
pmid: 34092097
Background: Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR. Methods: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%. Results: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded. Conclusions: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04500964.
Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences, Bioprosthesis, Heart Valve Prosthesis Implantation, bioprosthesis; heart failure; transcatheter aortic valve replacement, bioprosthesis, heart failure, Aortic Valve Stenosis, Prosthesis Design, Prosthesis Failure, Transcatheter Aortic Valve Replacement, Treatment Outcome, bioprosthesis; heart failure; transcatheter aortic valve replacement., Aortic Valve, Heart Valve Prosthesis, Journal Article, transcatheter aortic valve replacement, Humans, Cardiology and Cardiovascular Medicine, Cardiology - Radboud University Medical Center
Radboudumc 16: Vascular damage RIMLS: Radboud Institute for Molecular Life Sciences, Bioprosthesis, Heart Valve Prosthesis Implantation, bioprosthesis; heart failure; transcatheter aortic valve replacement, bioprosthesis, heart failure, Aortic Valve Stenosis, Prosthesis Design, Prosthesis Failure, Transcatheter Aortic Valve Replacement, Treatment Outcome, bioprosthesis; heart failure; transcatheter aortic valve replacement., Aortic Valve, Heart Valve Prosthesis, Journal Article, transcatheter aortic valve replacement, Humans, Cardiology and Cardiovascular Medicine, Cardiology - Radboud University Medical Center
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