Transcatheter aortic valve replacement for patients with severe bicuspid aortic stenosis - 19/06/20
Abstract |
Background |
Patients with bicuspid aortic valve stenosis (BAV) were excluded from all the trileaflet aortic valve stenosis (TAV) pivotal trials, and therefore, their outcomes are not clearly defined. The aim of the study was to evaluate the outcomes of transcatheter aortic valve replacement (TAVR) in patients with BAV and compared them with those of TAV.
Methods |
We evaluated the outcomes following TAVR of patients with BAV at our institution between April 2011 and November 2016 and compared them with the outcomes of patients with TAV treated with TAVR. The χ2 and the Mann-Whitney U tests were used to compare the groups, and a Kaplan-Meier analysis was performed to estimate long-term survival.
Results |
TAVR was performed in a total of 567 patients, from which 50 (8.8%) had BAV and 517 (91.2%) had TAV. Patients with BAV were younger and had higher prevalence of chronic obstructive pulmonary disease, lower prevalence of coronary artery disease, higher body mass index, and lower Society of Thoracic Surgeons score (STS PROM). Patients with BAV had a slightly higher mean aortic valve gradient postoperatively (median 12 mm Hg [10-15] vs 10 [7-13], P < .001), but paravalvular aortic regurgitation was not different between the groups (> mild 4.0% vs 3.5%, P = .541). Clinical outcomes were not different between the groups, including stroke (2.0% vs 1.5, P = .567) and the 30-day all-cause mortality (6.0% vs 1.5, P = .064). The 2-year survival (82.0% vs 83.4, P = .476) was similar between the groups.
Conclusions |
This initial experience suggests that TAVR can be safely performed in patients with BAV, achieving similar short-term procedural and clinical outcomes when compared with patients with TAV.
Le texte complet de cet article est disponible en PDF.Plan
| Source of funding: none. |
|
| Conflict of interest: none. |
|
| Ismail El-Hamamsy, MD, PhD, served as guest editor for this article. |
Vol 224
P. 105-112 - juin 2020 Retour au numéro
Article précédent
- Radial versus femoral access for percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction: Trial sequential analysis
- Mohammed Osman, Maryam Saleem, Khansa Osman, Babikir Kheiri, Sean Regner, Qais Radaideh, Jason A. Moreland, Sunil V Rao, Samir Kapadia
- Effects of the chymase inhibitor fulacimstat on adverse cardiac remodeling after acute myocardial infarction—Results of the Chymase Inhibitor in Adverse Remodeling after Myocardial Infarction (CHIARA MIA) 2 trial
- Hans-Dirk Duengen, Raymond J. Kim, Doron Zahger, Katia Orvin, Ran Kornowski, Dan Admon, Jiri Kettner, Avraham Shimony, Christiane Otto, Michael Becka, Friederike Kanefendt, Andres Iniguez Romo, Tal Hasin, Petr Ostadal, Gonzalo Calvo Rojas, Michele Senni, GROUP investigators of the CHIARA MIA 2 trial, Ivo Podpera, Hana Linkova, Petr Hajek, Johann Bauersachs, Niels Menck, Jan Fuisting, Sadrack Oumbe Tiam, Manuel Martinez Selles, Vicente Miro Palau, Mercedes Roque, Borja Ibanez, Yaron Arbel, Eugenia Nikolsky, Savina Nodari, Gian Carlo Silvio Marenzi, Felice Achilli, Bernhard Reimers
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?