Kim, Won-Keun and Schaefer, Ulrich and Tchetche, Didier and Nef, Holger and Arnold, Martin and Avanzas, Pablo and Rudolph, Tanja and Scholtz, Smita and Barbanti, Marco and Kempfert, Joerg and Mangieri, Antonio and Lauten, Alexander and Frerker, Christian and Yoon, Sung-Han and Holzamer, Andreas and Praz, Fabien and De Backer, Ole and Toggweiler, Stefan and Blumenstein, Johannes and Purita, Paola and Tarantini, Giuseppe and Thilo, Christian and Wolf, Alexander and Husser, Oliver and Pellegrini, Costanza and Burgdorf, Christof and Antolin, Rosa Ana Hernandez and Diaz, Victor A. Jimenez and Liebetrau, Christoph and Schofer, Niklas and Moellmann, Helge and Eggebrecht, Holger and Sondergaard, Lars and Walther, Thomas and Pilgrim, Thomas and Hilker, Michael and Makkar, Raj and Unbehaun, Axel and Boergermann, Jochen and Moris, Cesar and Achenbach, Stephan and Doerr, Oliver and Brochado, Bruno and Conradi, Lenard and Hamm, Christian W. (2019) Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration). EUROPEAN HEART JOURNAL, 40 (38). pp. 3156-3165. ISSN 0195-668X, 1522-9645
Full text not available from this repository. (Request a copy)Abstract
Aims Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort. Methods and results We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 +/- 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective. Conclusion Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | WEIGHTED METAANALYSIS; CLINICAL-OUTCOMES; IMPLANTATION; DEFINITIONS; THERAPY; Aortic stenosis; Embolization; Migration; Valve-in-valve; Prosthesis; Conversion; TAVR |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 25 Mar 2020 12:56 |
| Last Modified: | 25 Mar 2020 12:56 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26019 |
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