Balloon-expandable Versus Self-expanding Valves in Patients With Prior Surgical Mitral Valve Replacement Undergoing Transcatheter Aortic Valve Replacement.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Asmarats Lluis, Jiménez-Quevedo Pilar, Amat-Santos Ignacio J, Ferrer-Gracia María-Cruz, Sarnago Fernando, Alonso-Briales Juan H, Oteo Juan Francisco, Serra Vicenç, Muntané-Carol Guillem, Vilalta Victoria, Del Val David, Pan Manuel, De la Torre Hernández José M, García-Blas Sergio, Díez José Luis, Berenguer Alberto, Del Valle Raquel, Navarro Del Amo Felipe, Artaiz Miguel, Regueiro Ander, López-Pérez Manuel, Massó van-Roessel Albert, Paredes-Vázquez José G, Fernández-Cordón Clara, Diarte de Miguel José Antonio, Maneiro Nicolás, Piserra-López Alberto, De La Fuente Jorge, Muñoz Juan, Romaguera Rafael, Carrillo Xavier, Alfonso Fernando, Alvarado Marco, Veiga Gabriela, Millán Xavier, Nombela-Franco Luis, Arzamendi Dabit
Аннотация
METHODS: Patients from the Spanish TAVR registry with pre-existing surgical mitral prostheses were included in this investigation. The primary endpoints were Valve Academic Research Consortium-3 technical and device success, with analysis according to valve type. Transcatheter heart valve (THV) embolization, mitral valve impingement, THV performance, and pacemaker findings were also assessed.
RESULTS: A total of 243 patients were included (37% BEVs, 63% SEVs). Overall technical success was 95.9%. Thirty-day device success was higher in BEV patients (94.4% vs 85.0%, P = 0.036), mainly driven by fewer incidences of moderate residual aortic regurgitation (0% vs 5.9%, P = 0.028) and THV embolization (0% vs 3.9%, P = 0.087). BEV recipients exhibited higher mean transvalvular gradients (10.5 vs 8.1 mm Hg, P = 0.002) and lower rates of permanent pacemaker implantation (5.6% vs 15.7%, P = 0.023). There were no differences in mortality, bleeding, or readmission at 30 days. In the multivariate analysis, a mitroaortic distance of ≤ 7 mm and lack of transesophageal echocardiography guidance were associated with increased device failure.
CONCLUSIONS: In patients with pre-existing MV prostheses, TAVR was safe and effective regardless of the THV type. Nevertheless, the use of BEVs resulted in an increased rate of device success, driven by lesser THV embolization and residual aortic regurgitation.