Bicuspid Aortic Valve Stenosis Favorable Early Outcomes With a Next-Generation Transcatheter Heart Valve in a Multicenter Study

被引:141
作者
Perlman, Gidon Y. [1 ]
Blanke, Philipp [1 ]
Dvir, Danny [1 ]
Pache, Gregor [2 ,3 ]
Modine, Thomas [4 ]
Barbanti, Marco [5 ]
Holy, Erik W. [6 ]
Treede, Hendrik [7 ]
Ruile, Philipp [2 ,3 ]
Neumann, Franz-Josef [2 ,3 ]
Gandolfo, Caterina [8 ]
Saia, Francesco [9 ]
Tamburino, Corrado [5 ]
Mak, George [1 ]
Thompson, Christopher [1 ]
Wood, David [1 ]
Leipsic, Jonathon [1 ]
Webb, John G. [1 ]
机构
[1] St Pauls Hosp, Dept Cardiol, Vancouver, BC V6Z 1Y6, Canada
[2] Univ Heart Ctr Freiburg Bad Krozingen, Dept Radiol, Bad Krozingen, Germany
[3] Univ Heart Ctr Freiburg Bad Krozingen, Dept Cardiol, Bad Krozingen, Germany
[4] Hop Cardiol, Dept Cardiovasc Surg, Blvd Prof J Leclercq, F-59037 Lille, France
[5] Univ Catania, Ferrarotto Hosp, Dept Cardiol, Catania, Italy
[6] Univ Zurich Hosp, Univ Heart Ctr, Cardiol, CH-8091 Zurich, Switzerland
[7] Univ Heart Ctr, Dept Cardiovasc Surg, Hamburg, Germany
[8] Osped Civ, Palermo, Italy
[9] Univ Bologna, Inst Cardiol, Policlin St Orsola Malpighi, Cardiovasc Dept, Bologna, Italy
关键词
aortic stenosis; bicuspid; transcatheter aortic valve replacement; SAPIEN; 3; VALVE; IMPLANTATION; REPLACEMENT; REGURGITATION; REGISTRY; DISEASE; EXPERIENCE; FORCE; TERM; XT;
D O I
10.1016/j.jcin.2016.01.002
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES This study evaluated the results of transcatheter aortic valve replacement (TAVR) in bicuspid aortic stenosis (AS) using a new-generation TAVR device. BACKGROUND A bicuspid AS is often considered a relative contraindication to TAVR. Although initial reports have demonstrated feasibility using early-generation devices, outcomes have not matched those seen with tricuspid AS. Paravalvular aortic regurgitation (AR) has been particularly problematic. METHODS We collected baseline characteristics, procedural data, and 30-day clinical follow-up findings from 8 centers in Europe and Canada that had performed TAVR in bicuspid AS using the SAPIEN 3 valve. RESULTS 51 patients underwent TAVR using the SAPIEN 3 valve. Patient mean age was 76.2 +/- 9.3 years and the Society of Thoracic Surgeons predicted risk of mortality scores were 5.2 +/- 3.7%. Bicuspid valve types were: type 0, 11.8%; type 1, 82.3%; and type 2, 1.9%. There were no cases of valve embolization or need for a second valve. Post-dilation was performed in 7.8%. The mean aortic gradient decreased from 49.4 +/- 16.0 mm Hg to 11.2 +/- 4.7 mm Hg. Post-implantation AR was none/trivial in 63% and mild in 37%. There were no cases of moderate or severe AR. At 30-day follow-up, there were 2 deaths (3.9%), 2 major vascular complications, and 12 patients (23.5%) required pacemaker implantation. CONCLUSIONS TAVR in bicuspid AS using a new-generation device was feasible and effective with favorable valve performance and no cases of moderate or severe AR. (C) 2016 by the American College of Cardiology Foundation.
引用
收藏
页码:817 / 824
页数:8
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