Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Trimaille Antonin, Cepas-Guillén Pedro, Urena Marina, Alperi Alberto, Veiga-Fernandez Gabriela, Nombela-Franco Luis, Vilalta Victoria, Del Trigo Maria, Muñoz-García Antonio J, Esposito Giovanni, Auffret Vincent, Del Val David, Serra Vicenç, Nuche Jorge, Asmarats Lluis, Regueiro Ander, Carmona Adrien, Fisher Quentin, Avanzas Pablo, Fradejas-Sastre Víctor, Sanchez Ivan, Trichilo Michele, Francisco Oteo Juan, Franzone Anna, Nolf Maxime, Alfonso Fernando, Díaz Pockels Pedro, Rodríguez-Santolino Rocío, Arzamendi Dabit, Flores-Umanzor Eduardo, Morel Olivier, Avvedimento Marisa, Rodés-Cabau Josep
Аннотация
METHODS: We analyzed data from an international, multicenter registry including consecutive patients undergoing transcatheter aortic valve replacement at 13 centers. The primary outcome was BVF according to Valve Academic Research Consortium-3 criteria. The cumulative incidence of BVF was estimated using a competing-risk approach. The association between BVF and clinical outcomes was assessed using competing-risk models with BVF as a time-dependent covariate.
RESULTS: Among 7501 patients, BVF occurred in 380 (5.1%) patients over a median follow-up of 4 (interquartile range, 2-5) years. The cumulative incidence of BVF increased over time, reaching 1.4% at 1 year, 4.6% at 5 years, and 8.3% at 10 years. Independent predictors of BVF included younger age, smoking, balloon-expandable valve, prosthesis size <26 mm, valve-in-valve procedure, mean gradient at discharge ≥15 mm Hg, moderate or severe aortic regurgitation at discharge, and early hemodynamic valve deterioration. BVF was independently associated with an increased risk of all-cause mortality (adjusted hazard ratio, 1.72 [95% CI, 1.47-2.01]; P<0.001), cardiovascular mortality (adjusted hazard ratio, 3.23 [95% CI, 2.73-3.82]; P<0.001), stroke (adjusted hazard ratio, 2.08 [95% CI, 1.02-4.23]; P=0.043), and heart failure hospitalization (adjusted hazard ratio, 1.43 [95% CI, 1.03-1.98]; P=0.032). Consistent findings were observed in different sensitivity analyses.
CONCLUSIONS: BVF is a clinically relevant event associated with adverse long-term outcomes. These findings support the implementation of tailored surveillance and preventive strategies to mitigate BVF-related risk.