Patient characteristics and long-term outcomes in patients undergoing transcatheter aortic valve implantation in a failed surgical prosthesis vs in a native valve: A Danish nationwide study - 13/09/23
, Jawad H. Butt, MD a, Søren L. Kristensen, MD, PhD a, Peter E. Weeke, MD, PhD a, Ole De Backer, MD, PhD a, Jarl E. Strange, MD a, Morten Schou, MD, DMSc b, Lars Køber, MD, DMSc a, Emil L. Fosbøl, MD, PhD aRésumé |
Background |
Valve-in-valve-transcatheter aortic valve implantation (TAVI) is a feasible and increasingly used treatment option for failed surgical aortic prosthesis, but data from clinical practice are limited. We aimed to examine patient characteristics and outcomes of patients undergoing TAVI in a surgival valve (valve-in-valve TAVI) compared with patients undergoing TAVI in a native valve.
Methods |
Using nationwide registries, we identified all Danish citizens, who underwent TAVI from January 1, 2008, to December 31, 2020.
Results |
A total of 6,070 patients undergoing TAVI were identified; 247 (4%) patients had a history of SAVR (The valve-in-valve cohort). The median age of the study population was 81 (25th-75th percentile 77-85) and 55% were men. Patients with valve-in-valve-TAVI were younger but had a greater burden of cardiovascular comorbidities compared with patients with native-valve-TAVI. Within 30 days post procedure, 11 (0.2%) and 748 (13.8%) patients who underwent valve-in-valve-TAVI and native-valve-TAVI, respectively, had a pacemaker implantation. The cumulative 30-day risk of death among patients with valve-in-valve-TAVI was 2.4% (95% CI: 1.0%-5.0%) and 2.7% (95% CI: 2.3%-3.1%) in patients with native-valve-TAVI, respectively. Correspondingly, the cumulative 5-year risk of death was 42.5% (95% CI: 34.2%-50.6%) and 44.8% (95% CI: 43.2%-46.4%), respectively. In multivariable Cox proportional hazard analysis, valve-in-valve-TAVI was not associated with a significantly different risk of death at 30 days (Hazard ratio (HR) = 0.95, 95% CI 0.41-2.19) and 5 years (HR = 0.79, 95% CI 0.62-1.00) post-TAVI compared with native-valve-TAVI.
Conclusions |
TAVI in a failed surgical aortic prosthesis as compared to TAVI in a native valve, was not associated with significantly different short- and long-term mortality, suggesting that valve-in-valve-TAVI is a safe procedure.
Le texte complet de cet article est disponible en PDF.Abbreviations : TAVI, SAVR, NOMESCO, ICD-8, ICD-10, HR, CI, CABG
Plan
| Tweet: TAVI in a failed surgical aortic prosthesis as compared to TAVI in a native valve, was not associated with significantly different short- and long-term mortality. |
|
| This paper was handled by Guest Editor: Blase Carabello, MD. |
Vol 264
P. 183-189 - octobre 2023 Retour au numéro
Article précédent
- Gut barrier dysfunction and endotoxemia in heart failure: A dangerous connubium?
- Francesco Violi, Valentina Castellani, Danilo Menichelli, Pasquale Pignatelli, Daniele Pastori
- Temporal Changes in Clinical Characteristics and Outcomes of Adults With Congenital Heart Disease
- Alexander C. Egbe, William R. Miranda, C. Charles Jain, Elizabeth H. Stephens, Kartik Andi, Omar Abozied, Heidi M. Connolly
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 ?