In:
Journal of Interventional Cardiology, Wiley, Vol. 31, No. 6 ( 2018-12), p. 861-869
Abstract:
To compare the safety and efficacy of transcathether aortic valve‐in‐valve implantation (ViV‐TAVI) in degenerated stentless bioprostheses with failed stented valves and degenerated native aortic valves. Introduction Little is known about ViV‐TAVI in degenerated stentless valves. Methods Out of 45 ViV‐TAVI procedures reported in the POL‐TAVI registry, 20 failed stentless valves were compared with 25 stented prostheses and propensity‐matched with 45 native TAVI cases. The mean follow‐up was 633 (95% confidence interval [CI], 471–795) days and Valve Academic Research Consortium‐2 (VARC‐2) definitions were applied. Results Patients with degenerated stentless valves were younger (65.6, CI 58‐73.1 years vs 75.6, CI 72.2–78 [stented] vs 80.1, CI 78.7–81.6 y. [native] , P 〈 0.001). Implantation was required later after surgery (11.5, CI 8–14.9 years) in the stentless cohort as compared with the stented one (6.2, CI 4.7–7.6 years, P = 0.006). ViV‐TAVI in the stentless group was also associated with larger amount of contrast (211, CI 157–266 mL vs 135, CI 104‐167 mL [stented] vs 132 (119–145) mL [native] , P = 0.022). Using VARC‐2 composite endpoints, ViV‐TAVI in stentless prostheses was characterized by a lower device success (50% vs 76% in stented vs 88.9% in native TAVI, P 〈 0.001), but comparable early safety up to 30 days (73.7% vs 84% vs 81.8%, respectively, log‐rank P = 0.667) and long‐term clinical efficacy beyond 30 days (72.2% vs 72% vs 73.8%, respectively, log‐rank P = 0.963). Conclusions Despite technical challenges and a lower device success, ViV‐TAVI in stentless aortic bioprostheses achieves similar safety, efficacy, and functional improvement as in stented or degenerated native valves.
Type of Medium:
Online Resource
ISSN:
0896-4327
,
1540-8183
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2103585-4
