Transcatheter Aortic Valve Implantation in Mixed Aortic Valve Disease: A Multicenter Study.

Autor: Guddeti RR; Division of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, Nebraska., Gill GS; Division of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, Nebraska., Parekh JD; Division of Cardiovascular Diseases, University of Iowa, Iowa City, Iowa., Jhand AS; Division of Cardiovascular Diseases, University of Nebraska Medical Center, Omaha, Nebraska., Walters RW; Department of Clinical Research, Creighton University School of Medicine, Omaha, Nebraska., Panaich SS; Division of Cardiovascular Diseases, University of Iowa, Iowa City, Iowa., Goldsweig AM; Division of Cardiovascular Diseases, University of Nebraska Medical Center, Omaha, Nebraska., Alla VM; Division of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, Nebraska. Electronic address: venkataalla@creighton.edu.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2023 Sep 15; Vol. 203, pp. 394-402. Date of Electronic Publication: 2023 Jul 29.
DOI: 10.1016/j.amjcard.2023.07.064
Abstrakt: Mixed aortic valve disease (MAVD), defined by the concurrent presence of aortic stenosis (AS) and insufficiency is frequently seen in patients who have undergone transcatheter aortic valve implantation (TAVI). However, studies comparing the outcomes of TAVI in MAVD versus isolated AS have demonstrated conflicting results. Therefore, we aim to assess the outcomes of TAVI in patients with MAVD in comparison with those with isolated severe AS. Patients who underwent native valve TAVI for severe AS at 3 tertiary care academic centers between January 2012 and December 2020 were included and categorized into 3 groups based on concomitant aortic insufficiency (AI) as follows: group 1, no AI; group 2, mild AI; and group 3, moderate to severe AI. Outcomes of interest included all-cause mortality and all-cause readmission rates at 30 days and 1 year. Other outcomes include bleeding, stroke, vascular complications, and the incidence of paravalvular leak at 30 days after the procedure. Of the 1,588 patients who underwent TAVI during the study period, 775 patients (49%) had isolated AS, 606 (38%) had mild AI, and 207 (13%) had moderate to severe AI. Society of Thoracic Surgeons risk scores were significantly different among the 3 groups (5% in group 1, 5.5% in group 2, and 6% in group 3, p = 0.003). Balloon-expandable valves were used in about 2/3 of the population. No statistically significant differences in 30-day or 1-year all-cause mortality and all-cause readmission rates were noted among the 3 groups. Post-TAVI paravalvular leak at follow-up was significantly lower in group 1 (2.3%) and group 2 (2%) compared with group 3 (5.6%) (p = 0.01). In summary, TAVI in MAVD is associated with comparable outcomes at 1 year compared with patients with isolated severe AS.
Competing Interests: Declaration of Competing Interest Dr. Goldsweig reports consulting with Inari and speaker fees from Edwards and Philips. The remaining authors have no competing interests to declare.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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