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5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry

The Valve-in-Valve (ViV) technique is an established alternative for the treatment of structural bioprosthetic valve deterioration (SVD). Data describing the intermediate term follow up of patients treated with this approach is scarce. We report on our intermediate-term outcomes of patients with SVD...

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Autores principales: Schamroth Pravda, Nili, Kornowski, Ran, Levi, Amos, Witberg, Guy, Landes, Uri, Perl, Leor, Shapira, Yaron, Orvin, Katia, Mishaev, Raffael, Talmor Barkan, Yeela, Hamdan, Ashraf, Sharoni, Ram, Vaknin Assa, Hana, Codner, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458695/
https://www.ncbi.nlm.nih.gov/pubmed/34568456
http://dx.doi.org/10.3389/fcvm.2021.713341
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author Schamroth Pravda, Nili
Kornowski, Ran
Levi, Amos
Witberg, Guy
Landes, Uri
Perl, Leor
Shapira, Yaron
Orvin, Katia
Mishaev, Raffael
Talmor Barkan, Yeela
Hamdan, Ashraf
Sharoni, Ram
Vaknin Assa, Hana
Codner, Pablo
author_facet Schamroth Pravda, Nili
Kornowski, Ran
Levi, Amos
Witberg, Guy
Landes, Uri
Perl, Leor
Shapira, Yaron
Orvin, Katia
Mishaev, Raffael
Talmor Barkan, Yeela
Hamdan, Ashraf
Sharoni, Ram
Vaknin Assa, Hana
Codner, Pablo
author_sort Schamroth Pravda, Nili
collection PubMed
description The Valve-in-Valve (ViV) technique is an established alternative for the treatment of structural bioprosthetic valve deterioration (SVD). Data describing the intermediate term follow up of patients treated with this approach is scarce. We report on our intermediate-term outcomes of patients with SVD in the Aortic position treated with ViV. Included were patients with symptomatic SVD in the aortic position valve who were treated by Valve in valve transcatheter aortic valve implantation (ViV-TAVI) during the years 2010-2019 in our center. Three main outcomes were examined during the follow up period: NYHA functional class, ViV-TAVI hemodynamic per echocardiography, and mortality. Our cohort consisted of 85 patients (mean age 78.8 ± 8.9 years). The indications for aortic ViV were: SVD isolated aortic stenosis in 37.6%, SVD isolated aortic regurgitation in 42.2% and combined valve pathology in 20.0%. Self-expandable and balloon-expandable devices were used in 73 (85.9%) and 12 (14.1%), respectively. Average follow up was 3.7 ± 2.4 years. 95 and 91% of patients were in NYHA functional class I/II at 1 and 5 year follow up respectively. At one year, the mean trans-aortic valve pressure was 15 ± 9 mmHg and rates of ≥ moderate aortic regurgitation were 3.7%. Mortality at one year was 8.6% (95% CI 2.3–14.4) and 31% (95% CI 16.5–42.5) at 5 years. ViV in the aortic position offers an effective and durable treatment option for patient with SVD, with low rates of all-cause mortality, excellent hemodynamic and improved functional capacity at intermediate follow up.
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spelling pubmed-84586952021-09-24 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry Schamroth Pravda, Nili Kornowski, Ran Levi, Amos Witberg, Guy Landes, Uri Perl, Leor Shapira, Yaron Orvin, Katia Mishaev, Raffael Talmor Barkan, Yeela Hamdan, Ashraf Sharoni, Ram Vaknin Assa, Hana Codner, Pablo Front Cardiovasc Med Cardiovascular Medicine The Valve-in-Valve (ViV) technique is an established alternative for the treatment of structural bioprosthetic valve deterioration (SVD). Data describing the intermediate term follow up of patients treated with this approach is scarce. We report on our intermediate-term outcomes of patients with SVD in the Aortic position treated with ViV. Included were patients with symptomatic SVD in the aortic position valve who were treated by Valve in valve transcatheter aortic valve implantation (ViV-TAVI) during the years 2010-2019 in our center. Three main outcomes were examined during the follow up period: NYHA functional class, ViV-TAVI hemodynamic per echocardiography, and mortality. Our cohort consisted of 85 patients (mean age 78.8 ± 8.9 years). The indications for aortic ViV were: SVD isolated aortic stenosis in 37.6%, SVD isolated aortic regurgitation in 42.2% and combined valve pathology in 20.0%. Self-expandable and balloon-expandable devices were used in 73 (85.9%) and 12 (14.1%), respectively. Average follow up was 3.7 ± 2.4 years. 95 and 91% of patients were in NYHA functional class I/II at 1 and 5 year follow up respectively. At one year, the mean trans-aortic valve pressure was 15 ± 9 mmHg and rates of ≥ moderate aortic regurgitation were 3.7%. Mortality at one year was 8.6% (95% CI 2.3–14.4) and 31% (95% CI 16.5–42.5) at 5 years. ViV in the aortic position offers an effective and durable treatment option for patient with SVD, with low rates of all-cause mortality, excellent hemodynamic and improved functional capacity at intermediate follow up. Frontiers Media S.A. 2021-09-09 /pmc/articles/PMC8458695/ /pubmed/34568456 http://dx.doi.org/10.3389/fcvm.2021.713341 Text en Copyright © 2021 Schamroth Pravda, Kornowski, Levi, Witberg, Landes, Perl, Shapira, Orvin, Mishaev, Talmor Barkan, Hamdan, Sharoni, Vaknin Assa and Codner. 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). 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
Schamroth Pravda, Nili
Kornowski, Ran
Levi, Amos
Witberg, Guy
Landes, Uri
Perl, Leor
Shapira, Yaron
Orvin, Katia
Mishaev, Raffael
Talmor Barkan, Yeela
Hamdan, Ashraf
Sharoni, Ram
Vaknin Assa, Hana
Codner, Pablo
5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title_full 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title_fullStr 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title_full_unstemmed 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title_short 5 Year Outcomes of Patients With Aortic Structural Valve Deterioration Treated With Transcatheter Valve in Valve – A Single Center Prospective Registry
title_sort 5 year outcomes of patients with aortic structural valve deterioration treated with transcatheter valve in valve – a single center prospective registry
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8458695/
https://www.ncbi.nlm.nih.gov/pubmed/34568456
http://dx.doi.org/10.3389/fcvm.2021.713341
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