MedStar Authors catalog › Details for: Durability and Clinical Outcomes of Transcatheter Aortic Valve Replacement for Failed Surgical Bioprostheses.
Normal view MARC view ISBD view

Durability and Clinical Outcomes of Transcatheter Aortic Valve Replacement for Failed Surgical Bioprostheses.

by Waksman, Ron.
Citation: ; Circulation: Cardiovascular Interventions. 12(10):e008155, 2019 10..Journal: Circulation. Cardiovascular interventions.Published: ; 2019; ISSN: 1941-7640.Full author list: Bajwa T; Chetcuti SJ; Dauerman HL; de Marchena E; Deeb GM; Dries-Devlin JL; Hermiller JB Jr; Khabbaz K; Kleiman NS; Li S; O'Hair DP; Popma JJ; Reardon MJ; Salerno T; Waksman R; Yakubov SJ.UI/PMID: 31607151.Subject(s): Aged | Treatment Outcome | Transcatheter Aortic Valve Replacement/mo [Mortality] | *Transcatheter Aortic Valve Replacement/is [Instrumentation] | Transcatheter Aortic Valve Replacement/ae [Adverse Effects] | Time Factors | Risk Factors | Recovery of Function | Quality of Life | *Prosthesis Failure | Prosthesis Design | Prospective Studies | Middle Aged | Male | Humans | Hemodynamics | Heart Valve Prosthesis Implantation/mo [Mortality] | *Heart Valve Prosthesis Implantation/is [Instrumentation] | Heart Valve Prosthesis Implantation/ae [Adverse Effects] | *Heart Valve Prosthesis | Female | Bioprosthesis | *Aortic Valve Stenosis/su [Surgery] | Aortic Valve Stenosis/pp [Physiopathology] | Aortic Valve Stenosis/mo [Mortality] | Aortic Valve Stenosis/dg [Diagnostic Imaging] | *Aortic Valve/su [Surgery] | Aortic Valve/pp [Physiopathology] | Aortic Valve/dg [Diagnostic Imaging] | Aged, 80 and overInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1161/CIRCINTERVENTIONS.119.008155 (Click here) Abbreviated citation: ; Circ., Cardiovasc. interv.. 12(10):e008155, 2019 10.Local Holdings: Available online from MWHC library: 2008 - present.Abstract: BACKGROUND: Valve-in-valve transcatheter aortic valve replacement (TAVR) is an option when a surgical valve demonstrates deterioration and dysfunction. This study reports 3-year results following valve-in-valve with self-expanding TAVR.Abstract: CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01675440.Abstract: CONCLUSIONS: Self-expanding TAVR in patients with failed surgical bioprostheses at extreme risk for surgery was associated with durable hemodynamics and excellent clinical outcomes. Preexisting surgical valve prosthesis-patient mismatch was not associated with mortality but did limit patient improvement in quality of life over 3-year follow-up.Abstract: METHODS: The CoreValve US Expanded Use Study is a prospective, nonrandomized, single-arm study that evaluates safety and effectiveness of TAVR in extreme risk patients with symptomatic failed surgical biologic aortic valves. Study end points include all-cause mortality, need for valve reintervention, hemodynamic changes over time, and quality of life through 3 years. Patients were stratified by presence of preexisting surgical valve prosthesis-patient mismatch.Abstract: RESULTS: From March 2013 to May 2015, 226 patients deemed extreme risk (STS-PROM [Society of Thoracic Surgeons Predicted Risk of Mortality] 9.0+/-7%) had attempted valve-in-valve TAVR. Preexisting surgical valve prosthesis-patient mismatch was present in 47.2% of the cohort. At 3 years, all-cause mortality or major stroke was 28.6%, and 93% of patients were in New York Heart Association I or II heart failure. Valve performance was maintained over 3 years with low valve reintervention rates (4.4%), an improvement in effective orifice area over time and a 2.7% rate of severe structural valve deterioration. Preexisting severe prosthesis-patient mismatch was not associated with 3-year mortality but was associated with significantly less improvement in quality of life at 3-year follow-up (P=0.01).

Powered by Koha