Journal article
Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction.
- Landes U Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada; Rabin Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
- Webb JG Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada. Electronic address: johngraydonwebb@gmail.com.
- De Backer O Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
- Sondergaard L Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
- Abdel-Wahab M Herzzentrum Leipzig, Leipzig, Germany.
- Crusius L Herzzentrum Leipzig, Leipzig, Germany.
- Kim WK Kerckhoff Heart Center, Bad Nauheim, Germany.
- Hamm C Kerckhoff Heart Center, Bad Nauheim, Germany.
- Buzzatti N San Raffaele Scientific Institute, Milan, Italy.
- Montorfano M San Raffaele Scientific Institute, Milan, Italy.
- Ludwig S University Heart Center Hamburg, Hamburg, Germany.
- Schofer N University Heart Center Hamburg, Hamburg, Germany.
- Voigtlaender L University Heart Center Hamburg, Hamburg, Germany.
- Guerrero M Mayo Clinic, Rochester, Minnesota.
- El Sabbagh A Mayo Clinic, Rochester, Minnesota.
- Rodés-Cabau J Quebec Heart and Lung Institute, Quebec, Quebec, Canada.
- Guimaraes L Quebec Heart and Lung Institute, Quebec, Quebec, Canada.
- Kornowski R Rabin Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
- Codner P Rabin Medical Center, Tel-Aviv University, Tel-Aviv, Israel.
- Okuno T University Hospital of Bern, Bern, Switzerland.
- Pilgrim T University Hospital of Bern, Bern, Switzerland.
- Fiorina C Spedali Civili Brescia, Brescia, Italy.
- Colombo A Maria Cecilia Hospital, Cotignola, Ravenna, Italy.
- Mangieri A Maria Cecilia Hospital, Cotignola, Ravenna, Italy.
- Eltchaninoff H Normandie Univ, UNIROUEN, INSERM U1096, Rouen University Hospital, Department of Cardiology, FHU REMOD-VHF, F76000, Rouen, France.
- Nombela-Franco L Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
- Van Wiechen MPH Erasmus University Medical Center, Rotterdam, the Netherlands.
- Van Mieghem NM Erasmus University Medical Center, Rotterdam, the Netherlands.
- Tchétché D Clinique Pasteur, Toulouse, France.
- Schoels WH Herzzentrum Duisburg, Duisburg, Germany.
- Kullmer M Herzzentrum Duisburg, Duisburg, Germany.
- Tamburino C A.O.U. Policlinico Vittorio Emanuele, University of Catania, Catania, Italy.
- Sinning JM University Hospital Bonn, Bonn, Germany.
- Al-Kassou B University Hospital Bonn, Bonn, Germany.
- Perlman GY Hadassah Medical Center, Jerusalem, Israel.
- Danenberg H Hadassah Medical Center, Jerusalem, Israel.
- Ielasi A S. Ambrogio Cardio-Thoracic Center, Milan, Italy.
- Fraccaro C University Hospital of Padova, Padova, Italy.
- Tarantini G University Hospital of Padova, Padova, Italy.
- De Marco F IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
- Witberg G Rabin Medical Center, Tel-Aviv University, Tel-Aviv, Israel; St. Thomas' Hospital Campus, London, United Kingdom.
- Redwood SR St. Thomas' Hospital Campus, London, United Kingdom.
- Lisko JC Emory University Hospital, Atlanta, Georgia.
- Babaliaros VC Emory University Hospital, Atlanta, Georgia.
- Laine M Helsinki University Central Hospital, Helsinki, Finland.
- Nerla R Humanitas Gavazzeni, Bergamo, Italy.
- Castriota F Humanitas Gavazzeni, Bergamo, Italy.
- Finkelstein A Tel-Aviv Medical Center, Tel-Aviv, Israel.
- Loewenstein I Tel-Aviv Medical Center, Tel-Aviv, Israel.
- Eitan A Carmel Medical Center, Haifa, Israel.
- Jaffe R Carmel Medical Center, Haifa, Israel.
- Ruile P University Heart Center Freiburg, Bad Krozingen, Germany.
- Neumann FJ University Heart Center Freiburg, Bad Krozingen, Germany.
- Piazza N McGill University Health Center, Montreal, Quebec, Canada.
- Alosaimi H McGill University Health Center, Montreal, Quebec, Canada.
- Sievert H Cardiovascular Center, Frankfurt, Germany.
- Sievert K Cardiovascular Center, Frankfurt, Germany.
- Russo M Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
- Andreas M Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
- Bunc M University Medical Centre Ljubljana, Ljubljana, Slovenia.
- Latib A Montefiore Medical Center, New York, New York.
- Govdfrey R Brighton & Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
- Hildick-Smith D Brighton & Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
- Sathananthan J Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Hensey M Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Alkhodair A Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Blanke P Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Leipsic J Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Wood DA Centre for Cardiovascular Innovation Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital, Vancouver, British Columbia, Canada.
- Nazif TM Columbia University Medical Center, New York, New York.
- Kodali S Columbia University Medical Center, New York, New York.
- Leon MB Columbia University Medical Center, New York, New York.
- Barbanti M A.O.U. Policlinico Vittorio Emanuele, University of Catania, Catania, Italy. Electronic address: https://twitter.com/barbanti_marco.
- 2020-04-25
Published in:
- Journal of the American College of Cardiology. - 2020
English
BACKGROUND
Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail.
OBJECTIVES
The authors sought to examine outcomes following redo-TAVR.
METHODS
The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively.
RESULTS
Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm2 and 1.51 ± 0.57 cm2; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively.
CONCLUSIONS
Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern.
Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail.
OBJECTIVES
The authors sought to examine outcomes following redo-TAVR.
METHODS
The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively.
RESULTS
Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm2 and 1.51 ± 0.57 cm2; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively.
CONCLUSIONS
Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jacc.2020.02.051
- PMID 32327098
- Persistent URL
- https://folia.unifr.ch/global/documents/44290
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