Long-Term Durability of Transcatheter Aortic Valve Prostheses.
J Am Coll Cardiol
; 73(5): 537-545, 2019 02 12.
Article
en En
| MEDLINE
| ID: mdl-30732706
ABSTRACT
BACKGROUND:
Very little is known about long-term valve durability after transcatheter aortic valve replacement (TAVR).OBJECTIVES:
This study sought to evaluate the incidence of structural valve degeneration (SVD) 5 to 10 years post-procedure.METHODS:
Demographic, procedural, and in-hospital outcome data on patients who underwent TAVR from 2007 to 2011 were obtained from the U.K. TAVI (United Kingdom Transcatheter Aortic Valve Implantation) registry. Patients in whom echocardiographic data were available both at baseline and ≥5 years post-TAVR were included. Hemodynamic SVD was determined according to European task force committee guidelines.RESULTS:
A total of 241 patients (79.3 ± 7.5 years of age; 46% female) with paired post-procedure and late echocardiographic follow-up (median 5.8 years, range 5 to 10 years) were included. A total of 149 patients (64%) were treated with a self-expandable valve and 80 (34.7%) with a balloon-expandable valve. Peak aortic valve gradient at follow-up was lower than post-procedure (17.1 vs. 19.1 mm Hg; p = 0.002). More patients had none/trivial aortic regurgitation (AR) (47.5% vs. 33%), and fewer had mild AR (42.5% vs. 57%) at follow-up (p = 0.02). There was 1 case (0.4%) of severe SVD 5.3 years after implantation (new severe AR). There were 21 cases (8.7%) of moderate SVD (mean 6.1 years post-implantation; range 4.9 to 8.6 years). Twelve of these (57%) were due to new AR and 9 (43%) to restenosis.CONCLUSIONS:
Long-term transcatheter aortic valve function is excellent. In the authors' study, 91% of patients remained free of SVD between 5 and 10 years post-implantation. The incidence of severe SVD was <1%. Moderate SVD occurred in 1 in 12 patients.Palabras clave
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Bases de datos:
MEDLINE
Asunto principal:
Válvula Aórtica
/
Insuficiencia de la Válvula Aórtica
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Estenosis de la Válvula Aórtica
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Complicaciones Posoperatorias
/
Prótesis Valvulares Cardíacas
/
Reemplazo de la Válvula Aórtica Transcatéter
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País/Región como asunto:
Europa
Idioma:
En
Revista:
J Am Coll Cardiol
Año:
2019
Tipo del documento:
Article