Safety and Efficacy of Transcatheter Aortic Valve Replacement in the Treatment of Pure Aortic Regurgitation in Native Valves and Failing Surgical Bioprostheses
| Autor: | Pablo Codner, Josep Rodés-Cabau, Sabine Bleiziffer, Upul Wickramarachchi, Fadi J. Sawaya, Francesco Maisano, Raj Makkar, Marcus-André Deutsch, Mikko Savontaus, Antonio Mangieri, Maurizio Taramasso, A. Sonia Petronio, Marco Mocetti, Peter Gheeraert, Darren Mylotte, Ran Kornowski, Jason Chan, Johan Bosmans, David Hildick-Smith, Troels H. Jørgensen, Azeem Latib, Thierry Lefèvre, Lars Søndergaard, Ole De Backer, Luigi Biasco, Marco Spaziano, Sung-Han Yoon, Horst Sievert, Moritz Seiffert |
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| Rok vydání: | 2017 |
| Předmět: |
Aortic valve
medicine.medical_specialty Transcatheter aortic business.industry medicine.medical_treatment Regurgitation (circulation) 030204 cardiovascular system & hematology medicine.disease Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Valve replacement Internal medicine medicine Clinical endpoint Cardiology 030212 general & internal medicine Embolization Cardiology and Cardiovascular Medicine Complication business Aortic valve regurgitation |
| Zdroj: | JACC: Cardiovascular Interventions. 10:1048-1056 |
| ISSN: | 1936-8798 |
| Popis: | Objectives The aim of this study was to evaluate the use of transcatheter heart valves (THV) for the treatment of noncalcific pure native aortic valve regurgitation (NAVR) and failing bioprosthetic surgical heart valves (SHVs) with pure severe aortic regurgitation (AR). Background Limited data are available about the “off-label” use of transcatheter aortic valve replacement (TAVR) to treat pure severe AR. Methods The study population consisted of patients with pure severe AR treated by TAVR at 18 different centers. Study endpoints were device success, early safety, and clinical efficacy at 30 days, as defined by Valve Academic Research Consortium 2 criteria. Results A total of 146 patients were included, 78 patients in the NAVR group and 68 patients in the failing SHV group. In the NAVR group, device success, early safety, and clinical efficacy were 72%, 66%, and 61%, respectively. Device success and clinical efficacy were significantly better with newer generation THVs compared with old-generation THVs (85% vs. 54% and 75% vs. 46%, respectively, p 8%, major vascular or access complication, and moderate to severe AR. In the failing SHV group, device success, early safety, and clinical efficacy were 71%, 90%, and 77%, respectively. Conclusions TAVR for pure NAVR remains a challenging condition, with old-generation THVs being associated with THV embolization and migration and significant paravalvular regurgitation. Newer generation THVs show more promising outcomes. For those patients with severe AR due to failing SHVs, TAVR is a valuable therapeutic option. |
| Databáze: | OpenAIRE |
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