Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Bleiziffer Sabine, Simonato Matheus, Webb John G, Rodés-Cabau Josep, Pibarot Philippe, Kornowski Ran, Windecker Stephan, Erlebach Magdalena, Duncan Alison, Seiffert Moritz, Unbehaun Axel, Frerker Christian, Conzelmann Lars, Wijeysundera Harindra, Kim Won-Keun, Montorfano Matteo, Latib Azeem, Tchetche Didier, Allali Abdelhakim, Abdel-Wahab Mohamed, Orvin Katia, Stortecky Stefan, Nissen Henrik, Holzamer Andreas, Urena Marina, Testa Luca, Agrifoglio Marco, Whisenant Brian, Sathananthan Janarthanan, Napodano Massimo, Landi Antonio, Fiorina Claudia, Zittermann Armin, Veulemans Verena, Sinning Jan-Malte, Saia Francesco, Brecker Stephen, Presbitero Patrizia, De Backer Ole, Søndergaard Lars, Bruschi Giuseppe, Franco Luis Nombela, Petronio Anna Sonia, Barbanti Marco, Cerillo Alfredo, Spargias Konstantinos, Schofer Joachim, Cohen Mauricio, Muñoz-Garcia Antonio, Finkelstein Ariel, Adam Matti, Serra Vicenç, Teles Rui Campante, Champagnac Didier, Iadanza Alessandro, Chodor Piotr, Eggebrecht Holger, Welsh Robert, Caixeta Adriano, Salizzoni Stefano, Dager Antonio, Auffret Vincent, Cheema Asim, Ubben Timm, Ancona Marco, Rudolph Tanja, Gummert Jan, Tseng Elaine, Noble Stephane, Bunc Matjaz, Roberts David, Kass Malek, Gupta Anuj, Leon Martin B, Dvir Danny
Аннотация
METHODS AND RESULTS: A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) ≤ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)].
CONCLUSIONS: The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.