TY - JOUR
T1 - Outcomes in Valve-in-Valve Transcatheter Aortic Valve Implantation
AU - van Nieuwkerk, Astrid C.
AU - Santos, Raquel B.
AU - Fernandez-Nofrerias, Eduard
AU - Tchétché, Didier
AU - de Brito, Fabio S.
AU - Barbanti, Marco
AU - Kornowski, Ran
AU - Latib, Azeem
AU - D'Onofrio, Augusto
AU - Ribichini, Flavio
AU - Mainar, Vicente
AU - Dumonteil, Nicolas
AU - Baan, Jan
AU - Abizaid, Alexandre
AU - Sartori, Samantha
AU - D'Errigo, Paola
AU - Tarantini, Giuseppe
AU - Lunardi, Mattia
AU - Orvin, Katia
AU - Pagnesi, Matteo
AU - Larraya, Garikoitz Lasa
AU - Ghattas, Angie
AU - Dangas, George
AU - Mehran, Roxana
AU - Delewi, R.
N1 - Funding Information: We acknowledge the support from the Netherlands CardioVascular Research Initiative: the Dutch Heart Foundation (CVON 2018-28 and 2012-06 Heart-Brain Connection), Den Haag; Dutch Federation of University Medical Centres, Utrecht; the Netherlands Organisation for Health Research and Development, Den Haag; and the Royal Netherlands Academy of Sciences, Amsterdam, the Netherlands. Funding Information: Dr. de Brito Jr is a proctor for Edwards Lifesciences and Medtronic. Dr. Barbanti is a consultant for Edwards Lifesciences and Boston Scientific. Dr. Latib is a consultant for Medtronic and has received honoraria from Abbott Vascular. Dr. Baan receives an unrestricted research grant from Edwards Lifesciences. The remaining authors have no conflicts of interest to declare. Publisher Copyright: © 2022 The Author(s)
PY - 2022/6/1
Y1 - 2022/6/1
N2 - The use of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasing, but studies evaluating clinical outcomes in these patients are scarce. Also, there are limited data to guide the choice of valve type in ViV-TAVI. Therefore, this CENTER-study evaluated clinical outcomes in patients with ViV-TAVI compared to patients with native valve TAVI (NV-TAVI). In addition, we compared outcomes in patients with ViV-TAVI treated with self-expandable versus balloon-expandable valves. A total of 256 patients with ViV-TAVI and 11333 patients with NV-TAVI were matched 1:2 using propensity score matching, resulting in 256 patients with ViV-TAVI and 512 patients with NV-TAVI. Mean age was 81±7 years, 58% were female, and the Society of Thoracic Surgeons Predicted Risk of Mortality was 6.3% (4.0% to 12.8%). Mortality rates were comparable between ViV-TAVI and NV-TAVI patients at 30 days (4.1% vs 5.9%, p = 0.30) and 1 year (14.2% vs 17.3%, p = 0.34). Stroke rates were also similar at 30 days (2.8% vs 1.8%, p = 0.38) and 1 year (4.9% vs 4.3%, p = 0.74). Permanent pacemakers were less frequently implanted in patients with ViV-TAVI (8.8% vs 15.0%, relative risk 0.59, 95% confidence interval [CI] 0.37 to 0.92, p = 0.02). Patients with ViV-TAVI were treated with self-expandable valves (n = 162) and balloon-expandable valves (n = 94). Thirty-day major bleeding was less frequent in patients with self-expandable valves (3% vs 13%, odds ratio 5.12, 95% CI 1.42 to 18.52, p = 0.01). Thirty-day mortality was numerically lower in patients with self-expandable valves (3% vs 7%, odds ratio 3.35, 95% CI 0.77 to 14.51, p = 0.11). In conclusion, ViV-TAVI seems a safe and effective treatment for failing bioprosthetic valves with low mortality and stroke rates comparable to NV-TAVI for both valve types.
AB - The use of valve-in-valve transcatheter aortic valve implantation (ViV-TAVI) is increasing, but studies evaluating clinical outcomes in these patients are scarce. Also, there are limited data to guide the choice of valve type in ViV-TAVI. Therefore, this CENTER-study evaluated clinical outcomes in patients with ViV-TAVI compared to patients with native valve TAVI (NV-TAVI). In addition, we compared outcomes in patients with ViV-TAVI treated with self-expandable versus balloon-expandable valves. A total of 256 patients with ViV-TAVI and 11333 patients with NV-TAVI were matched 1:2 using propensity score matching, resulting in 256 patients with ViV-TAVI and 512 patients with NV-TAVI. Mean age was 81±7 years, 58% were female, and the Society of Thoracic Surgeons Predicted Risk of Mortality was 6.3% (4.0% to 12.8%). Mortality rates were comparable between ViV-TAVI and NV-TAVI patients at 30 days (4.1% vs 5.9%, p = 0.30) and 1 year (14.2% vs 17.3%, p = 0.34). Stroke rates were also similar at 30 days (2.8% vs 1.8%, p = 0.38) and 1 year (4.9% vs 4.3%, p = 0.74). Permanent pacemakers were less frequently implanted in patients with ViV-TAVI (8.8% vs 15.0%, relative risk 0.59, 95% confidence interval [CI] 0.37 to 0.92, p = 0.02). Patients with ViV-TAVI were treated with self-expandable valves (n = 162) and balloon-expandable valves (n = 94). Thirty-day major bleeding was less frequent in patients with self-expandable valves (3% vs 13%, odds ratio 5.12, 95% CI 1.42 to 18.52, p = 0.01). Thirty-day mortality was numerically lower in patients with self-expandable valves (3% vs 7%, odds ratio 3.35, 95% CI 0.77 to 14.51, p = 0.11). In conclusion, ViV-TAVI seems a safe and effective treatment for failing bioprosthetic valves with low mortality and stroke rates comparable to NV-TAVI for both valve types.
UR - http://www.scopus.com/inward/record.url?scp=85127860316&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.amjcard.2022.02.028
DO - https://doi.org/10.1016/j.amjcard.2022.02.028
M3 - Article
C2 - 35351288
SN - 0002-9149
VL - 172
SP - 81
EP - 89
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -