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Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve
BACKGROUND: Valve-in-valve (ViV) transfemoral transcatheter aortic valve implantation (TAVI) for failing aortic surgical bioprostheses or transcatheter heart valves (THV) has demonstrated a reasonable clinical and hemodynamic efficacy. Traditionally, self-expanding (SE) supra-annular THV are conside...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505706/ https://www.ncbi.nlm.nih.gov/pubmed/37727306 http://dx.doi.org/10.3389/fcvm.2023.1209184 |
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author | Schaefer, Andreas Demal, Till Joscha Bhadra, Oliver D. Grundmann, David Voigtländer, Lisa Waldschmidt, Lara Schirmer, Johannes Pecha, Simon Schneeberger, Yvonne Schofer, Niklas Sörensen, Nils Blankenberg, Stefan Reichenspurner, Hermann Seiffert, Moritz Conradi, Lenard |
author_facet | Schaefer, Andreas Demal, Till Joscha Bhadra, Oliver D. Grundmann, David Voigtländer, Lisa Waldschmidt, Lara Schirmer, Johannes Pecha, Simon Schneeberger, Yvonne Schofer, Niklas Sörensen, Nils Blankenberg, Stefan Reichenspurner, Hermann Seiffert, Moritz Conradi, Lenard |
author_sort | Schaefer, Andreas |
collection | PubMed |
description | BACKGROUND: Valve-in-valve (ViV) transfemoral transcatheter aortic valve implantation (TAVI) for failing aortic surgical bioprostheses or transcatheter heart valves (THV) has demonstrated a reasonable clinical and hemodynamic efficacy. Traditionally, self-expanding (SE) supra-annular THV are considered to result in superior hemodynamics compared with balloon-expandable intra-annular THV after ViV. However, so far no data are found on latest-generation intra-annular SE THV for aortic ViV procedures which might be superior with regard to coronary access or subsequent valve reintervention. AIM: We herein aim to evaluate a latest-generation SE intra-annular THV for aortic ViV procedures. MATERIALS AND METHODS: Between May 2022 and November 2022, five consecutive patients (4/5 female with mean age of 76.2 years and mean Society of Thoracic Surgeons predicted risk of mortality score of 2.9%) received ViV TAVI using the Navitor system (Abbott, Chicago, IL, USA) for treatment of failing surgical bioprostheses or THV. Data were retrospectively analyzed according to updated Valve Academic Research Consortium 3 (VARC-3) definitions. RESULTS: At 30 days, absence of mortality and VARC-3 adjudicated clinical endpoints were documented. Echocardiography at 30 days revealed complete absence of paravalvular leakage and single-digit mean transvalvular gradients (mean of 6.0 mmHg) in all patients. CONCLUSION: The investigated intra-annular SE THV results in excellent 30-day outcomes for aortic ViV procedures for failing surgical bioprostheses or THV. Despite the intra-annular design, hemodynamic results were excellent, even in small bioprostheses. Ease of use of this valve platform is reflected by only two cycles of resheathing in five ViV procedures with hemodynamic stability during all steps of valve deployment. |
format | Online Article Text |
id | pubmed-10505706 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-105057062023-09-19 Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve Schaefer, Andreas Demal, Till Joscha Bhadra, Oliver D. Grundmann, David Voigtländer, Lisa Waldschmidt, Lara Schirmer, Johannes Pecha, Simon Schneeberger, Yvonne Schofer, Niklas Sörensen, Nils Blankenberg, Stefan Reichenspurner, Hermann Seiffert, Moritz Conradi, Lenard Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Valve-in-valve (ViV) transfemoral transcatheter aortic valve implantation (TAVI) for failing aortic surgical bioprostheses or transcatheter heart valves (THV) has demonstrated a reasonable clinical and hemodynamic efficacy. Traditionally, self-expanding (SE) supra-annular THV are considered to result in superior hemodynamics compared with balloon-expandable intra-annular THV after ViV. However, so far no data are found on latest-generation intra-annular SE THV for aortic ViV procedures which might be superior with regard to coronary access or subsequent valve reintervention. AIM: We herein aim to evaluate a latest-generation SE intra-annular THV for aortic ViV procedures. MATERIALS AND METHODS: Between May 2022 and November 2022, five consecutive patients (4/5 female with mean age of 76.2 years and mean Society of Thoracic Surgeons predicted risk of mortality score of 2.9%) received ViV TAVI using the Navitor system (Abbott, Chicago, IL, USA) for treatment of failing surgical bioprostheses or THV. Data were retrospectively analyzed according to updated Valve Academic Research Consortium 3 (VARC-3) definitions. RESULTS: At 30 days, absence of mortality and VARC-3 adjudicated clinical endpoints were documented. Echocardiography at 30 days revealed complete absence of paravalvular leakage and single-digit mean transvalvular gradients (mean of 6.0 mmHg) in all patients. CONCLUSION: The investigated intra-annular SE THV results in excellent 30-day outcomes for aortic ViV procedures for failing surgical bioprostheses or THV. Despite the intra-annular design, hemodynamic results were excellent, even in small bioprostheses. Ease of use of this valve platform is reflected by only two cycles of resheathing in five ViV procedures with hemodynamic stability during all steps of valve deployment. Frontiers Media S.A. 2023-09-01 /pmc/articles/PMC10505706/ /pubmed/37727306 http://dx.doi.org/10.3389/fcvm.2023.1209184 Text en © 2023 Schaefer, Demal, Bhadra, Grundmann, Voigtläender, Waldschmidt, Schirmer, Pecha, Schneeberger, Schofer, Sörensen, Blankenberg, Reichenspurner, Seiffert and Conradi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Schaefer, Andreas Demal, Till Joscha Bhadra, Oliver D. Grundmann, David Voigtländer, Lisa Waldschmidt, Lara Schirmer, Johannes Pecha, Simon Schneeberger, Yvonne Schofer, Niklas Sörensen, Nils Blankenberg, Stefan Reichenspurner, Hermann Seiffert, Moritz Conradi, Lenard Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title | Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title_full | Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title_fullStr | Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title_full_unstemmed | Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title_short | Valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
title_sort | valve-in-valve procedures for degenerated surgical and transcatheter aortic valve bioprostheses using a latest-generation self-expanding intra-annular transcatheter heart valve |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10505706/ https://www.ncbi.nlm.nih.gov/pubmed/37727306 http://dx.doi.org/10.3389/fcvm.2023.1209184 |
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