Bicuspid aortic valve morphology and outcomes after transcatheter aortic valve replacement
| العنوان: | Bicuspid aortic valve morphology and outcomes after transcatheter aortic valve replacement |
|---|---|
| المؤلفون: | Yoon, S.H., Kim, W.K., Dhoble, A., Pio, S.M., Babaliaros, V., Jilaihawi, H., Pilgrim, T., Backer, O. de, Bleiziffer, S., Vincent, F., Schmidit, T., Butter, C., Kamioka, N., Eschenbach, L., Renker, M., Asami, M., Lazkani, M., Fujita, B., Birs, A., Barbanti, M., Pershad, A., Landes, U., Oldemeyer, B., Kitamura, M., Oakley, L., Ochiai, T., Chakravarty, T., Nakamura, M., Ruile, P., Deuschl, F., Berman, D., Modine, T., Ensminger, S., Kornowski, R., Lange, R., McCabe, J.M., Williams, M.R., Whisenant, B., Delgado, V., Windecker, S., Belle, E. van, Sondergaard, L., Chevalier, B., Mack, M., Bax, J.J., Leon, M.B., Makkar, R.R., Bicuspid Aortic Valve Stenosis |
| المصدر: | Journal of the American College of Cardiology, 76(9), 1018-1030. ELSEVIER SCIENCE INC Yoon, S H, Kim, W K, Dhoble, A, Milhorini Pio, S, Babaliaros, V, Jilaihawi, H, Pilgrim, T, De Backer, O, Bleiziffer, S, Vincent, F, Schmidit, T, Butter, C, Kamioka, N, Eschenbach, L, Renker, M, Asami, M, Lazkani, M, Fujita, B, Birs, A, Barbanti, M, Pershad, A, Landes, U, Oldemeyer, B, Kitamura, M, Oakley, L, Ochiai, T, Chakravarty, T, Nakamura, M, Ruile, P, Deuschl, F, Berman, D, Modine, T, Ensminger, S, Kornowski, R, Lange, R, McCabe, J M, Williams, M R, Whisenant, B, Delgado, V, Windecker, S, Van Belle, E, Sondergaard, L, Chevalier, B, Mack, M, Bax, J J, Leon, M B, Makkar, R R & Bicuspid Aortic Valve Stenosis Transcatheter Aortic Valve Replacement Registry Investigators 2020, ' Bicuspid Aortic Valve Morphology and Outcomes After Transcatheter Aortic Valve Replacement ', Journal of the American College of Cardiology, vol. 76, no. 9, pp. 1018-1030 . https://doi.org/10.1016/j.jacc.2020.07.005Test |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Internationality, bicuspid aortic valve, Transcatheter aortic, medicine.medical_treatment, 030204 cardiovascular system & hematology, Transcatheter Aortic Valve Replacement, 03 medical and health sciences, 0302 clinical medicine, Bicuspid aortic valve, Aortic valve replacement, Valve replacement, Bicuspid Aortic Valve Disease, Internal medicine, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Registries, Mortality, 610 Medicine & health, transcatheter aortic valve implantation, Aged, Aged, 80 and over, Raphe, business.industry, aortic stenosis, medicine.disease, Clinical trial, Stenosis, Treatment Outcome, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Tomography, X-Ray Computed, Calcification, Follow-Up Studies |
| الوصف: | Background: Bicuspid aortic stenosis accounts for almost 50% of patients undergoing surgical aortic valve replacement in the younger patients. Expanding the indication of transcatheter aortic valve replacement (TAVR) toward lower-risk and younger populations will lead to increased use of TAVR for patients with bicuspid aortic valve (BAV) stenosis despite the exclusion of bicuspid anatomy in all pivotal clinical trials. Objectives: This study sought to evaluate the association of BAV morphology and outcomes of TAVR with the new-generation devices. Methods: Patients with BAV confirmed by central core laboratory computed tomography (CT) analysis were included from the international multicenter BAV TAVR registry. BAV morphology including the number of raphe, calcification grade in raphe, and leaflet calcium volume were assessed with CT analysis in a masked fashion. Primary outcomes were all-cause mortality at 1 and 2 years, and secondary outcomes included 30-day major endpoints and procedural complications. Results: A total of 1,034 CT-confirmed BAV patients with a mean age of 74.7 years and Society of Thoracic Surgeons score of 3.7% underwent TAVR with contemporary devices (n = 740 with Sapien 3; n = 188 with Evolut R/Pro; n = 106 with others). All-cause 30-day, 1-year, and 2-year mortality was 2.0%, 6.7%, and 12.5%, respectively. Multivariable analysis identified calcified raphe and excess leaflet calcification (defined as more than median calcium volume) as independent predictors of 2-year all-cause mortality. Both calcified raphe plus excess leaflet calcification were found in 269 patients (26.0%), and they had significantly higher 2-year all-cause mortality than those with 1 or none of these morphological features (25.7% vs. 9.5% vs. 5.9%; log-rank p < 0.001). Patients with both morphological features had higher rates of aortic root injury (p < 0.001), moderate-to-severe paravalvular regurgitation (p = 0.002), and 30-day mortality (p = 0.016). Conclusions: Outcomes of TAVR in bicuspid aortic stenosis depend on valve morphology. Calcified raphe and excess leaflet calcification were associated with increased risk of procedural complications and midterm mortality. (Bicuspid Aortic Valve Stenosis Transcatheter Aortic Valve Replacement Registry; NCT03836521) |
| وصف الملف: | application/pdf |
| اللغة: | English |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8e8164475485b6728e296843a9e1be31Test http://hdl.handle.net/1887/3232633Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....8e8164475485b6728e296843a9e1be31 |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |