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Early outcomes of transcatheter aortic valve implantation for degenerated aortic bioprostheses in Japanese patients: insights from the AORTIC VIV study.
- Source :
- General Thoracic & Cardiovascular Surgery; Dec2019, Vol. 67 Issue 12, p1038-1047, 10p
- Publication Year :
- 2019
-
Abstract
- Objective: The valve-in-valve procedure, in which a transcatheter heart valve (THV) is implanted into a degenerated bioprosthetic valve, is standardized for high-risk patients. However, this procedure is challenging in Japanese patients who have a small aortic annulus. We investigated the feasibility, safety, and therapeutic efficacy of the valve-in-valve procedure involving a degenerated stented bioprosthesis, stentless bioprosthesis, or THV. Methods: We performed a single-center, non-comparative study of the aortic valve-in-valve procedure (AORTIC VIV study). Beginning in October 2016, the aortic valve-in-valve procedure was performed in seven patients with a stented bioprosthesis, in three patients with a stentless bioprosthesis, and in one patient with a THV. Results: No 30-day post-procedure mortality or severe morbidities occurred. The mean echocardiographic gradient in the aortic position improved from 41 (38–48) to 17 (11–22) mmHg at 30 days (p = 0.01). No paravalvular or mild and more transvalvular leaks were detected. The New York Heart Association functional class improved from 2 (2–2.5) to 1 (1–1) at 30 days postoperatively (p = 0.01). Although the procedure failed in two patients with an implanted stentless bioprosthesis, the third patient with a stentless bioprosthesis and the one patient with a degenerated THV successfully underwent the valve-in-valve procedure. Conclusions: Feasibility, safety, and potential efficacy of the aortic valve-in-valve procedure were confirmed in selected Japanese patients with a degenerated aortic bioprosthesis. The valve-in-valve procedure for stentless bioprostheses was technically challenging. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 18636705
- Volume :
- 67
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- General Thoracic & Cardiovascular Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 139772344
- Full Text :
- https://doi.org/10.1007/s11748-019-01133-3