Assessment of Long-Term Structural Deterioration of Transcatheter Aortic Bioprosthetic Valves Using the New European Definition
| Autor: | Eric, Durand, Anastasia, Sokoloff, Marina, Urena-Alcazar, Bernard, Chevalier, Stephan, Chassaing, Romain, Didier, Christophe, Tron, Pierre-Yves, Litzler, Claire, Bouleti, Dominique, Himbert, Thomas, Hovasse, Olivier, Bar, Guillaume, Avinée, Bernard, Iung, Didier, Blanchard, Martine, Gilard, Alain, Cribier, Thierry, Lefevre, Hélène, Eltchaninoff |
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| Rok vydání: | 2019 |
| Předmět: |
Aged
80 and over Balloon Valvuloplasty Bioprosthesis Male Reoperation Time Factors Incidence Aortic Valve Stenosis Prosthesis Design Risk Assessment Prosthesis Failure Transcatheter Aortic Valve Replacement Postoperative Complications Treatment Outcome Risk Factors Aortic Valve Heart Valve Prosthesis Humans Female France Aged Retrospective Studies |
| Zdroj: | Circulation. Cardiovascular interventions. 12(4) |
| ISSN: | 1941-7632 |
| Popis: | The durability of transcatheter aortic bioprosthetic valves is a crucial issue, but data are scarce, especially beyond 5 years of follow-up. We aimed to assess long-term (7 years) structural valve deterioration (SVD) and bioprosthetic valve failure of transcatheter aortic bioprosthetic valves.Consecutive patients with at least 5-year follow-up available undergoing transcatheter aortic valve implantation from April 2002 to December 2011 in 5 French centers were included. Incidence of SVD and bioprosthetic valve failure were defined according to newly standardized criteria of the European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio-Thoracic Surgery and reported as cumulative incidence function to account for the competing risk of death. One thousand four hundred three consecutive patients were included with a mean age of 82.6±7.5 years and with a mean logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) of 21.3±7.5%. A balloon-expandable valve was used in 83.7% of cases. Survival rates were 83.5% (95% CI, 81.4%-85.5%) and 18.6% (95% CI, 15.3%-21.8%) at 1 and 7 years, respectively. Median duration of follow-up was 3.9 years. Bioprosthetic valve failure occurred in 19 patients with a 7-year cumulative incidence of 1.9% (95% CI, 1.4%-2.4%). SVD occurred in 49 patients (moderate, n=32; severe, n=17) with a 7-year cumulative incidence of moderate and severe SVD of 7.0% (95% CI, 5.6%-8.4%) and 4.2% (95% CI, 2.9%-5.5%), respectively. Five patients had aortic valve reintervention (1.0%; 95% CI, 0.4%-1.6%) including 1 case of surgical aortic valve replacement and 4 redo-transcatheter aortic valve implantation. The incidences of SVD and bioprosthetic valve failure were not significantly different between balloon and self-expandable prostheses.The long-term assessment of transcatheter aortic bioprosthetic valves durability is limited by the poor survival of our population beyond 5 years. Further studies are warranted, particularly in younger and lower-risk patients. |
| Databáze: | OpenAIRE |
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