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Valve-in-valve transcatheter aortic valve implantation after failed surgically implanted aortic bioprosthesis versus native transcatheter aortic valve implantation for aortic stenosis: Data from a nationwide analysis.
- Source :
-
Archives of cardiovascular diseases [Arch Cardiovasc Dis] 2021 Jan; Vol. 114 (1), pp. 41-50. Date of Electronic Publication: 2020 Jun 10. - Publication Year :
- 2021
-
Abstract
- Background: Valve-in-valve transcatheter aortic valve implantation (TAVI) has emerged as a treatment for aortic bioprosthesis failure in case of prohibitive risk for redo surgery. However, clinical evaluation of valve-in-valve TAVI remains limited by the number of patients analysed.<br />Aim: To evaluate outcomes of valve-in-valve TAVI compared with native aortic valve TAVI at a nationwide level in France.<br />Methods: Based on the French administrative hospital discharge database, the study collected information for all consecutive patients treated with TAVI for aortic stenosis or with isolated valve-in-valve TAVI for aortic bioprosthesis failure between 2010 and 2019. Propensity score matching was used for the analysis of outcomes.<br />Results: A total of 44,218 patients were found in the database. After matching on baseline characteristics, 2749 patients were analysed in each arm. At 30 days, no significant differences were observed regarding the occurrence of major clinical events (composite of cardiovascular mortality, all-cause stroke, myocardial infarction, major or life-threatening bleeding and conversion to open heart surgery) (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.68-1.01; P=0.32). During follow-up (mean 516 days), the combined endpoint of cardiovascular death, all-cause stroke or rehospitalization for heart failure was not different between the valve-in-valve TAVI and native TAVI groups (RR 1.03, 95% CI 0.94-1.13; P=1.00).<br />Conclusion: We observed that valve-in-valve TAVI was associated with good short- and long-term outcomes. No significant differences were observed compared with native valve TAVI regarding clinical follow-up.<br /> (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Aortic Valve diagnostic imaging
Aortic Valve physiopathology
Aortic Valve Stenosis diagnostic imaging
Aortic Valve Stenosis mortality
Aortic Valve Stenosis physiopathology
Databases, Factual
Female
France
Heart Valve Prosthesis Implantation adverse effects
Heart Valve Prosthesis Implantation mortality
Humans
Longitudinal Studies
Male
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Transcatheter Aortic Valve Replacement adverse effects
Transcatheter Aortic Valve Replacement mortality
Treatment Outcome
Aortic Valve surgery
Aortic Valve Stenosis surgery
Bioprosthesis
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation instrumentation
Prosthesis Failure
Transcatheter Aortic Valve Replacement instrumentation
Subjects
Details
- Language :
- English
- ISSN :
- 1875-2128
- Volume :
- 114
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Archives of cardiovascular diseases
- Publication Type :
- Academic Journal
- Accession number :
- 32532695
- Full Text :
- https://doi.org/10.1016/j.acvd.2020.04.005