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Transcatheter Valve-in-Valve Replacement With Balloon- Versus Self-Expanding Valves in Patients With Degenerated Stentless Aortic Bioprosthesis.
Moubarak, Ghadi; Salih, Mohammed; Eisenga, John; McCullough, Kyle; Ramos, Osniel Gonzalez; Banwait, Jasjit; Al-Azizi, Karim; Mack, Michael J; DiMaio, J Michael; Szerlip, Molly I.
Afiliación
  • Moubarak G; Department of Research, Baylor Scott and White Research Institute Plano, Texas. Electronic address: hadi.moubarak@bswhealth.org.
  • Salih M; Research Department, The Heart Hospital Baylor, Plano, Texas.
  • Eisenga J; Department of Research, Baylor Scott and White Research Institute Plano, Texas.
  • McCullough K; Department of Research, Baylor Scott and White Research Institute Plano, Texas.
  • Ramos OG; Department of Research, Baylor Scott and White Research Institute Plano, Texas.
  • Banwait J; Department of Research, Baylor Scott and White Research Institute Plano, Texas.
  • Al-Azizi K; Research Department, The Heart Hospital Baylor, Plano, Texas.
  • Mack MJ; Department of Research, Baylor Scott and White Research Institute Plano, Texas; Department of Cardiothoracic Surgery, Baylor Scott and White The Heart Hospital Plano, Texas.
  • DiMaio JM; Department of Research, Baylor Scott and White Research Institute Plano, Texas; Department of Cardiothoracic Surgery, Baylor Scott and White The Heart Hospital Plano, Texas.
  • Szerlip MI; Department of Research, Baylor Scott and White Research Institute Plano, Texas; Research Department, The Heart Hospital Baylor, Plano, Texas.
Am J Cardiol ; 230: 50-57, 2024 Aug 06.
Article en En | MEDLINE | ID: mdl-39117008
ABSTRACT
Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) has been associated with favorable outcomes in patients with degenerated stentless bioprosthesis. However, whether the outcomes after ViV TAVR for failed stentless bioprosthesis differ between balloon-expandable valves (BEVs) and self-expanding valves (SEVs) remains unknown. Therefore, we retrospectively analyzed 59 consecutive patients who underwent ViV TAVR for failed stentless bioprsothesis with BEVs (n = 42) versus SEVs (n = 17) in a single-health care system between 2013 and 2022. Overall, the mean age was 70.8 years and 74.6% were men. The mean transcatheter valve size was 26.3 ± 2.2 mm for BEVs and 26.4 ± 4 mm for SEVs (p = 0.93). The mean Society of Thoracic Surgeons score was 6.0 ± 3.6 for BEVs and 7.5 ± 5.5 for SEVs (p = 0.22). Compared with patients who received BEVs, those who received SEVs had higher rates of device malposition (2.4% vs 23.5%, p <0.01), postdeployment balloon dilation (11.9% vs 35.5%, p = 0.04) and need for a second transcatheter device (2.4% vs 35.5%, p <0.01). However, both groups showed similar improvement in aortic valve function at 30-day and 1-year follow-up (incidence of 1-year severe patient-prosthesis mismatch in BEVs 17.6% vs 14.3% in SEVs, p = 0.78). The 1- and 3-year mortality did not differ between BEVs and SEVs (11.9% vs 11.8% and 25% vs 30%, respectively, Log rank p = 0.9). In conclusion, performing ViV TAVR for failed stentless bioprsothesis is technically challenging, especially when using SEVs; however, satisfactory positioning is possible in most cases, with excellent hemodynamic and clinical outcomes with BEVs and SEVs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Am J Cardiol Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos