Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves Results From the Global Valve-in-Valve Registry

Dvir, Danny and Webb, John and Brecker, Stephen and Bleiziffer, Sabine and Hildick-Smith, David and Colombo, Antonio and Descoutures, Fleur and Hengstenberg, Christian and Moat, Neil E. and Bekeredjian, Raffi and Napodano, Massimo and Testa, Luca and Lefevre, Thierry and Guetta, Victor and Nissen, Henrik and Hernandez, Jose-Maria and Roy, David and Teles, Rui C. and Segev, Amit and Dumonteil, Nicolas and Fiorina, Claudia and Gotzmann, Michael and Tchetche, Didier and Abdel-Wahab, Mohamed and De Marco, Federico and Baumbach, Andreas and Laborde, Jean-Claude and Kornowski, Ran (2012) Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves Results From the Global Valve-in-Valve Registry. CIRCULATION, 126 (19). 2335-+. ISSN 0009-7322,

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Abstract

Background-Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry. Methods and Results-The Global Valve-in-Valve Registry included 202 patients with degenerated bioprosthetic valves (aged 77.7 +/- 10.4 years; 52.5% men) from 38 cardiac centers. Bioprosthesis mode of failure was stenosis (n +/- 85; 42%), regurgitation (n = 68; 34%), or combined stenosis and regurgitation (n = 49; 24%). Implanted devices included CoreValve (n = 124) and Edwards SAPIEN (n = 78). Procedural success was achieved in 93.1% of cases. Adverse procedural outcomes included initial device malposition in 15.3% of cases and ostial coronary obstruction in 3.5%. After the procedure, valve maximum/mean gradients were 28.4 +/- 14.1/15.9 +/- 8.6 mm Hg, and 95% of patients had <= +1 degree of aortic regurgitation. At 30-day follow-up, all-cause mortality was 8.4%, and 84.1% of patients were at New York Heart Association functional class I/II. One-year follow-up was obtained in 87 patients, with 85.8% survival of treated patients. Conclusions-The valve-in-valve procedure is clinically effective in the vast majority of patients with degenerated bioprosthetic valves. Safety and efficacy concerns include device malposition, ostial coronary obstruction, and high gradients after the procedure. (Circulation. 2012; 126: 2335-2344.)

Item Type: Article
Uncontrolled Keywords: MEDTRONIC COREVALVE SYSTEM; HIGH-RISK PATIENTS; HEART-VALVES; BALLOON VALVULOPLASTY; IMPLANTATION; STENOSIS; SURGERY; OUTCOMES; PROOF; bioprosthesis; transcatheter aortic valve implantation; valve-in-valve
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin II
Depositing User: Dr. Gernot Deinzer
Date Deposited: 04 May 2020 08:24
Last Modified: 04 May 2020 08:24
URI: https://pred.uni-regensburg.de/id/eprint/17816

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