TCT-79 Multimodality Assessment of Prosthetic Valve Regurgitation to Predict Reverse Cardiac Remodeling and Long-Term Clinical Outcomes After Transcatheter Aortic Valve Replacement: Results From the Prospective POST-TAVI Registry

Abstract Aims This study aimed to assess the impact of valvular/subvalvular calcium burden on procedural and long-term outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Methods and results In this prospective observational cohort study, we included patients with AS undergoing TAVR between March 2010 and December 2019. Calcium burden at baseline was quantified using multidetector computed tomography and the patients were classified into tertile groups according to the amount of calcium. Procedural outcomes [paravalvular leakage (PVL) or permanent pacemaker insertion (PPI)] and 12-month clinical outcomes (composite of death, stroke, or rehospitalization, and all-cause mortality) were assessed. A total of 676 patients (age, 79.8 ± 5.4 years) were analysed. The 30-day rates of moderate or severe PVL (P-for-trend = 0.03) and PPI (P-for-trend = 0.002) proportionally increased with the tertile levels of calcium volume. The 12-month rate of primary composite outcomes was 34.2% in low-tertile, 23.9% in middle-tertile, and 25.8% in high-tertile groups (log-rank P = 0.02). After multivariable adjustment, the risk for primary composite outcomes at 12 months was not significantly different between the tertile groups of calcium volume [reference = low-tertile; middle-tertile, hazard ratio (HR) 0.81; 95% confidence interval (CI) 0.54–1.22; P = 0.31; high-tertile, HR 0.93; 95% CI 0.56–1.57; P = 0.80]. A similar pattern was observed for all-cause mortality. Conclusion The rates of PVL and PPI proportionally increased according to the levels of valvular/subvalvular calcium volume, while the adjusted risks for composite outcomes and mortality at 12 months were not significantly different.

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The JenaValve pericardial transcatheter aortic valve replacement system to treat aortic valve disease

Future Cardiology ◽

10.2217/fca-2021-0065 ◽

2021 ◽

Author(s):

Thomas Poschner ◽

Paul Werner ◽

Alfred Kocher ◽

Guenther Laufer ◽

Francesco Musumeci ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Pacemaker Implantation ◽

Limited Data ◽

Transcatheter Aortic Valve ◽

Paper Clip ◽

Replacement System

Transcatheter aortic valve replacement is a valuable alternative technique to surgery and the spectrum of therapy continues to evolve. The JenaValve Pericaridal transcatheter aortic valve replacement System allows prosthesis fixation in a native, noncalcified aortic annulus with a unique paper clip-like anchorage mechanism. The low rate of paravalvular leakage and permanent pacemaker implantation emphasizes the further widespread use of the JenaValve – despite the limited data available. In May 2021, a CE mark for the transfemoral implantation in both aortic regurgitation and aortic stenosis was granted. However, no data have been published so far. The ongoing ALIGN trials are expected to provide the pending long-term data.

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Transcatheter Aortic Valve Replacement in Lebanon: Population and Procedural Characteristics and Long-term Outcome – A Single Center Experience

10.37191/mapsci-jccr-2(1)-023 ◽

2021 ◽

Author(s):

Antonio H. Frangieh

Keyword(s):

Middle East ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Cardiovascular Mortality ◽

Transcatheter Aortic Valve Replacement ◽

Single Center ◽

Long Term Outcome ◽

Transcatheter Aortic Valve

Background: Transcatheter aortic valve replacement (TAVR) programs are growing in the Middle East, but data on treated patients in this region is scarce. We sought in this study to analyze the largest single-center population in Lebanon. Methods and Results: Baseline clinical, procedural characteristics as well as in-hospital and up to five years follow-up outcomes were collected and analyzed for the 141 patients (80 ± 7 years, 51.8% females) included between 2014 and 2019. All-cause mortality at 30 days found in 5 (3.5%) cases was considered as the primary endpoint while Major Adverse Cardiovascular Events at 30 days as secondary ones: cardiovascular mortality in 3 cases (2.1%), strokes in 1 case (0.7%), percutaneous coronary intervention in 3 cases (2.1%) and myocardial infarction in 3 cases (2.1%). Device success and intended prosthesis performance were achieved in 119 (84.4%) and 121 (85.8%) patients, respectively. Multivariate analysis showed that cardiovascular mortality is strongly associated with end-stage renal failure and peripheral artery disease. The dichotomization of patients into two cohorts A and B corresponding to the first and second 3 years of the TAVR time interval showed slow evolution of TAVR patients to a younger and lower risk population but maintained good results. Conclusion: TAVR in Lebanon shows satisfactory results and good long-term outcomes. Data from the regional prospective registry is needed to assess the evolution of this therapy in the middle-east region.

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Abstract 15741: Long Term Survival Following Transcatheter Aortic Valve Replacement: Results From a Single US High Volume Center

Circulation ◽

10.1161/circ.130.suppl_2.15741 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Ricardo O Escarcega ◽

Rebecca Torguson ◽

Marco A Magalhaes ◽

Nevin C Baker ◽

Sa’ar Minha ◽

...

Keyword(s):

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Term Survival ◽

Transcatheter Aortic Valve ◽

Significant Difference ◽

Long Term Mortality

Introduction: Mortality following Transcatheter aortic valve replacement (TAVR) has been reported up to 5 years. However, mortality after 5 years remains unclear. Hypothesis: We aim to determine the mortality in patients undergoing TAVR >5 years follow up. Methods: From our institution’s prospectively collected TAVR database we analyzed all patients undergoing TAVR to a maximum follow up of 8 years. We divided our population into transapical TAVR (TA-TAVR) and transfemoral TAVR (TF-TAVR) groups. A Kaplan-Meier survival analysis was conducted. Results: A total of 511 patients who underwent TAVR were included in the analysis. Patients undergoing TA-TAVR had higher rates of peripheral vascular disease compared with TF-TAVR (56% vs 29%, p<0.001) and Society of Thoracic Surgeons Score (10.9 ± 4 vs 9.2 ± 4, p<0.001). TA-TAVR was associated with higher mortality at 1 year (32% vs 21%, p=0.01). However, there was no significant difference in very-long term mortality of patients undergoing TA-TAVR vs TF-TAVR (Figure). Conclusions: Long-term mortality following TAVR surpasses 50%. While in the first 2 years TA-TAVR is associated with higher mortality rates after three years the survival rates are similar in both approaches.

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