Comparison of in-hospital outcomes and long-term survival for valve-in-valve transcatheter aortic valve replacement versus the benchmark native valve transcatheter aortic valve replacement procedure

Matta, Anthony; Lévai, László; Roncalli, Jérôme; Elbaz, Meyer; Bouisset, Frédéric; Nader, Vanessa; Blanco, Stéphane; Parada, Francisco Campelo; Carrié, Didier; Lhermusier, Thibault

doi:10.3389/fcvm.2023.1113012

Cited by 6 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Aortic stenosis is notably prevalent in the elderly population, as evidenced by a prospective study highlighting a notable rise in its incidence from 0.2% among individuals in their 50s to a significant 9.8% among those in their 80s. (13). The etiology of concomitant valvular dysfunction in patients with severe AS is frequent and often multifactorial.…”

Section: Discussionmentioning

confidence: 99%

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Abraham,

Botros,

Fath

et al. 2024

Preprint

View full text Add to dashboard Cite

Tricuspid regurgitation (TR) and mitral regurgitation (MR) are common valvular conditions encountered in patients undergoing transcatheter aortic valve implantation (TAVI). This retrospective study investigates the impact of moderate or severe TR and MR on all-cause mortality in one-year post-TAVI patients. Consecutive patients who underwent TAVI at our institution between 2012 and 2018 were identified. Patients were stratified into 2 groups based on valvular regurgitation severity: moderate/severe MR vs. no/mild MR, and moderate/severe TR vs. no/mild TR. Primary outcome was all-cause mortality at 1-year follow up, and secondary outcome was in-hospital death. Logistic regression analysis was conducted to assess the relationship between moderate/severe MR or TR and all-cause mortality at 1-year follow-up. We included a total of 1,071 patients who underwent TAVI with mean age 80.9 ± 8.6 years, 97% white, and 58.3% males. Moderate or severe MR group included 52 (4.88%) patients while mild or no MR group included 1,015 (95.12%) patients. There was no significant difference between both groups in TAVI procedure success rate (100% vs. 97.83%, p=0.283), in-hospital mortality (0 vs. 1.08%, p=0.450), or mortality at 1-year follow up (15.38% vs. 14.09%, p=0.794). In the logistic regression analysis, moderate or severe MR did not show significant correlation with all-cause mortality at 1-year follow up (OR 0.88, 95% CI [0.38 - 1.99], p=0.761). Moderate or severe TR group included 86 (8.03%) patients while mild or no TR group included 985 (91.97%) patients. There was no difference between both groups in TAVI procedure success (98.8% vs. 97.9%, p=0.54) or in-hospital mortality (0% vs. 1.1%, p=0.33). At 1-year follow up, patients with moderate or severe TR had higher mortality (26.7% vs. 13.2%, p=0.001) compared to patients with mild or no TR. In the logistic regression analysis, moderate or severe TR was correlated with higher all-cause mortality at 1-year (OR 1.89, 95% CI [1.07, 3.34], P=0.027). At 1 year follow up, moderate/severe TR, but not MR, is associated with higher mortality in patients underwent TAVI. Careful assessment of multi-valvular heart disease prior to the procedure is warranted.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Abraham,

Botros,

Fath

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…Compared to TAVI on the native valve, ViV-TAVI has a higher risk of CO (0.1% vs. 3.1%), especially in failed surgical prostheses. Indeed, the incidence of this complication is much higher in stentless and externally mounted leaflets valves (such as Mitroflow and Trifecta) [35,36]. In a recent study, Malvidini et al showed the failure modalities of Trifecta valves: a total of 1228 patients received Trifecta prosthetic and among them, 44 patients (3.5%) underwent aortic valve reintervention.…”

Section: Valve-in-valvementioning

confidence: 99%

Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review

et al. 2023

View full text Add to dashboard Cite

Transcatheter aortic valve implantation (TAVI) is a widely adopted treatment option for patients with severe aortic stenosis. Its popularity has grown significantly in recent years due to advancements in technology and imaging. As TAVI use is increasingly expanded to younger patients, the need for long-term assessment and durability becomes paramount. This review aims to provide an overview of the diagnostic tools to evaluate the hemodynamic performance of aortic prosthesis, with a special focus on the comparison between transcatheter and surgical aortic valves and between self-expandable and balloon-expandable valves. Moreover, the discussion will encompass how cardiovascular imaging can effectively detect long-term structural valve deterioration.

show abstract

“…A comparison from FRANCE‐TAVI registry reported higher rates of paravalvular regurgitation, in‐hospital and 2‐year mortality with self‐expanding transcatheter heart valves 3 . There is a growing body of literature on long‐term outcomes post‐TAVR, 4–7 but to our knowledge, few research have focused on patients with severe cardiac dysfunction. For example, patients with left ventricular ejection fraction (LVEF) below 30% were excluded from the Partner 3 clinical trial 8 .…”

Section: Introductionmentioning

confidence: 99%

Survival outcomes of TAVR and self‐expanding versus balloon‐expandable valves in patients with advanced cardiac dysfunction

Matta,

Lhermusier,

Ohlmann

et al. 2024

ESC Heart Failure

Self Cite

View full text Add to dashboard Cite

AimsThere is a growing body of literature on long‐term outcomes post‐transcatheter aortic valve replacement (TAVR), but to our knowledge, few research have focused on patients with advanced cardiac dysfunction. This challenging category of patients was excluded from the Partner 3 clinical trial. There are no data to guide the choice of valve type in patients with severely depressed ejection fraction. This study evaluates the safety, efficacy, and outcomes of TAVR in patients with severe aortic stenosis and left ventricular ejection fraction (LVEF) ≤ 35%. It compares post‐TAVR survival outcomes with self‐expanding (SEV) versus balloon‐expandable (BEV) valves in the context of cardiac dysfunction.Methods and resultsA retrospective cohort was conducted on 977 patients who underwent TAVR at Toulouse University Hospital between January 2016 and December 2020. The study population included two groups: LVEF ≤ 35% (N = 157) and LVEF ≥ 50% (N = 820). The group of LVEF ≤ 35% was divided into two subgroups according to the type of implanted device: self‐expanding (N = 66) versus balloon‐expandable (N = 91). The living status of each of study's participants was observed in December 2022. Patients with low ejection fraction were younger (82 vs. 84.6 years) and commonly males (71.3% vs. 45.6%). Procedural success was almost 98% in both study groups (97.5% vs. 97.9%). The prevalence of all in‐hospital post‐TAVR complications [acute kidney injury (3.8% vs. 2.2%), major bleeding events (2.5% vs. 3.2%), stroke (1.3% vs. 1.6%), pacemaker implantation (10.2% vs. 10.7%), major vascular complication (4.5% vs. 4.5%), new onset atrial fibrillation (3.2% vs. 3.4%), and in‐hospital death (3.2% vs. 2.8%)] were similar between groups (LVEF ≤ 35% vs. LVEF ≥ 50%). No difference in long‐term survival has been revealed over 3.4 years (P = 0.268). In patients with LVEF ≤ 35%, except for post‐TAVR mean aortic gradient (7.8 ± 4.2 vs. 10.2 ± 3.6), baseline and procedural characteristics were comparable between SEV versus BEV subgroups. An early improvement in LVEF (from 29.2 ± 5.5 to 37.4 ± 10.8) was observed. In patients with LVEF ≤ 35%, the all‐cause mortality rate was significantly higher in BEV than that in SEV subgroups, respectively (40.7% vs. 22.7%, P = 0.018). Kaplan–Meier curve showed better survival outcomes after SEV implantation (P = 0.032). A Cox regression identified BEV as independent predictor of mortality [HR = 3.276, 95% CI (1.520–7.060), P = 0.002].ConclusionsIn the setting of low LVEF, TAVR remains a safe and effective procedure not associated with an increased risk of complications and mortality. SEV implantation may likely result in superior survival outcomes in patients with advanced cardiac dysfunction.

show abstract

Comparison of in-hospital outcomes and long-term survival for valve-in-valve transcatheter aortic valve replacement versus the benchmark native valve transcatheter aortic valve replacement procedure

Cited by 6 publications

References 30 publications

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Impact of Moderate to Severe Mitral and Tricuspid Valves Regurgitation after Transcatheter Aortic Valve Implantation: A Multicenter Retrospective Study

Hemodynamic Performance of Transcatheter Aortic Valves: A Comprehensive Review

Survival outcomes of TAVR and self‐expanding versus balloon‐expandable valves in patients with advanced cardiac dysfunction

Contact Info

Product

Resources

About