Five-Year Survival of Transcatheter Aortic Valve Implantation in High-Risk Patients

Haymet, Andrew B.; Seco, Michael; Brown, Christopher; Cristoloveanu, Cristina; Murray, Scott A; Wu, Jun; Cartwright, Bruce; Adams, Mark; Vallely, Michael P.; Bannon, Paul G.; Wilson, Michael K.; Ng, M.

doi:10.1016/j.hlc.2021.05.093

Cited by 2 publications

(1 citation statement)

References 27 publications

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“…[ 6 ] Various techniques employed to replace aortic valve include the use of bioprosthetic valve sourced from using animal valve or pericardium, the use of mechanical valve made by tolerable synthetic materials for the body such as metal and carbon, pulmonary autograft (removing the aortic valve and replacing with patient's own pulmonary valve) and prosthetic valve replacement by TAVR. [ 7 8 ]…”

Section: Introductionmentioning

confidence: 99%

Comparing clinical and hemodynamic parameters between the two aortic valve replacement in patients with severe aortic stenosis

Moaref

Zarrabi

Hassanzadeh

et al. 2022

J Cardiovasc Echography

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Context: Various techniques have been proposed for suturing following prosthetic aortic valve implantation, but each has its potential side effects such as patient-prosthesis mismatch (PPM) and paravalvular leak (PVL). Aims: In the present study, we aimed to compare the postoperative sequels of aortic valve replacement (AVR) following the use of two suturing techniques including from the inside of the aorta as the common and classic suturing techniques as compared to new approach including from the outside of the aorta. Settings and Design: This cross-sectional study was performed on patients suffering from symptomatic severe aortic valve disease and candidates for AVR in one of three referral hospitals for cardiovascular disease patients in Shiraz from 2019–2021. Subjects and Methods: The patients underwent one of the two considered surgical techniques for AVR including traditional approach ( n = 60) or the tested approach (suturing from the outside of the aorta) ( n = 30). Statistical Analysis Used: For statistical analysis, results were presented as mean ± standard deviation for quantitative variables and were summarized by frequency (percentage) for categorical variables. Results: PVL and PPM were revealed in none of the participants undergoing the tested approach, while the pointed complications were found in 41.7% and 25.0% of patients underwent traditional approach, respectively, indicating a significant difference. There was no evidence of abnormal dimensionless valve index (DVI) in the patients undergoing sutures from outside the aorta, whereas the rate of DVI abnormality in the patients undergoing traditional procedures was shown to be 18.3%. The mean aortic valve gradient was significantly higher in the group scheduling for the traditional surgical method. Conclusions: Applying new suturing method as suturing from the outside of the aorta, due to the selection of appropriate valve size, the risk for adverse consequences including PPM, PVL, or DVI can be significantly reduced.

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Section: Introductionmentioning

confidence: 99%

Comparing clinical and hemodynamic parameters between the two aortic valve replacement in patients with severe aortic stenosis

Moaref

Zarrabi

Hassanzadeh

et al. 2022

J Cardiovasc Echography

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Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

et al. 2023

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Aim Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic valve stenosis in elderly patients, but there is uncertainty on their long-term effectiveness. We aimed to assess the long-term outcome of patients undergoing TAVI with the Portico valve. Methods We retrospectively collected the data on patients in whom TAVI with Portico was attempted from 7 high-volume centres. Only patients theoretically eligible for 3 or more years of follow-up were included. Clinical outcomes, including death, stroke, myocardial infarction, reintervention for valve degeneration and hemodynamic valve performance were systematically assessed. Results A total of 803 patients were included, with 504 (62.8%) women, mean age of 82 years, median EuroSCORE II of 3.1%, and 386 (48.1%) subjects at low/moderate risk. The median follow-up was 3.0 years (3.0; 4.0). The composite of death, stroke, myocardial infarction, and reintervention for valve degeneration occurred in 37.5% (95% confidence interval: 34.1–40.9%), with all-cause death in 35.1% (31.8–38.4%), stroke in 3.4% (1.3–3.4%), myocardial infarction in 1.0% (0.3–1.5%), and reintervention for valve degeneration in 1.1% (0.6–2.1%). The mean aortic valve gradient at follow-up was 8.1 ± 4.6 mmHg, and at least moderate aortic regurgitation was present in 9.1% (6.7–12.3%). Independent predictors of major adverse events or death were: peripheral artery disease, chronic obstructive pulmonary disease, estimated glomerular filtration rate, atrial fibrillation, prior pacemaker implantation, EuroSCORE II, and reduced left ventricular ejection fraction (all p < 0.05). Conclusions Portico use is associated with favorable long-term clinical outcomes. Clinical outcomes were largely impacted by baseline risk factors and surgical risk.

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Five-Year Survival of Transcatheter Aortic Valve Implantation in High-Risk Patients

Cited by 2 publications

References 27 publications

Comparing clinical and hemodynamic parameters between the two aortic valve replacement in patients with severe aortic stenosis

Comparing clinical and hemodynamic parameters between the two aortic valve replacement in patients with severe aortic stenosis

Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

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