Giordana, Francesca and Bruno, Francesco and Conrotto, Federico and Sagliettoa, Andrea and D'Ascenzo, Fabrizio and Marra, Walter Grosso and Dvir, Danny and Webb, John and D'Onofrio, Augusto and Camboni, Daniele and Grubitzsch, Herko and Duncan, Alison and Kaneko, Tsuyoshi and Toggweiler, Stefan and Latib, Azeem and Nerla, Roberto and Salizzoni, Stefano and La Torre, Michele and Trompeo, Anna and D'Amico, Maurizio and Rinaldi, Mauro and De Ferrari, Gaetano (2020) Incidence, predictors and outcomes of valve-in-valve TAVI: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY, 316. pp. 64-69. ISSN 0167-5273, 1874-1754
Full text not available from this repository. (Request a copy)Abstract
Aims: Surgical aortic valve replacement has been the treatment of choice for patientswith aortic valve disease before the arrival of transcatheter aortic valve replacement (TAVI), although limited by degeneration of the bioprosthesis. "Redo" intervention itself is burdened by high risk of complications and valve-in-valve (ViV) TAVI could be a valid strategy of redo for patients with comorbidities. Methods and results: Two independent reviewers screened all studies investigating patients undergoing ViV TAVI. Mortality at 30 days and at 1 year was the primary end point. Of 286 studies identified, 26 articles were included in this review with a total of 1448 patients. Median age was 78.8 years, 57.7% male. Median STS score and Logistic EuroSCORE were 9.4% and 31.3% respectively. Stenosis (45%) was the leading cause of prosthesis failure. Transfemoral approach was preferred (76%), with a prevalence of balloon expandable valves (73.3%). Mean follow up was 376 days. Overall and cardiovascular mortality at 30 days was 6.5% and 5.5% respectively, while at 1 year it was 14.5% and 8.9% respectively. At meta-regression analysis study year (p <.001), Logistic EuroSCORE (p <.01) and valve diameter <= 21 mm (p b.05) at 30 days, and stenosis as reason for failure (p =.05) at 1 year were identified as possible predictors of survival. Conclusions: ViV TAVI offers a valid strategy to treat high risk patients with a failure of bioprosthesis with satisfying results in terms of short and mid-term mortality. Future studies are needed to find predictors of long term survival and outcomes in lower risk patients. (C) 2020 Elsevier B.V. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | HEMODYNAMIC OUTCOMES; CLINICAL-OUTCOMES; EDWARDS SAPIEN; IMPLANTATION; REPLACEMENT; FAILURE; REOPERATION; STRATEGIES; MORTALITY; PACEMAKER; Aortic stenosis; Valve-in-valve; Transcatheter aortic valve implantation; Heart team |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Petra Gürster |
| Date Deposited: | 20 Apr 2021 11:30 |
| Last Modified: | 20 Apr 2021 11:30 |
| URI: | https://pred.uni-regensburg.de/id/eprint/43629 |
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