Resheathing of self-expanding bioprosthesis: Impact on procedural results, clinical outcome and prosthetic valve durability after transcatheter aortic valve implantation
| Autor: | Christophe de Meester, Joelle Kefer, Anne-Catherine Pouleur, Jean Renkin, Shakeel Kautbally, Frédéric Maes, Marine Delacour |
|---|---|
| Přispěvatelé: | UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de pathologie cardiovasculaire |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty Transcatheter aortic Transcatheter aortic valve medicine.medical_treatment viruses Valve durability 030204 cardiovascular system & hematology Resheath Prosthesis 03 medical and health sciences 0302 clinical medicine medicine Overall survival 030212 general & internal medicine Stroke Prosthetic valve Original Paper business.industry Significant difference Acute kidney injury virus diseases respiratory system medicine.disease Pulmonary hypertension Surgery lcsh:RC666-701 Cardiology and Cardiovascular Medicine business |
| Zdroj: | International journal of cardiology. Heart & vasculature, Vol. 26, p. 100462 [1-7] (2020) International Journal of Cardiology. Heart & Vasculature International Journal of Cardiology: Heart & Vasculature, Vol 26, Iss, Pp-(2020) |
| Popis: | Highlights • To resheath a SEV doesn’t increase the procedural risk of TAVI. • To resheath a SEV doesn’t impair the clinical outcome of patients. • The resheath has no negative impact on the acute prosthetic valve function. • Resheathing manœuvre has no deleterious effect on the prosthetic valve durability at short term follow-up. Background New transcatheter aortic valves were recently developed, enabling to resheath and reposition the prosthesis. The aim of the present study was to investigate whether the resheath manoeuvre did not impair the outcome of patients and the bioprosthesis durability after transcatheter aortic valve implantation (TAVI). Methods and results On the 346 consecutive patients (84 ± 7 yrs-old, mean STS 6.7 ± 5%) undergoing a transfemoral TAVI in our institution since January 2008, 170 patients were implanted using a self-expanding valve (SEV). Among those, 39 (Group 1) required resheathing to achieve a successful implantation, while 131 did not require it (Group 2, N = 131). A balloon-expanding valve (BEV) was used in 176 patients (Group 3). Baseline characteristics were similar between groups. Device success was 98%, the rate of in-hospital death was 2%, and the number of procedural complications was similarly low, with no significant difference between groups. The follow-up was complete in 337 of 338 patients undergoing a successful TAVI (781 patients-year). Kaplan-Meier analysis showed that overall survival was 80 ± 2% and 42 ± 3% at 1 and 5 years respectively, with no difference between groups. On multivariate analysis, acute kidney injury, post-dilatation, pulmonary hypertension, porcelain aorta and STS score, but not resheath, were independant predictors of death after TAVI. The annual event rate of structural valve deterioration was 0.6% patients-year, and similar between groups. Conclusions Our study shows that SEV resheath did not impair the procedural results, the outcome of patients nor the valve durability at short term after TAVI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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