Early and Midterm Clinical Outcomes of Transcatheter Valve-in-Valve Implantation Versus Redo Surgical Aortic Valve Replacement for Aortic Bioprosthetic Valve Degeneration: Two Faces of the Same Medal
Copyright policy )Early and Midterm Clinical Outcomes of Transcatheter Valve-in-Valve Implantation Versus Redo Surgical Aortic Valve Replacement for Aortic Bioprosthetic Valve Degeneration: Two Faces of the Same Medal
To compare early and midterm outcomes of transcatheter valve-in-valve implantation (ViV-TAVI) and redo surgical aortic valve replacement (re-SAVR) for aortic bioprosthetic valve degeneration.Patients who underwent ViV-TAVI and re-SAVR for aortic bioprosthetic valve degeneration between January 2010 and October 2018 were retrospectively analyzed. Mean follow-up was 3.0 years.In-hospital, early, and mid-term outcomes.Eighty-eight patients were included in the analysis.Thirty-one patients (37.3%) had ViV-TAVI, and 57 patients (62.7%) had re-SAVR.In the ViV-TAVI group, patients were older (79.1 ± 7.4 v 67.2 ± 14.1, p 24 hours, total amount of chest tube losses, red blood cell transfusions, plasma transfusions, and reoperation for bleeding were significantly higher in the re-SAVR cohort (p < 0.01). There was no difference regarding in-hospital permanent pacemaker implantation (ViV-TAVI = 3.2% v re-SAVR = 8.8%, p = 0.27), patient-prosthesis mismatch (ViV-TAVI = 12 patients [mean 0.53 ± 0.07] and re-SAVR = ten patients [mean 0.56 ± 0.08], p = 0.4), stroke (ViV-TAVI = 3.2% v re-SAVR = 7%, p = 0.43), acute kidney injury (ViV-TAVI = 9.7% v re-SAVR = 15.8%, p = 0.1), and all-cause infections (ViV-TAVI = 0% v re-SAVR = 8.8%, p = 0.02), between the two groups. In-hospital mortality was 0% and 7% for ViV-TAVI and re-SAVR, respectively (p = 0.08). At three-years' follow-up, the incidence of pacemaker implantation was higher in the re-SAVR group (ViV-TAVI = 0 v re-SAVR = 13.4%, p < 0.01). There were no differences in reintervention (ViV-TAVI = 3.8% v re-SAVR = 0%, p = 0.32) and survival (ViV-TAVI = 83.9% v re-SAVR = 93%, p = 0.10) between the two cohorts.ViV-TAVI is a safe, feasible, and reliable procedure.
- St. Michael's Hospital Canada
- Azienda Ospedaliera Universitaria Senese Italy
- University of Florence Italy
- Ospedale Santa Maria alle Scotte Italy
- Maastricht University Netherlands
SURGERY, predictors of outcome, redo aortic surgery, TAVI valve-in-valve, cardiac surgery, predictors of outcome; redo aortic surgery; TAVI valve-in-valve; Aged; Aged, 80 and over; Aortic Valve; Humans; Retrospective Studies; Risk Factors; Treatment Outcome; Aortic Valve Stenosis; Bioprosthesis; Heart Valve Prosthesis Implantation; Transcatheter Aortic Valve Replacement, Transcatheter Aortic Valve Replacement, Retrospective Studie, Risk Factors, 80 and over, Humans, Bioprosthesi, Aged, Retrospective Studies, RISK, Aged, 80 and over, Bioprosthesis, Heart Valve Prosthesis Implantation, predictors of outcome, Risk Factor, redo aortic surgery, Aortic Valve Stenosis, Aortic Valve Stenosi, Treatment Outcome, Aortic Valve, TAVI valve-in-valve, Human
SURGERY, predictors of outcome, redo aortic surgery, TAVI valve-in-valve, cardiac surgery, predictors of outcome; redo aortic surgery; TAVI valve-in-valve; Aged; Aged, 80 and over; Aortic Valve; Humans; Retrospective Studies; Risk Factors; Treatment Outcome; Aortic Valve Stenosis; Bioprosthesis; Heart Valve Prosthesis Implantation; Transcatheter Aortic Valve Replacement, Transcatheter Aortic Valve Replacement, Retrospective Studie, Risk Factors, 80 and over, Humans, Bioprosthesi, Aged, Retrospective Studies, RISK, Aged, 80 and over, Bioprosthesis, Heart Valve Prosthesis Implantation, predictors of outcome, Risk Factor, redo aortic surgery, Aortic Valve Stenosis, Aortic Valve Stenosi, Treatment Outcome, Aortic Valve, TAVI valve-in-valve, Human
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