دورية أكاديمية
Durability and clinical outcomes of transcatheter aortic valve replacement for failed surgical bioprostheses
| العنوان: | Durability and clinical outcomes of transcatheter aortic valve replacement for failed surgical bioprostheses |
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| المؤلفون: | Dauerman, Harold L, Deeb, G Michael, O'Hair, Daniel, Waksman, Ron, Yakubov, Steven J, Kleiman, Neal S, Chetcuti, Stanley J, Hermiller, James B, Bajwa, Tanvir, Khabbaz, Kamal, de Marchena, Eduardo, Salerno, Tomas, Dries-Devlin, Jessica L, Li, Shuzhen, Popma, Jeffrey J, Reardon, Michael J |
| المصدر: | Cardiovascular Surgery |
| بيانات النشر: | Advocate Aurora Health Institutional Repository |
| سنة النشر: | 2019 |
| المجموعة: | Aurora Health Care Digital Repository |
| مصطلحات موضوعية: | aortic valve, aortic valve stenosis, bioprosthesis, transcatheter aortic valve replacement |
| الوصف: | Background: Valve-in-valve transcatheter aortic valve replacement (TAVR) is an option when a surgical valve demonstrates deterioration and dysfunction. This study reports 3-year results following valve-in-valve with self-expanding TAVR. Methods: The CoreValve US Expanded Use Study is a prospective, nonrandomized, single-arm study that evaluates safety and effectiveness of TAVR in extreme risk patients with symptomatic failed surgical biologic aortic valves. Study end points include all-cause mortality, need for valve reintervention, hemodynamic changes over time, and quality of life through 3 years. Patients were stratified by presence of preexisting surgical valve prosthesis-patient mismatch. Results: From March 2013 to May 2015, 226 patients deemed extreme risk (STS-PROM [Society of Thoracic Surgeons Predicted Risk of Mortality] 9.0±7%) had attempted valve-in-valve TAVR. Preexisting surgical valve prosthesis-patient mismatch was present in 47.2% of the cohort. At 3 years, all-cause mortality or major stroke was 28.6%, and 93% of patients were in New York Heart Association I or II heart failure. Valve performance was maintained over 3 years with low valve reintervention rates (4.4%), an improvement in effective orifice area over time and a 2.7% rate of severe structural valve deterioration. Preexisting severe prosthesis-patient mismatch was not associated with 3-year mortality but was associated with significantly less improvement in quality of life at 3-year follow-up (P=0.01). Conclusions: Self-expanding TAVR in patients with failed surgical bioprostheses at extreme risk for surgery was associated with durable hemodynamics and excellent clinical outcomes. Preexisting surgical valve prosthesis-patient mismatch was not associated with mortality but did limit patient improvement in quality of life over 3-year follow-up. Clinical trial registration: URL: http://www.clinicaltrials.govTest. Unique identifier: NCT01675440. |
| نوع الوثيقة: | text |
| اللغة: | unknown |
| العلاقة: | https://institutionalrepository.aah.org/cardiosurg/84Test; https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:31607151Test |
| DOI: | 10.1161/CIRCINTERVENTIONS.119.008155 |
| الإتاحة: | https://doi.org/10.1161/CIRCINTERVENTIONS.119.008155Test https://institutionalrepository.aah.org/cardiosurg/84Test https://xk8bg6rv9a.search.serialssolutions.com/?sid=Entrez:PubMed&id=pmid:31607151Test |
| رقم الانضمام: | edsbas.75D2B2E5 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1161/CIRCINTERVENTIONS.119.008155 |
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