Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI

被引：2

作者：

Landes, Uri ^{[1
,2
]}

Morelli, Olga ^{[3
]}

Danenberg, Haim ^{[1
,2
]}

Sathananthan, Janarthanan ^{[4
]}

De Backer, Ole ^{[5
]}

Sondergaard, Lars ^{[5
]}

Abdel-Wahab, Mohamed ^{[6
]}

Yoon, Sung-Han ^{[7
]}

Makkar, Raj R. ^{[7
]}

Thiele, Holger ^{[6
]}

Kim, Won-Keun ^{[8
]}

Hamm, Christian ^{[8
]}

Guerrero, Mayra ^{[9
]}

Rodes-Cabau, Josep ^{[10
]}

Okuno, Taishi ^{[11
]}

Pilgrim, Thomas ^{[11
]}

Mangieri, Antonio ^{[12
,13
]}

Van Mieghem, Nicolas M. ^{[14
]}

Tchetche, Didier ^{[15
]}

Schoels, Wolfgang H. ^{[16
]}

Barbanti, Marco ^{[17
]}

Sinning, Jan-Malte ^{[18
]}

Ielasi, Alfonso ^{[19
]}

Tarantini, Giuseppe ^{[20
]}

De Marco, Federico ^{[21
]}

Finkelstein, Ariel ^{[22
]}

Sievert, Horst ^{[23
]}

Andreas, Martin ^{[24
]}

Latib, Azeem ^{[25
]}

Godfrey, Rebecca ^{[26
]}

Hildick-Smith, David ^{[27
]}

Manevich, Lisa ^{[1
,2
]}

Kornowski, Ran ^{[3
]}

Nazif, Tamim M. ^{[27
]}

Leon, Martin B. ^{[27
]}

Webb, John G. ^{[4
]}

机构：

[1] Edith Wolfson Med Ctr, Ha Lokhamim St 62, IL-5822012 Holon, Israel

[2] Tel Aviv Univ, Tel Aviv, Israel

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

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

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

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

[7] Cedars Sinai Med Ctr, Smidt Cedars Sinai Heart Inst, Los Angeles, CA USA

[8] Kerckhoff Heart Ctr, Bad Nauheim, Germany

[9] Mayo Clin, Rochester, MN USA

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

[11] Univ Hosp Bern, Bern, Switzerland

[12] Humanitas Univ, Invas Cardiol Humanitas Clin & Res Ctr, IRCCS, Milan, Italy

[13] Humanitas Univ, Dept Biomed Sci, Milan, Italy

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

[15] Clin Pasteur, Toulous, France

[16] Herzzentrum Duisburg, Duisburg, Germany

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

[18] Univ Hosp Bonn, Bonn, Germany

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

[20] Univ Hosp Padova, Padua, Italy

[21] IRCCS Policlin San Donato, Milan, Italy

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

[23] Cardiovasc Ctr, Frankfurt, Germany

[24] Med Univ Vienna, Dept Cardiac Surg, Vienna, Austria

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

[26] Brighton & Sussex Univ Hosp NHS Trust, Brighton, E Sussex, England

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

来源：

INTERNATIONAL JOURNAL OF CARDIOLOGY | 2022年 / 364卷

关键词：

TAVI; Para-valvular aortic regurgitation; Para-valvular leak; Redo-TAVI; Valve-in-valve; REPLACEMENT;

D O I：

10.1016/j.ijcard.2022.06.014

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Para-valvular regurgitation (PVR) after transcatheter aortic valve (TAV) implantation is associated with increased mortality. Redo-TAVI may be applied to treat PVR, yet with unknown efficacy. We thought to assess redo-TAVI efficacy in reducing PVR using the Redo-TAVI registry (45 centers; 600 TAV-in-TAV cases). Methods: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation. Results: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR = moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR = moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV. Conclusions: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.

引用

页码：31 / 34

页数：4

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