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Outcomes Following Transcatheter Aortic Valve Replacement for Aortic Stenosis in Patients With Type 0 Bicuspid, Type 1 Bicuspid, and Tricuspid Aortic Valves.
He, Jingjing; Xiong, Tian-Yuan; Yao, Yi-Jun; Peng, Yong; Wei, Jia-Fu; Zhao, Zhen-Gang; Chen, Guo; Ou, Yuan-Weixiang; Liu, Qi; Wang, Xi; Zhu, Zhongkai; Yang, Hao-Ran; Jia, Kaiyu; Mylotte, Darren; Piazza, Nicolo; Prendergast, Bernard; Feng, Yuan; Chen, Mao.
Affiliation
  • He J; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Xiong TY; Cardiology Department, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (J.H.).
  • Yao YJ; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Peng Y; Laboratory of Heart Valve Disease (T.-Y.X., Z.-G.Z., H.-R.Y., M.C.), West China Hospital, Sichuan University.
  • Wei JF; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Zhao ZG; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Chen G; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Ou YW; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Liu Q; Laboratory of Heart Valve Disease (T.-Y.X., Z.-G.Z., H.-R.Y., M.C.), West China Hospital, Sichuan University.
  • Wang X; Department of Anesthesiology (G.C.), West China Hospital, Sichuan University.
  • Zhu Z; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Yang HR; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Jia K; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Mylotte D; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Piazza N; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Prendergast B; Laboratory of Heart Valve Disease (T.-Y.X., Z.-G.Z., H.-R.Y., M.C.), West China Hospital, Sichuan University.
  • Feng Y; Department of Cardiology (J.H., T.-Y.X., Y.-J.Y., Y.P., J.-F.W., Z.-G.Z., Y.-W.O., Q.L., X.W., Z.Z., H.-R.Y., K.J., Y.F., M.C.), West China Hospital, Sichuan University.
  • Chen M; Department of Cardiology, University Hospital Galway, National University of Ireland (D.M.).
Circ Cardiovasc Interv ; 16(12): e013083, 2023 12.
Article in En | MEDLINE | ID: mdl-37846559
ABSTRACT

BACKGROUND:

Data concerning the outcomes of transcatheter aortic valve replacement in type 0 bicuspid aortic stenosis (AS) are scarce. The study aims to compare the outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy.

METHODS:

We enrolled consecutive patients undergoing transcatheter aortic valve replacement for severe AS between 2012 and 2022 in this single-center retrospective cohort study. The primary outcome was mortality, while secondary outcomes included in-hospital complications such as stroke and pacemaker implantation and transcatheter heart valve hemodynamic performance.

RESULTS:

The number of patients with AS with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy was 328, 302, and 642, respectively. Self-expanding transcatheter heart valves were used in the majority of patients (n=1160; 91.4%). In the matched population, differences in mortality (30 days 4.2% versus 1.7% versus 1.7%, Poverall=0.522; 1 year 10% versus 2.3% versus 6.2%, Poverall=0.099) and all stroke (30 days 1.0% versus 0.9% versus 0.0%, Poverall=0.765; 1 year 1.4% versus 1.6% versus 1.3%, Poverall=NS) were nonsignificant, and the incidence of overall in-hospital complications was comparable among groups. Ascending aortic diameter was the single predictor of 1-year mortality in type 0 bicuspid patients (hazard ratio, 1.59 [95% CI, 1.03-2.44]; P=0.035). The proportion of patients with a mean residual gradient ≥20 mm Hg was the highest in those with type 0 bicuspid anatomy, although the need for permanent pacemaker implantation was the lowest in this group.

CONCLUSIONS:

Major clinical outcomes of transcatheter aortic valve replacement for AS in patients with type 0 bicuspid, type 1 bicuspid, and tricuspid aortic valve anatomy are equivalent at short- and mid-term follow-up. These observations merit further exploration in prospective international registries and randomized controlled trials.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Aortic Valve Stenosis / Stroke / Transcatheter Aortic Valve Replacement / Heart Valve Diseases Limits: Humans Language: En Journal: Circ Cardiovasc Interv Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2023 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Aortic Valve Stenosis / Stroke / Transcatheter Aortic Valve Replacement / Heart Valve Diseases Limits: Humans Language: En Journal: Circ Cardiovasc Interv Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2023 Document type: Article