MedElevator
Войти в исследования JTCVS structural and endovascular · 2026
Redo surgical aortic valve replacement versus valve-in-valve transcatheter aortic valve replacement with balloon valve fracture: Short-term clinical outcomes.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
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.
Kanade Rahul, Tagliafierro Marco, Anzai Isao, Soliman Fady, Mitchell William M, Kirilina Darina, Kurlansky Paul, Hahn Rebecca T, Kodali Susheel, Nazif Tamim M, Vahl Torsten P, Geirsson Arnar, Argenziano Michael, George Isaac, Pirelli Luigi
Аннотация
OBJECTIVE: To evaluate short-term outcomes of redo surgical aortic valve replacement (SAVR) versus valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) with bioprosthetic valve fracture (ViVBVF) in patients with bioprosthetic structural valve deterioration undergoing reintervention.
METHODS: This retrospective single-center study was conducted between 2015 and 2025. Data were obtained from institutional registries. A total of 128 consecutive patients met the inclusion criteria (75 with redo-SAVR and 53 with ViVBVF). Patients requiring concomitant cardiac procedures, mechanical valves, or unsuitable anatomy for ViV were excluded. The primary endpoints were 30-day mortality, stroke, and readmission; secondary endpoints included echocardiographic changes and postoperative complications. Overlap propensity score weighting to adjust baseline differences was performed.
RESULTS: Compared to the redo-SAVR patients, the ViVBVF patients were older and had a higher predicted risk of mortality. The rates of 30-day mortality, stroke, and readmission were similar in the 2 groups. ViVBVF achieved significantly greater reductions in mean gradient (-26.0 mm Hg vs -17.4 mm Hg; P =.003), peak gradient (-39.2 mm Hg vs -23.3 mm Hg; P =.004), and peak velocity. After matching, 30-day mortality was higher after redo-SAVR (8.9% vs 0%; P < .001). The ViVBVF group showed a greater reduction in peak velocity but more frequent pacemaker implantation.
CONCLUSIONS: In patients with bioprosthetic valves requiring reintervention, ViVBVF offers greater gradient reduction, with a perioperative safety advantage suggested in the adjusted analysis.
METHODS: This retrospective single-center study was conducted between 2015 and 2025. Data were obtained from institutional registries. A total of 128 consecutive patients met the inclusion criteria (75 with redo-SAVR and 53 with ViVBVF). Patients requiring concomitant cardiac procedures, mechanical valves, or unsuitable anatomy for ViV were excluded. The primary endpoints were 30-day mortality, stroke, and readmission; secondary endpoints included echocardiographic changes and postoperative complications. Overlap propensity score weighting to adjust baseline differences was performed.
RESULTS: Compared to the redo-SAVR patients, the ViVBVF patients were older and had a higher predicted risk of mortality. The rates of 30-day mortality, stroke, and readmission were similar in the 2 groups. ViVBVF achieved significantly greater reductions in mean gradient (-26.0 mm Hg vs -17.4 mm Hg; P =.003), peak gradient (-39.2 mm Hg vs -23.3 mm Hg; P =.004), and peak velocity. After matching, 30-day mortality was higher after redo-SAVR (8.9% vs 0%; P < .001). The ViVBVF group showed a greater reduction in peak velocity but more frequent pacemaker implantation.
CONCLUSIONS: In patients with bioprosthetic valves requiring reintervention, ViVBVF offers greater gradient reduction, with a perioperative safety advantage suggested in the adjusted analysis.