janarthanan ^{[1
]}

Witberg, Guy ^{[2
]}

De Backer, Ole ^{[3
]}

Sondergaard, Lars ^{[3
]}

Abdel-Wahab, Mohamed ^{[4
]}

Holzhey, David ^{[4
]}

Kim, Won-Keun ^{[5
]}

Hamm, Christian ^{[5
]}

Buzzatti, Nicola ^{[6
]}

Montorfano, Matteo ^{[6
]}

Ludwig, Sebastian ^{[7
]}

Conradi, Lenard ^{[7
]}

Seiffert, Moritz ^{[7
]}

Guerrero, Mayra ^{[8
]}

El Sabbagh, Abdallah ^{[8
]}

Rodes-Cabau, Josep ^{[9
]}

Guimaraes, Leonardo ^{[9
]}

Codner, Pablo ^{[2
]}

Okuno, Taishi ^{[10
,11
]}

Pilgrim, Thomas ^{[10
]}

Fiorina, Claudia ^{[12
]}

Colombo, Antonio ^{[13
]}

Mangieri, Antonio ^{[13
]}

Eltchaninoff, Helene ^{[13
]}

Nombela-Franco, Luis ^{[14
,15
]}

Van Wiechen, Maarten P. H. ^{[16
]}

Van Mieghem, Nicolas M. ^{[16
]}

Tchetche, Didier ^{[17
]}

Schoels, Wolfgang H. ^{[17
]}

Kullmer, Matthias ^{[18
]}

Tamburino, Corrado ^{[19
]}

Sinning, Jan-Malte ^{[20
]}

Al-Kassou, Baravan ^{[20
]}

Perlman, Gidon Y. ^{[20
]}

Danenberg, Haim ^{[22
]}

Ielasi, Alfonso ^{[22
]}

Fraccaro, Chiara ^{[23
]}

Tarantini, Giuseppe ^{[21
,23
]}

De Marco, Federico ^{[24
]}

Redwood, Simon R. ^{[25
]}

Lisko, John C. ^{[26
]}

Babaliaros, Vasilis C. ^{[26
]}

Laine, Mika ^{[27
]}

Nerla, Roberto ^{[1
,28
]}

Castriota, Fausto ^{[1
,28
]}

Finkelstein, Ariel ^{[2
,29
]}

Loewenstein, Itamar ^{[2
,29
]}

Eitan, Amnon ^{[3
,30
]}

Jaffe, Ronen ^{[3
,30
]}

机构：

[1] St Pauls & Vancouver Gen Hosp, Ctr Heart Valve & Cardiovasc Innovat, Vancouver, BC, Canada

[2] Tel Aviv Univ, Rabin Med Ctr, Tel Aviv, Israel

[3] Copenhagen Univ Hosp, Rigshosp, Copenhagen, Denmark

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

[5] Kerckhoff Heart Ctr, Bad Nauheim, Germany

[6] Ist Sci San Raffaele, Milan, Italy

[7] Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany

[8] Mayo Clin, Rochester, MN USA

[9] Laval Univ, Quebec Heart & Lung Inst, Quebec City, PQ, Canada

[10] Univ Hosp Bern, Bern, Switzerland

[11] Spedali Civili Brescia, Brescia, Italy

[12] Maria Cecilia Hosp, Cotignola, Ravenna, Italy

[13] Normandie Univ, Rouen Univ Hosp, UNIROUEN, INSERM U1096, Rouen, France

[14] Hosp Clin San Carlos, Cardiovasc Inst, Madrid, Spain

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

[16] Clin Pasteur, Toulouse, France

[17] Herzzentrum Duisburg, Duisburg, Germany

[18] Univ Catania, AOU Policlin Vittorio Emanuele, Catania, Italy

[19] Univ Hosp Bonn, Bonn, Germany

[20] Hadassah Med Ctr, Jerusalem, Israel

[21] S Ambrogio Cardio Thorac Ctr, Milan, Italy

[22] Univ Hosp Padova, Padua, Italy

[23] IRCCS Policlin San Donato, Milan, Italy

[24] St Thomas Hosp Campus, London, England

[25] Emory Univ Hosp, Atlanta, GA USA

[26] Helsinki Univ Cent Hosp, Helsinki, Finland

[27] Humanitas Gavazzeni, Bergamo, Italy

[28] Tel Aviv Med Ctr & Sch Med, Tel Aviv, Israel

[29] Carmel Hosp, Haifa, Israel

[30] Univ Heart Ctr Freiburg Bad Krozingen, Bad Krozingen, Germany

[31] McGill Univ, Hlth Ctr, Montreal, PQ, Canada

[32] Cardiovasc Ctr, Frankfurt, Germany

[33] Med Univ Vienna, Vienna, Austria

[34] Univ Med Ctr, Ljubljana, Slovenia

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

[36] NHS Trust, Brighton Sussex Univ Hosp, Brighton, E Sussex, England

[37] Columbia Univ, Med Ctr, New York, NY USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2021年 / 77卷 / 01期

关键词：

Redo-TAVR; surgical aortic valve; TAVR; transcatheter aortic valve; valve-in-valve; OUTCOMES; DURABILITY;

D O I：

10.1016/j.jacc.2020.10.053

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Surgical aortic valve replacement and transcatheter aortic valve replacement (TAVR) are now both used to treat aortic stenosis in patients in whom life expectancy may exceed valve durability. The choice of initial bioprosthesis should therefore consider the relative safety and efficacy of potential subsequent interventions. OBJECTIVES The aim of this study was to compare TAVR in failed transcatheter aortic valves (TAVs) versus surgical aortic valves (SAVs). METHODS Data were collected on 434 TAV-in-TAV and 624 TAV-in-SAV consecutive procedures performed at centers participating in the Redo-TAVR international registry. Propensity score matching was applied, and 330 matched (165:165) patients were analyzed. Principal endpoints were procedural success, procedural safety, and mortality at 30 days and 1 year. RESULTS For TAV-in-TAV versus TAV-in-SAV, procedural success was observed in 120 (72.7%) versus 103 (62.4%) patients (p = 0.045), driven by a numerically lower frequency of residual high valve gradient (p = 0.095), ectopic valve deployment (p = 0.081), coronary obstruction (p = 0.091), and conversion to open heart surgery (p = 0.082). Procedural safety was achieved in 116 (70.3%) versus 119 (72.1%) patients (p = 0.715). Mortality at 30 days was 5 (3%) after TAV-in-TAV and 7 (4.4%) after TAV-in-SAV (p = 0.570). At 1 year, mortality was 12 (11.9%) and 10 (10.2%), respectively (p = 0.633). Aortic valve area was larger (1.55 +/- 0.5 cm(2) vs. 1.37 +/- 0.5 cm(2); p = 0.040), and the mean residual gradient was lower (12.6 +/- 5.2 mm Hg vs. 14.9 +/- 5.2 mm Hg; p = 0.011) after TAV-in-TAV. The rate of moderate or greater residual aortic regurgitation was similar, but mild aortic regurgitation was more frequent after TAV-in-TAV (p = 0.003). CONCLUSIONS In propensity score-matched cohorts of TAV-in-TAV versus TAV-in-SAV patients, TAV-in-TAV was associated with higher procedural success and similar procedural safety or mortality. (C) 2021 by the American College of Cardiology Foundation.

引用

页码：1 / 14

页数：14

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