Transcatheter aortic valve-in-valve implantation to treat aortic para-valvular regurgitation after TAVI.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Landes Uri, Morelli Olga, Danenberg Haim, Sathananthan Janarthanan, Backer Ole De, Sondergaard Lars, Abdel-Wahab Mohamed, Yoon Sung-Han, Makkar Raj R, Thiele Holger, Kim Won-Keun, Hamm Christian, Guerrero Mayra, Rodés-Cabau Josep, Okuno Taishi, Pilgrim Thomas, Mangieri Antonio, Van Mieghem Nicolas M, Tchétché Didier, Schoels Wolfgang H, Barbanti Marco, Sinning Jan-Malte, Ielasi Alfonso, Tarantini Giuseppe, De Marco Federico, Finkelstein Ariel, Sievert Horst, Andreas Martin, Latib Azeem, Godfrey Rebecca, Hildick-Smith David, Manevich Lisa, Kornowski Ran, Nazif Tamim M, Leon Martin B, Webb John G
Аннотация
METHODS: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation.
RESULTS: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR ≥ moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR ≥ moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV.
CONCLUSIONS: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.