Transcatheter aortic valveinvalve implantation for failed surgical bioprostheses: results from the Polish Transcatheter Aortic Valve-in-Valve Implantation (ViVTAVI) Registry
Pol Arch Intern Med
; 132(2)2022 02 28.
Article
in En
| MEDLINE
| ID: mdl-34845900
ABSTRACT
INTRODUCTION:
Transcatheter aortic valvein valve implantation (ViVTAVI) has emerged as an alternative to redo surgery in patients with failed surgical aortic bioprosthesis.OBJECTIVES:
We evaluated the safety and efficacy of ViVTAVI in Polish patients after surgical aortic valve replacement. PATIENTS ANDMETHODS:
This was a nationwide multicenter registry of ViVTAVI procedures. Data were collected using an online form, and the clinical follow up lasted 1 year.RESULTS:
From 2008 to 2020, 130 ViVTAVI procedures were performed (1.9% of all transcatheter aortic valve implantation [TAVI] cases). A considerable increase in ViVTAVI procedures since 2018 has been observed (n = 59, 45% of ViVTAVI cases). Hancock II, Freestyle, and homograft were the most frequently treated bioprostheses. The self expanding supra annular Corevalve / Evolut valve was used in 76% of cases. In 21% of cases, the mean postprocedural pressure gradient (PG) exceeded 20 mm Hg. Allcause mortality at 1 year was 10.8%. Aortic valve stenosis was associated with a higher mean PG than aortic valve regurgitation or mixed disease (P = 0.004). Supra annular transcatheter aortic valves were associated with lower mean PGs than intra annular valves (P = 0.004). Second generation devices were associated with shorter procedure time (120 min vs 135 min, P = 0.04), less frequent need for additional TAVI (2% vs 10%, P = 0.04), and lower 1year cardiovascular mortality (95% vs 82.8%, P = 0.03) than firstgeneration valves.CONCLUSIONS:
Transcatheter treatment of failed bioprostheses is increasingly common, with the best hemodynamic effect shown for supra annular valves. The introduction of secondgeneration valves has improved procedural and clinical outcomes.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bioprosthesis
/
Transcatheter Aortic Valve Replacement
Type of study:
Clinical_trials
Limits:
Humans
Country/Region as subject:
Europa
Language:
En
Journal:
Pol Arch Intern Med
Year:
2022
Document type:
Article