Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis.

Autor: Gatta F; Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. francesca.gatta@lhch.nhs.uk., Haqzad Y; Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull. yhaqzad@nhs.net., Gradinariu G; Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow. George.gradinariu2@nhs.scot., Malvindi PG; Department of Cardiology and Cardiothoracic Surgery, Southampton General Hospital. pg.malvindi@hotmail.com., Khalid Z; Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull. doczkhalid@gmail.com., Suelo-Calanao RL; Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull. rona.calanao@nhs.net., Moawad N; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. nadermoawad@nhs.net., Bashir A; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. aladdin.bashir@nhs.net., Rogers LJ; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. lukerogers1@nhs.net., Lloyd C; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. clinton.lloyd@nhs.net., Nguyen B; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. bao.nguyen@nhs.net., Booth K; Department of Cardiology and Cardiothoracic Surgery, Freeman Hospital, Newcastle. Karen.booth16@nhs.net., Wang L; Department of Cardiology and Cardiothoracic Surgery, Freeman Hospital, Newcastle. lu.wang.cam@gmail.com., Al-Attar N; Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow. nawwar.al-attar@gjnh.scot.nhs.uk., McDowall N; Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow. neil.mcdowall@ggc.scot.nhs.uk., Watkins S; Department of Cardiology and Cardiothoracic Surgery, Golden Jubilee National Hospital, Glasgow. stuart.watkins@gjnh.scot.nhs.uk., Sayeed R; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. rana.sayeed@ouh.nhs.uk., Baghdadi S; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. saleh.baghdadi@ouh.nhs.uk., D'Alessio A; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. andrea.dalessio@ouh.nhs.uk., Monteagudo-Vela M; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. maria.monteagudo-vela@ouh.nhs.uk., Djordjevic J; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. Jasmina.djordjevic@ouh.nhs.uk., Goricar M; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. matej.goricar@ouh.nhs.uk., Hoppe S; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. sol.hoppe@gmail.com., Bocking C; Department of Cardiology and Cardiothoracic Surgery, John Radcliffe Hospital, Oxford. charlotte.bocking@nhs.net., Hussain A; Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary. dr_azarhussain@hotmail.com., Evans B; Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary. betsy.evans@nhs.net., Arif S; Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary. sa_aimc186@hotmail.com., Malkin C; Department of Cardiology and Cardiothoracic Surgery, Leeds General Infirmary. Christopher.malkin@nhs.net., Field M; Department of Cardiology and Cardiothoracic Surgery, Derriford Hospital. mark.field@lhch.nhs.uk., Sandhu K; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. kully.sandhu@lhch.nhs.uk., Harky A; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. aaharky@gmail.com., Torky A; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. ahmed.torky@lhch.nhs.uk., Uddin M; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. mauin.uddin@lhch.nhs.uk., Abdulhakeem M; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. muhammad.abdulhakeem@lhch.nhs.uk., Kenawy A; Department of Cardiology and Cardiothoracic Surgery, Liverpool Heart and Chest Hospital. ayman.kenawy@lhch.nhs.uk., Massey J; Department of Cardiology and Cardiothoracic Surgery, Northern General Hospital, Sheffield. john.massey@nhs.net., Cartwright N; Department of Cardiology and Cardiothoracic Surgery, Northern General Hospital, Sheffield. neil.cartwright1@nhs.net., Tyson N; Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital. Nathan.tyson@nhs.net., Nicou N; Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital. niki.nicou@nhs.net., Baig K; Department of Cardiology and Cardiothoracic Surgery, Nottingham City Hospital. Kamran.baig@nuh.nhs.uk., Jones M; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. mark.jones@belfasttrust.hscni.net., Aljanadi F; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. firas.aljanadi@belfasttrust.hscni.net., Owens CG; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. colum.owens@belfasttrust.hscni.net., Oyebanji T; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. Tunde.Oyebanji@belfasttrust.hscni.net., Doyle J; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. jdoyle15@qub.ac.uk., Spence MS; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. markspence1@yahoo.co.uk., Brennan PF; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. pbrennan07@qub.ac.uk., Manoharan G; Department of Cardiology and Cardiothoracic Surgery, Royal Victoria Hospital, Belfast. ganesh.manoharan@belfasttrust.hscni.net., Ramadan T; Department of Cardiology and Cardiothoracic Surgery, Southampton General Hospital. tahaaramdan90@gmail.com., Ohri S; Department of Cardiology and Cardiothoracic Surgery, Southampton General Hospital. sunil.ohri@uhs.nhs.uk., Loubani M; Department of Cardiology and Cardiothoracic Surgery, Castle Hill Hospital, Hull. mahmoud.loubani@nhs.net.
Jazyk: angličtina
Zdroj: Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace [Monaldi Arch Chest Dis] 2023 Apr 19; Vol. 94 (1). Date of Electronic Publication: 2023 Apr 19.
DOI: 10.4081/monaldi.2023.2546
Abstrakt: This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients underwent valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. The mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR versus 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including intra-aortic balloon pump support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p<0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from the hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve TAVI provides better early outcomes as opposed to redo-AVR, although there was no difference in mid-term survival in patients successfully discharged from the hospital.
Databáze: MEDLINE
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