TY  - BOOK
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
TI  - Transcatheter Aortic Valve Implantation Within Degenerated Aortic Surgical Bioprostheses: PARTNER 2 Valve-in-Valve Registry
SN  - 0735-1097
PY  - 2017///
KW  - *Aortic Valve
KW  - *Bioprosthesis/ae [Adverse Effects]
KW  - *Heart Valve Prosthesis
KW  - *Registries
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aged
KW  - Aged, 80 and over
KW  - Follow-Up Studies
KW  - Humans
KW  - Prospective Studies
KW  - Prosthesis Failure
KW  - Quality of Life
KW  - Reoperation
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results; CONCLUSIONS: In high-risk patients, TAVR for bioprosthetic aortic valve failure is associated with relatively low mortality and complication rates, improved hemodynamics, and excellent functional and quality-of-life outcomes at 1 year. (The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves [PARTNER II]; NCT01314313); Copyright � 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved; METHODS: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (>50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries; OBJECTIVES: The authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR; RESULTS: Valve-in-valve procedures were performed in 365 patients (96 initial registry, 269 continued access patients). Mean age was 78.9 +/- 10.2 years, and mean Society of Thoracic Surgeons score was 9.1 +/- 4.7%. At 30 days, all-cause mortality was 2.7%, stroke was 2.7%, major vascular complication was 4.1%, conversion to surgery was 0.6%, coronary occlusion was 0.8%, and new pacemaker insertion was 1.9%. One-year all-cause mortality was 12.4%. Mortality fell from the initial registry to the subsequent continued access registry, both at 30 days (8.2% vs. 0.7%, respectively; p = 0.0001) and at 1 year (19.7% vs. 9.8%, respectively; p = 0.006). At 1 year, mean gradient was 17.6 mm Hg, and effective orifice area was 1.16 cm<sup>2</sup>, with greater than mild paravalvular regurgitation of 1.9%. Left ventricular ejection fraction increased (50.6% to 54.2%), and mass index decreased (135.7 to 117.6 g/m<sup>2</sup>), with reductions in both mitral (34.9% vs. 12.7%) and tricuspid (31.8% vs. 21.2%) moderate or severe regurgitation (all p < 0.0001). Kansas City Cardiomyopathy Questionnaire score increased (mean: 43.1 to 77.0) and 6-min walk test distance results increased (mean: 163.6 to 252.3 m; both p < 0.0001)
UR  - https://dx.doi.org/10.1016/j.jacc.2017.02.057
ER  -