Late Surgical Treatment for Transcatheter Aortic Valve Prosthesis Dysfunction

Malvindi, Pietro Giorgio; Lorusso, Roberto; Jiritano, Federica; Santarpino, Giuseppe; Pilato, Michele; Cammardella, Antonio Giovanni; Putte, Bart Van de; Bonaros, Nikolaos; Garatti, Andrea; Paparella, Domenico

doi:10.1016/j.athoracsur.2020.06.138

Cited by 4 publications

(18 citation statements)

References 5 publications

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“…In addition, 75 articles were excluded for the following reasons: 35 studies that reported outcomes of SAVR explant, 32 studies that reported outcomes of valve-in-valve replacement, 5 case reports, 2 commentaries, and 1 study with significant duplicated data with other studies. 20 Ten articles met the inclusion and exclusion criteria and were included in the meta-analysis 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ( Figure E1 ). Most of the data variables from 2 of these articles 9 , 13 were excluded from the analysis owing to potential cohort duplication with other articles.…”

Section: Resultsmentioning

confidence: 99%

“…Among the 10 included articles, with a total of 1690 patients, 7 articles were from the United States and 1 article each were from Japan, 10 Germany, 8 and Italy. 16 The frequency of TAVR explants were reported in 4 articles. 10 , 11 , 14 , 15 Seven articles presented the age at TAVR explant 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 and 5 articles included the interval between index TAVR and TAVR explant.…”

Section: Resultsmentioning

confidence: 99%

“… 16 The frequency of TAVR explants were reported in 4 articles. 10 , 11 , 14 , 15 Seven articles presented the age at TAVR explant 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 and 5 articles included the interval between index TAVR and TAVR explant. 8 , 9 , 11 , 12 , 14 STS-PROM at index TAVR was reported in 3 articles, 12 , 13 , 14 and STS-PROM at TAVR explant also was reported in 3 articles.…”

Section: Resultsmentioning

confidence: 99%

“…Only a limited number of studies have described post-TAVR valve reinterventions, either repeat TAVR 6 , 7 or surgical TAVR valve explant (TAVR explant) procedures. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 Of particular concern is the consistent dismal outcomes in patients requiring TAVR explant. In this context, we conducted a systematic review and meta-analysis to better characterize the clinical implications of TAVR explant in patients with a failing TAVR valve using existing evidence and ultimately help refine patient selection for TAVR as the initial valve procedure.…”

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confidence: 99%

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Surgical explantation of transcatheter aortic bioprosthesis: A systematic review and meta-analysis

et al. 2021

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Surgical explantation of transcatheter aortic bioprosthesis: A systematic review and meta-analysis

et al. 2021

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“…This raises the second potential issue in the TAVR bridge to SAVR, namely the possibility of making TAVR removal challenging or risky by waiting too long or by choice of TAVR device. The world experience with SAVR after TAVR is limited 3 …”

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confidence: 99%

Is this a bridge too far?

Glower

2020

J Card Surg

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Maeda et al. present what may be the second reported case of transcatheter aortic valve replacement (TAVR) followed by staged open surgical aortic valve replacement (SAVR) in a high-risk patient. The authors propose that TAVR may serve as a bridge procedure before SAVR for aortic stenosis in selected younger patients with high surgical risk. Further experience may clarify how long to wait after TAVR to perform SAVR. Timing will be a balance between improving surgical risk versus increasing difficulty removing the prosthesis. Knowledge of TAVR durability will ultimately be needed to decide between "destination" TAVR versus bridging to SAVR with a more durable device. K E Y W O R D S aortic valve replacement, transcatheter aortic valve replacement Maeda et al. 1 present a case of transcatheter aortic valve replacement (TAVR) followed by staged open surgical aortic valve replace-How to cite this article: Glower DD. Is this a bridge too far? J

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Endocarditis in Patients with Aortic Valve Prosthesis: Comparison between Surgical and Transcatheter Prosthesis

Palo¹,

Scicchitano²,

Malvindi

et al. 2021

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The interventional treatment of aortic stenosis is currently based on transcatheter aortic valve implantation/replacement (TAVI/TAVR) and surgical aortic valve replacement (SAVR). Prosthetic valve infective endocarditis (PVE) is the most worrisome complication after valve replacement, as it still carries high mortality and morbidity rate. Studies have not highlighted the differences in the occurrence of PVE in SAVR as opposed to TAVR, but the reported incidence rates are widely uneven. Literature portrays different microbiological profiles for SAVR and TAVR PVE: Staphylococcus, Enterococcus, and Streptococcus are the pathogens that are more frequently involved with differences regarding the timing from the date of the intervention. Imaging by means of transoesophageal echocardiography, and computed tomography (CT) Scan is essential in identifying vegetations, prosthesis dysfunction, dehiscence, periannular abscess, or aorto-ventricular discontinuity. In most cases, conservative medical treatment is not able to prevent fatal events and surgery represents the only viable option. The primary objectives of surgical treatment are radical debridement and the removal of infected tissues, the reconstruction of cardiac and aortic morphology, and the restoration of the aortic valve function. Different surgical options are discussed. Fast diagnosis, the adequacy of antibiotics treatment, and prompt interventions are essential in preventing the negative consequences of infective endocarditis (IE).

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Late Surgical Treatment for Transcatheter Aortic Valve Prosthesis Dysfunction

Cited by 4 publications

References 5 publications

Surgical explantation of transcatheter aortic bioprosthesis: A systematic review and meta-analysis

Surgical explantation of transcatheter aortic bioprosthesis: A systematic review and meta-analysis

Is this a bridge too far?

Endocarditis in Patients with Aortic Valve Prosthesis: Comparison between Surgical and Transcatheter Prosthesis

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