Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project.
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История · было → стало
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Testa Luca, Agnifili Mauro, Van Mieghem Nicolas M, Tchétché Didier, Asgar Anita W, De Backer Ole, Latib Azeem, Reimers Bernhard, Stefanini Giulio, Trani Carlo, Colombo Antonio, Giannini Francesco, Bartorelli Antonio, Wojakowski Wojtek, Dabrowski Maciej, Jagielak Dariusz, Banning Adrian P, Kharbanda Rajesh, Moreno Raul, Schofer Joachim, van Royen Niels, Pinto Duane, Serra Antoni, Segev Amit, Giordano Arturo, Brambilla Nedy, Popolo Rubbio Antonio, Casenghi Matteo, Oreglia Jacopo, De Marco Federico, Tanja Rudolph, McCabe James M, Abizaid Alexander, Voskuil Michiel, Teles Rui, Biondi Zoccai Giuseppe, Bianchi Giovanni, Sondergaard Lars, Bedogni Francesco
Аннотация
METHODS: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%.
RESULTS: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded.
CONCLUSIONS: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04500964.