Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves

Sabine Bleiziffer; Matheus Simonato; John G. Webb; Josep Rodés-Cabau; Philippe Pibarot; Ran Kornowski; Stephan Windecker; Magdalena Erlebach; Alison Duncan; Moritz Seiffert; Axel Unbehaun; Christian Frerker; Lars Conzelmann; Harindra Wijeysundera; Won Keun Kim; Matteo Montorfano; Azeem Latib; Didier Tchetche; Abdelhakim Allali; Mohamed Abdel-Wahab; Katia Orvin; Stefan Stortecky; Henrik Nissen; Andreas Holzamer; Marina Urena; Luca Testa; Marco Agrifoglio; Brian Whisenant; Janarthanan Sathananthan; Massimo Napodano; Antonio Landi; Claudia Fiorina; Armin Zittermann; Verena Veulemans; Jan Malte Sinning; Francesco Saia; Stephen Brecker; Patrizia Presbitero; Ole de Backer; Lars Søndergaard; Giuseppe Bruschi; Luis Nombela Franco; Anna Sonia Petronio; Marco Barbanti; Alfredo Cerillo; Konstantinos Spargias; Joachim Schofer; Mauricio Cohen; Antonio Muñoz-Garcia; Ariel Finkelstein; Matti Adam; Vicenç Serra; Rui Campante Teles; Didier Champagnac; Alessandro Iadanza; Piotr Chodor; Holger Eggebrecht; Robert Welsh; Adriano Caixeta; Stefano Salizzoni; Antonio Dager; Vincent Auffret; Asim Cheema; Timm Ubben; Marco Ancona; Tanja Rudolph; Jan Gummert; Elaine Tseng; Stephane Noble; Matjaz Bunc; David Roberts; Malek Kass; Anuj Gupta; Martin B. Leon; Danny Dvir

doi:10.1093/eurheartj/ehaa544

Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves

Sabine Bleiziffer, Matheus Simonato, John G. Webb, Josep Rodés-Cabau, Philippe Pibarot, Ran Kornowski, Stephan Windecker, Magdalena Erlebach, Alison Duncan, Moritz Seiffert, Axel Unbehaun, Christian Frerker, Lars Conzelmann, Harindra Wijeysundera, Won Keun Kim, Matteo Montorfano, Azeem Latib, Didier Tchetche, Abdelhakim Allali, Mohamed Abdel-WahabKatia Orvin, Stefan Stortecky, Henrik Nissen, Andreas Holzamer, Marina Urena, Luca Testa, Marco Agrifoglio, Brian Whisenant, Janarthanan Sathananthan, Massimo Napodano, Antonio Landi, Claudia Fiorina, Armin Zittermann, Verena Veulemans, Jan Malte Sinning, Francesco Saia, Stephen Brecker, Patrizia Presbitero, Ole de Backer, Lars Søndergaard, Giuseppe Bruschi, Luis Nombela Franco, Anna Sonia Petronio, Marco Barbanti, Alfredo Cerillo, Konstantinos Spargias, Joachim Schofer, Mauricio Cohen, Antonio Muñoz-Garcia, Ariel Finkelstein, Matti Adam, Vicenç Serra, Rui Campante Teles, Didier Champagnac, Alessandro Iadanza, Piotr Chodor, Holger Eggebrecht, Robert Welsh, Adriano Caixeta, Stefano Salizzoni, Antonio Dager, Vincent Auffret, Asim Cheema, Timm Ubben, Marco Ancona, Tanja Rudolph, Jan Gummert, Elaine Tseng, Stephane Noble, Matjaz Bunc, David Roberts, Malek Kass, Anuj Gupta, Martin B. Leon, Danny Dvir^*

^*Corresponding author for this work

Cardiology

Research output: Contribution to journal › Article › peer-review

129 Scopus citations

Abstract

Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; and results median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) <_ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. Conclusions The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.

Original language	English
Pages (from-to)	2731-2742
Number of pages	12
Journal	European Heart Journal
Volume	41
Issue number	29
DOIs	https://doi.org/10.1093/eurheartj/ehaa544
State	Published - 1 Aug 2020

Funding

Funders	Funder number
Institute of Valvular Research

Keywords

Aortic valve-in-valve
Reintervention
SAPIEN valve
Severe prosthesis-patient mismatch
TAVR

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10.1093/eurheartj/ehaa544

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Bleiziffer, S., Simonato, M., Webb, J. G., Rodés-Cabau, J., Pibarot, P., Kornowski, R., Windecker, S., Erlebach, M., Duncan, A., Seiffert, M., Unbehaun, A., Frerker, C., Conzelmann, L., Wijeysundera, H., Kim, W. K., Montorfano, M., Latib, A., Tchetche, D., Allali, A., ... Dvir, D. (2020). Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves. European Heart Journal, 41(29), 2731-2742. https://doi.org/10.1093/eurheartj/ehaa544

@article{c774240fd0cf4309a7bf86dedaf17fd3,

title = "Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves",

abstract = "Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; and results median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) <_ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. Conclusions The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.",

keywords = "Aortic valve-in-valve, Reintervention, SAPIEN valve, Severe prosthesis-patient mismatch, TAVR",

author = "Sabine Bleiziffer and Matheus Simonato and Webb, {John G.} and Josep Rod{\'e}s-Cabau and Philippe Pibarot and Ran Kornowski and Stephan Windecker and Magdalena Erlebach and Alison Duncan and Moritz Seiffert and Axel Unbehaun and Christian Frerker and Lars Conzelmann and Harindra Wijeysundera and Kim, {Won Keun} and Matteo Montorfano and Azeem Latib and Didier Tchetche and Abdelhakim Allali and Mohamed Abdel-Wahab and Katia Orvin and Stefan Stortecky and Henrik Nissen and Andreas Holzamer and Marina Urena and Luca Testa and Marco Agrifoglio and Brian Whisenant and Janarthanan Sathananthan and Massimo Napodano and Antonio Landi and Claudia Fiorina and Armin Zittermann and Verena Veulemans and Sinning, {Jan Malte} and Francesco Saia and Stephen Brecker and Patrizia Presbitero and {de Backer}, Ole and Lars S{\o}ndergaard and Giuseppe Bruschi and Franco, {Luis Nombela} and Petronio, {Anna Sonia} and Marco Barbanti and Alfredo Cerillo and Konstantinos Spargias and Joachim Schofer and Mauricio Cohen and Antonio Mu{\~n}oz-Garcia and Ariel Finkelstein and Matti Adam and Vicen{\c c} Serra and Teles, {Rui Campante} and Didier Champagnac and Alessandro Iadanza and Piotr Chodor and Holger Eggebrecht and Robert Welsh and Adriano Caixeta and Stefano Salizzoni and Antonio Dager and Vincent Auffret and Asim Cheema and Timm Ubben and Marco Ancona and Tanja Rudolph and Jan Gummert and Elaine Tseng and Stephane Noble and Matjaz Bunc and David Roberts and Malek Kass and Anuj Gupta and Leon, {Martin B.} and Danny Dvir",

year = "2020",

month = aug,

day = "1",

doi = "10.1093/eurheartj/ehaa544",

language = "אנגלית",

volume = "41",

pages = "2731--2742",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "29",

}

Bleiziffer, S, Simonato, M, Webb, JG, Rodés-Cabau, J, Pibarot, P, Kornowski, R, Windecker, S, Erlebach, M, Duncan, A, Seiffert, M, Unbehaun, A, Frerker, C, Conzelmann, L, Wijeysundera, H, Kim, WK, Montorfano, M, Latib, A, Tchetche, D, Allali, A, Abdel-Wahab, M, Orvin, K, Stortecky, S, Nissen, H, Holzamer, A, Urena, M, Testa, L, Agrifoglio, M, Whisenant, B, Sathananthan, J, Napodano, M, Landi, A, Fiorina, C, Zittermann, A, Veulemans, V, Sinning, JM, Saia, F, Brecker, S, Presbitero, P, de Backer, O, Søndergaard, L, Bruschi, G, Franco, LN, Petronio, AS, Barbanti, M, Cerillo, A, Spargias, K, Schofer, J, Cohen, M, Muñoz-Garcia, A, Finkelstein, A, Adam, M, Serra, V, Teles, RC, Champagnac, D, Iadanza, A, Chodor, P, Eggebrecht, H, Welsh, R, Caixeta, A, Salizzoni, S, Dager, A, Auffret, V, Cheema, A, Ubben, T, Ancona, M, Rudolph, T, Gummert, J, Tseng, E, Noble, S, Bunc, M, Roberts, D, Kass, M, Gupta, A, Leon, MB & Dvir, D 2020, 'Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves', European Heart Journal, vol. 41, no. 29, pp. 2731-2742. https://doi.org/10.1093/eurheartj/ehaa544

TY - JOUR

T1 - Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves

AU - Bleiziffer, Sabine

AU - Simonato, Matheus

AU - Webb, John G.

AU - Rodés-Cabau, Josep

AU - Pibarot, Philippe

AU - Kornowski, Ran

AU - Windecker, Stephan

AU - Erlebach, Magdalena

AU - Duncan, Alison

AU - Seiffert, Moritz

AU - Unbehaun, Axel

AU - Frerker, Christian

AU - Conzelmann, Lars

AU - Wijeysundera, Harindra

AU - Kim, Won Keun

AU - Montorfano, Matteo

AU - Latib, Azeem

AU - Tchetche, Didier

AU - Allali, Abdelhakim

AU - Abdel-Wahab, Mohamed

AU - Orvin, Katia

AU - Stortecky, Stefan

AU - Nissen, Henrik

AU - Holzamer, Andreas

AU - Urena, Marina

AU - Testa, Luca

AU - Agrifoglio, Marco

AU - Whisenant, Brian

AU - Sathananthan, Janarthanan

AU - Napodano, Massimo

AU - Landi, Antonio

AU - Fiorina, Claudia

AU - Zittermann, Armin

AU - Veulemans, Verena

AU - Sinning, Jan Malte

AU - Saia, Francesco

AU - Brecker, Stephen

AU - Presbitero, Patrizia

AU - de Backer, Ole

AU - Søndergaard, Lars

AU - Bruschi, Giuseppe

AU - Franco, Luis Nombela

AU - Petronio, Anna Sonia

AU - Barbanti, Marco

AU - Cerillo, Alfredo

AU - Spargias, Konstantinos

AU - Schofer, Joachim

AU - Cohen, Mauricio

AU - Muñoz-Garcia, Antonio

AU - Finkelstein, Ariel

AU - Adam, Matti

AU - Serra, Vicenç

AU - Teles, Rui Campante

AU - Champagnac, Didier

AU - Iadanza, Alessandro

AU - Chodor, Piotr

AU - Eggebrecht, Holger

AU - Welsh, Robert

AU - Caixeta, Adriano

AU - Salizzoni, Stefano

AU - Dager, Antonio

AU - Auffret, Vincent

AU - Cheema, Asim

AU - Ubben, Timm

AU - Ancona, Marco

AU - Rudolph, Tanja

AU - Gummert, Jan

AU - Tseng, Elaine

AU - Noble, Stephane

AU - Bunc, Matjaz

AU - Roberts, David

AU - Kass, Malek

AU - Gupta, Anuj

AU - Leon, Martin B.

AU - Dvir, Danny

PY - 2020/8/1

Y1 - 2020/8/1

N2 - Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; and results median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) <_ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. Conclusions The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.

AB - Aims Due to bioprosthetic valve degeneration, aortic valve-in-valve (ViV) procedures are increasingly performed. There are no data on long-term outcomes after aortic ViV. Our aim was to perform a large-scale assessment of long-term survival and reintervention after aortic ViV. Methods A total of 1006 aortic ViV procedures performed more than 5 years ago [mean age 77.7 ± 9.7 years; 58.8% male; and results median STS-PROM score 7.3% (4.2-12.0)] were included in the analysis. Patients were treated with Medtronic self-expandable valves (CoreValve/Evolut, Medtronic Inc., Minneapolis, MN, USA) (n = 523, 52.0%), Edwards balloon-expandable valves (EBEV, SAPIEN/SAPIEN XT/SAPIEN 3, Edwards Lifesciences, Irvine, CA, USA) (n = 435, 43.2%), and other devices (n = 48, 4.8%). Survival was lower at 8 years in patients with small-failed bioprostheses [internal diameter (ID) <_ 20 mm] compared with those with large-failed bioprostheses (ID > 20 mm) (33.2% vs. 40.5%, P = 0.01). Independent correlates for mortality included smaller-failed bioprosthetic valves [hazard ratio (HR) 1.07 (95% confidence interval (CI) 1.02-1.13)], age [HR 1.21 (95% CI 1.01-1.45)], and non-transfemoral access [HR 1.43 (95% CI 1.11-1.84)]. There were 40 reinterventions after ViV. Independent correlates for all-cause reintervention included pre-existing severe prosthesis-patient mismatch [subhazard ratio (SHR) 4.34 (95% CI 1.31-14.39)], device malposition [SHR 3.75 (95% CI 1.36-10.35)], EBEV [SHR 3.34 (95% CI 1.26-8.85)], and age [SHR 0.59 (95% CI 0.44-0.78)]. Conclusions The size of the original failed valve may influence long-term mortality, and the type of the transcatheter valve may influence the need for reintervention after aortic ViV.

KW - Aortic valve-in-valve

KW - Reintervention

KW - SAPIEN valve

KW - Severe prosthesis-patient mismatch

KW - TAVR

UR - http://www.scopus.com/inward/record.url?scp=85089127388&partnerID=8YFLogxK

U2 - 10.1093/eurheartj/ehaa544

DO - 10.1093/eurheartj/ehaa544

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C2 - 32592401

AN - SCOPUS:85089127388

SN - 0195-668X

VL - 41

SP - 2731

EP - 2742

JO - European Heart Journal

JF - European Heart Journal

IS - 29

ER -

Long-term outcomes after transcatheter aortic valve implantation in failed bioprosthetic valves

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