In-hospital outcomes of valve-in-valve vs. native valve transcatheter aortic valve implantation in Brazil: A propensity-matched analysis.
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Calomeni Pedro, Abizaid Marcella Sousa, Bernardi Fernando, de Brito Fábio Sandoli, Lemos Pedro Alves, Feres Fausto, Siqueira Dimytri Alexandre, Costa Ricardo, Zukowski Cleverson, Sarmento-Leite Rogério, Mangione Fernanda, Mangione José Armando, Thiago Luiz Eduardo Koenig São, de Lima Valter Correira, Oliveira Adriano Dias Dourado, Marino Marcos Antônio, Cardoso Carlos José Francisco, Caramori Paulo Ricardo Avancini, Tumelero Rogério Tadeu, Portela Antenor Lages Fortes, Prudente Maurício Lopes, Henriques Leônidas Alvarenga, de Freitas Souza Fábio Solano, Bezerra Cristiano Guedes, de Almeida Prado Junior Guy Fernandes, de Freitas Leandro Zacarias Figueiredo, Nogueira Ederlon Ferreira, Meireles George César Ximenes, Pope Renato Bastos, Guérios Ênio Eduardo, de Andrade Pedro Beraldo, de Moura Santos Luciano, Esteves Vinicius Borges Cardozo, Abizaid Alexandre, Ribeiro Henrique Barbosa
Аннотация
METHODS: This is a retrospective study based on a Brazilian clinical registry of TAVI patients between January 2009 and December 2021. We compared ViV-TAVI patients with native aortic valve (NV-TAVI) patients. Temporal trends, procedural, and in-hospital outcomes were evaluated. We performed propensity score matching (PSM) and multivariable regression to adjust comparisons.
RESULTS: Among 3194 patients from 25 centers, 135 underwent ViV-TAVI. The ViV volume increased slightly over time in proportion to NV-TAVI. After PSM, there were 127 ViV and 248 NV-TAVI patients. ViV patients had lower device success (71.7% vs. 87.9%; OR 0.35; 95% CI 0.20-0.60; p < 0.01) and permanent pacemaker implantation (4.7% vs. 12.9%; OR 0.35; 95% CI 0.13-0.79; p < 0.01) compared with NV-TAVI. Valve embolization was more frequent in ViV-TAVI (3.9% vs. 0.8%; OR 4.44; 95% CI 1.03-25.59; p = 0.04). Among ViV patients, no difference in embolization risk was detected (OR 1.11; 95% CI 0.18-11.80; p = 0.91) between radiopaque vs. radiolucent SHV. Major vascular complication, major or life-threatening bleeding, stroke, and in-hospital mortality did not differ significantly between groups.
CONCLUSION: During the study period, a modest but significant increase was observed in the number of ViV-TAVI procedures. Device success and PPI were lower, and valve embolization was more frequent in ViV-TAVI compared with NV-TAVI. In-hospital safety outcomes did not differ between groups.