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Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement

BACKGROUND: Long‐term data on durability of currently available transcatheter heart valves are sparse. We sought to assess the incidence of long‐term (8‐year) structural valve dysfunction and bioprosthetic valve failure in a cohort of patients with transcatheter aortic valve replacement (TAVR) who r...

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Autores principales: Barbanti, Marco, Costa, Giuliano, Zappulla, Paolo, Todaro, Denise, Picci, Andrea, Rapisarda, Giulia, Di Simone, Emanuela, Sicuso, Rita, Buccheri, Sergio, Gulino, Simona, Pilato, Gerlando, La Spina, Ketty, D'Arrigo, Paolo, Valvo, Roberto, Indelicato, Antonino, Giannazzo, Daniela, Immè, Sebastiano, Tamburino, Claudia, Patanè, Martina, Sgroi, Carmelo, Giuffrida, Angelo, Trovato, Danilo, Monte, Ines Paola, Deste, Wanda, Capranzano, Piera, Capodanno, Davide, Tamburino, Corrado
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201462/
https://www.ncbi.nlm.nih.gov/pubmed/30371244
http://dx.doi.org/10.1161/JAHA.117.008440
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author Barbanti, Marco
Costa, Giuliano
Zappulla, Paolo
Todaro, Denise
Picci, Andrea
Rapisarda, Giulia
Di Simone, Emanuela
Sicuso, Rita
Buccheri, Sergio
Gulino, Simona
Pilato, Gerlando
La Spina, Ketty
D'Arrigo, Paolo
Valvo, Roberto
Indelicato, Antonino
Giannazzo, Daniela
Immè, Sebastiano
Tamburino, Claudia
Patanè, Martina
Sgroi, Carmelo
Giuffrida, Angelo
Trovato, Danilo
Monte, Ines Paola
Deste, Wanda
Capranzano, Piera
Capodanno, Davide
Tamburino, Corrado
author_facet Barbanti, Marco
Costa, Giuliano
Zappulla, Paolo
Todaro, Denise
Picci, Andrea
Rapisarda, Giulia
Di Simone, Emanuela
Sicuso, Rita
Buccheri, Sergio
Gulino, Simona
Pilato, Gerlando
La Spina, Ketty
D'Arrigo, Paolo
Valvo, Roberto
Indelicato, Antonino
Giannazzo, Daniela
Immè, Sebastiano
Tamburino, Claudia
Patanè, Martina
Sgroi, Carmelo
Giuffrida, Angelo
Trovato, Danilo
Monte, Ines Paola
Deste, Wanda
Capranzano, Piera
Capodanno, Davide
Tamburino, Corrado
author_sort Barbanti, Marco
collection PubMed
description BACKGROUND: Long‐term data on durability of currently available transcatheter heart valves are sparse. We sought to assess the incidence of long‐term (8‐year) structural valve dysfunction and bioprosthetic valve failure in a cohort of patients with transcatheter aortic valve replacement (TAVR) who reached at least 5‐year follow‐up. METHODS AND RESULTS: Consecutive patients with at least 5‐year follow‐up available undergoing TAVR from June 4, 2007 to March 30, 2012 were included. Structural valve dysfunction and bioprosthetic valve failure were defined according to newly standardized European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio‐Thoracic Surgery criteria and reported as cumulative incidence function to account for the competing risk of death. A total of 288 consecutive patients with a mean age of 80.7±5.3 years and with a mean Society of Thoracic Surgery mortality score of 8.1±5.1% were analyzed. Survival rate at 8 years was 29.8%. Mean pressure gradients decreased from 53.3±15.9 mm Hg (pre‐TAVR) to 10.5±4.5 mm Hg (in‐hospital post‐TAVR) (P<0.001). There was a small, not significant, increase in the transaortic gradient throughout follow‐up. Bioprosthetic valve failure was observed in a total of 11 patients (8‐year cumulative incidence function: 4.51%; 95% confidence interval, 1.95%–8.76%). Severe and moderate structural valve dysfunctions were reported in 7 patients (8‐year cumulative incidence function: 2.39%; 95% confidence interval, 0.77%–5.71%) and 13 patients (8‐year cumulative incidence function: 5.87%; 95% confidence interval, 3.06%–9.96%), respectively. Aortic valve reintervention (redo TAVR) was successfully performed in 2 patients (0.7%) presenting with symptomatic severe restenosis and intraprosthetic regurgitation subsequent to endocarditis. CONCLUSIONS: In an aged population of patients with symptomatic severe aortic stenosis treated with first‐generation bioprostheses, TAVR was associated with a survival rate of 30% but low rates of bioprosthetic valve failure and structural valve dysfunction at 8 years.
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spelling pubmed-62014622018-10-31 Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement Barbanti, Marco Costa, Giuliano Zappulla, Paolo Todaro, Denise Picci, Andrea Rapisarda, Giulia Di Simone, Emanuela Sicuso, Rita Buccheri, Sergio Gulino, Simona Pilato, Gerlando La Spina, Ketty D'Arrigo, Paolo Valvo, Roberto Indelicato, Antonino Giannazzo, Daniela Immè, Sebastiano Tamburino, Claudia Patanè, Martina Sgroi, Carmelo Giuffrida, Angelo Trovato, Danilo Monte, Ines Paola Deste, Wanda Capranzano, Piera Capodanno, Davide Tamburino, Corrado J Am Heart Assoc Original Research BACKGROUND: Long‐term data on durability of currently available transcatheter heart valves are sparse. We sought to assess the incidence of long‐term (8‐year) structural valve dysfunction and bioprosthetic valve failure in a cohort of patients with transcatheter aortic valve replacement (TAVR) who reached at least 5‐year follow‐up. METHODS AND RESULTS: Consecutive patients with at least 5‐year follow‐up available undergoing TAVR from June 4, 2007 to March 30, 2012 were included. Structural valve dysfunction and bioprosthetic valve failure were defined according to newly standardized European Association of Percutaneous Cardiovascular Interventions/European Society of Cardiology/European Association for Cardio‐Thoracic Surgery criteria and reported as cumulative incidence function to account for the competing risk of death. A total of 288 consecutive patients with a mean age of 80.7±5.3 years and with a mean Society of Thoracic Surgery mortality score of 8.1±5.1% were analyzed. Survival rate at 8 years was 29.8%. Mean pressure gradients decreased from 53.3±15.9 mm Hg (pre‐TAVR) to 10.5±4.5 mm Hg (in‐hospital post‐TAVR) (P<0.001). There was a small, not significant, increase in the transaortic gradient throughout follow‐up. Bioprosthetic valve failure was observed in a total of 11 patients (8‐year cumulative incidence function: 4.51%; 95% confidence interval, 1.95%–8.76%). Severe and moderate structural valve dysfunctions were reported in 7 patients (8‐year cumulative incidence function: 2.39%; 95% confidence interval, 0.77%–5.71%) and 13 patients (8‐year cumulative incidence function: 5.87%; 95% confidence interval, 3.06%–9.96%), respectively. Aortic valve reintervention (redo TAVR) was successfully performed in 2 patients (0.7%) presenting with symptomatic severe restenosis and intraprosthetic regurgitation subsequent to endocarditis. CONCLUSIONS: In an aged population of patients with symptomatic severe aortic stenosis treated with first‐generation bioprostheses, TAVR was associated with a survival rate of 30% but low rates of bioprosthetic valve failure and structural valve dysfunction at 8 years. John Wiley and Sons Inc. 2018-07-31 /pmc/articles/PMC6201462/ /pubmed/30371244 http://dx.doi.org/10.1161/JAHA.117.008440 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Barbanti, Marco
Costa, Giuliano
Zappulla, Paolo
Todaro, Denise
Picci, Andrea
Rapisarda, Giulia
Di Simone, Emanuela
Sicuso, Rita
Buccheri, Sergio
Gulino, Simona
Pilato, Gerlando
La Spina, Ketty
D'Arrigo, Paolo
Valvo, Roberto
Indelicato, Antonino
Giannazzo, Daniela
Immè, Sebastiano
Tamburino, Claudia
Patanè, Martina
Sgroi, Carmelo
Giuffrida, Angelo
Trovato, Danilo
Monte, Ines Paola
Deste, Wanda
Capranzano, Piera
Capodanno, Davide
Tamburino, Corrado
Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title_full Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title_fullStr Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title_full_unstemmed Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title_short Incidence of Long‐Term Structural Valve Dysfunction and Bioprosthetic Valve Failure After Transcatheter Aortic Valve Replacement
title_sort incidence of long‐term structural valve dysfunction and bioprosthetic valve failure after transcatheter aortic valve replacement
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6201462/
https://www.ncbi.nlm.nih.gov/pubmed/30371244
http://dx.doi.org/10.1161/JAHA.117.008440
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