Holzamer, Andreas and Kim, Won-Keun and Ruck, Andreas and Sathananthan, Janarthanan and Keller, Lukas and Cosma, Joseph and Bauer, Timm and Nef, Holger and Amat-Santos, Ignacio J. and Brinkert, Miriam and Husser, Oliver and Pellegrini, Costanza and Schofer, Joachim and Nerla, Roberto and Montorfano, Matteo and Giannini, Francesco and Stella, Pieter and Kuwata, Shingo and Hilker, Michael and Castriota, Fausto and Ussia, Gian Paolo and Webb, John G. and Nietlispach, Fabian and Toggweiler, Stefan (2019) Valve-in-Valve Implantation Using the ACURATE Neo in Degenerated Aortic Bioprostheses An International Multicenter Analysis. JACC-CARDIOVASCULAR INTERVENTIONS, 12 (22). pp. 2309-2316. ISSN 1936-8798, 1876-7605
Full text not available from this repository. (Request a copy)Abstract
OBJECTIVES This study reports an international experience using the transfemoral ACURATE neo transcatheter heart valve (Boston Scientific, Marlborough, Massachusetts) for the treatment of degenerated surgical aortic bioprostheses. BACKGROUND Transcatheter valve-in-valve procedures have emerged as an alternative to redo surgery. Supra-annular prostheses might be particularly useful in this indication. METHODS This is an international multicenter analysis including 85 patients from 14 centers in Europe and Canada undergoing an ACURATE neo valve-in-valve procedure from March 2015 to February 2019. RESULTS Internal diameter of the degenerated bioprosthesis was 20.3 +/- 2.1 mm. Prosthesis size S was used in 70 (82%) procedures. The median depth of implantation was 3 mm and the upper crown of the ACURATE neo was positioned above the stent posts of the degenerated bioprosthesis in 54 (64%) and inside in 31 (36%). Mean transvalvular gradient before discharge was significantly lower if the upper crown was above the degenerated bioprosthesis (13.7 +/- 5.9 mm Hg vs. 19.5 +/- 10.0 mm Hg; p = 0.001). However, a high position of the ACURATE neo resulted in embolization in 1 patient, conversion to open-heart surgery in 1, and need for reintervention due to transcatheter heart valve failure within the first 18 months of follow-up in 4. CONCLUSIONS This early experience shows that a high implantation of the ACURATE neo with the upper crown above the stent posts of the degenerated bioprosthesis resulted in lower mean transvalvular gradients but a higher rate of malpositioning and early valve degeneration. (C) 2019 by the American College of Cardiology Foundation.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | TRANSCATHETER HEART-VALVE; SURGICAL BIOPROSTHESES; EUROPEAN ASSOCIATION; SURGERY; SOCIETY; DISEASE; degenerated bioprosthesis; transcatheter aortic valve implantation; transcatheter aortic valve replacement; transfemoral; valve-in-valve |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Mar 2020 08:18 |
| Last Modified: | 24 Mar 2020 08:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25805 |
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