Initial and mid-term follow-up of patients with concomitant moderate or more severe mitral and tricuspid regurgitation undergoing transcatheter aortic valve implantation

2014 ◽  
Vol 62 (S 01) ◽  
Author(s):  
K. Alexiou ◽  
M. Wilbring ◽  
S. Arzt ◽  
U. Kappert ◽  
K. Matschke
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Tricuspid Regurgitation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

P1136Is there a negative impact of permanent pacemaker implantation in long-term outcomes after transcatheter aortic valve implantation?

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
T J Carvalho Mendonca ◽  
L Patricio ◽  
M Oliveira ◽  
I Rodrigues ◽  
G Portugal ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Permanent Pacemaker ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Introduction Transcatheter aortic valve implantation (TAVI) is an established treatment in patients (P) with aortic stenosis. Despite the continuous developments of this procedure, high-grade conduction disturbances requiring permanent pacemaker (PPM) implantation is still a major and common complication of TAVI. Furthermore, long-term chronic right ventricular pacing has been associated with negative effects on ventricular function and heart failure (HF). Aim   to evaluate the long-term impact of PPM after TAVI focusing on mortality and HF hospitalization. Methods  We retrospectively examined P who underwent TAVI with a self-expanding valve from 2009 to 2018 at our institution. All P had pre-procedural clinical evaluation, including ECG, cardiac computed tomographic angiography and transthoracic echocardiography. P with previous PPM were excluded. Results  265P (57% male, mean age 81.4 years, 20% with left ventricular ejection fraction <40%) were analysed. Mean STS score and mean Euroscore II were 6.33% and 7.07%, respectively. Mean transvalvular gradient was 52.78 mmHg and mean aortic valve area 0.67 cm2. Forty-seven P (17%) underwent PPM implantation during the first 30 days after TAVI. P requiring PPM had higher prevalence of diabetes mellitus, chronic renal disease, atrial fibrillation and right bundle branch block. During a mean follow-up of 20.3 months, post-TAVI PPM was associated with similar mortality rate (29.8% vs. 25.6%, HR 1.28, 95% CI 0.72-2.29, p = 0.42) and similar cardiovascular mortality (9.8% vs. 6.4%, HR 0.72, 95% CI 0.21-2.4, p = 0.59) compared to P without PPM. There were no significant differences in HF hospitalization (4.9% vs. 2.4%, p = 0.47). Kaplan-Meier curves of total mortality and cardiovascular mortality according to the need for PPM post-TAVI were similar.  Conclusions  In P submitted to TAVI, PPM implantation is a relatively common finding, not associated with higher risk of total mortality, cardiovascular mortality or HF hospitalization in a long-term follow-up.

Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices

2020 ◽  
Vol 125 (8) ◽  
pp. 1209-1215 ◽  
Author(s):  
Nicola Corcione ◽  
Giuseppe Biondi-Zoccai ◽  
Paolo Ferraro ◽  
Alberto Morello ◽  
Sirio Conte ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Long Term Follow Up ◽  
Aortic Valve Implantation ◽  
Valve Implantation

4069From first in man transcatheter aortic valve implantation, a 15-year experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Avinee ◽  
E Durand ◽  
T Levesque ◽  
P Y Litzler ◽  
J N Dacher ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Kaplan Meier ◽  
Transcatheter Heart Valve ◽  
Structural Valve Deterioration ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Abstract Background Since the first-in-man transcatheter aortic valve implantation (TAVI) performed in 2002, the number of procedures has dramatically increased. However, long-term data regarding outcome and valve durability remain poor. Purpose We aimed to evaluate the evolution of 30-day outcomes over years and long-term mortality and valve durability after TAVI. Methods All consecutive patients presenting with severe symptomatic aortic stenosis treated by TAVI in our center were included prospectively. Clinical and echocardiographic follow-up was performed at 30 days and annually thereafter. Survival curves were constructed using Kaplan-Meier analysis. We also evaluated valve durability according to the European standardized definition of structural valve deterioration. Results Between 2002 and 2018, 1530 consecutive patients underwent TAVI including 1285 (84.0%) patients via a femoral approach. A balloon-expandable transcatheter heart valve was predominantly used (1421 patients; 92.9%). The annual transfemoral approach rate increased progressively to reach 93.3%. Age of patients remained stable over time with a global mean age of 83.7±6.5 years old. Logistic EuroSCORE decreased from 49.2±8.2% to 14.3±8.6% (p<0.0001). Thirty-day mortality dramatically decreased below 3% since 2015 and was 0% in 2018. Similarly, major vascular complications decreased from 50.0% in the first year to less than 1% since 2017 (p=0.001). The length of hospital-stay progressively shortened up to a median of 2 days in 2018. The Kaplan-Meier survival estimation was 82.3%, 60.3%, 33.0%; 11.7% and 8.9% respectively at 1, 3, 5, 8 and 10 years. On long-term follow-up the mean aortic gradient remained unchanged (Figure), and only five patients presented a severe prosthetic valve deterioration. Among them, four patients successfully benefited from a valve in valve TAVI procedure. The competing risk analysis at 10 years estimates risk for severe and moderate-or-severe valve deterioration of 1.9±0.9% and 4.3±1.3% respectively. TEE mean transaortic gradient Conclusions Long-term (up to 10 years) follow-up of our large pioneer series of patients treated by TAVI shows a dramatic improvement of outcomes and no warning signs of valve deterioration suggesting very encouraging valve durability, using predominantly, a balloon expandable prosthesis. Further studies are warranted to study valve durability after TAVI before extension to lower risk patients.

scholarly journals First Egyptian experience of Transcatheter Aortic Valve Implantation: Immediate results and one year follow up

2014 ◽  
Vol 66 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Ahmed A. Khashaba ◽  
Walaa Adel ◽  
Alaa Roshdi ◽  
Ahmed Gafar ◽  
Sherif Essam ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Implantation ◽  
Transcatheter Aortic Valve ◽  
Aortic Valve Implantation ◽  
One Year ◽  
Valve Implantation

scholarly journals Transaortic Transcatheter Aortic Valve Implantation: Learning Curve, Perioperative, and Midterm Follow-Up Results of a Single Center

2019 ◽  
Vol 22 (2) ◽  
pp. E134-E139 ◽  
Author(s):  
Giuseppe D’Ancona ◽  
Huesyin Ince ◽  
Christoph Raspé ◽  
Alper Öner ◽  
Evren Caglayan ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Learning Curve ◽  
Contrast Agent ◽  
Transcatheter Aortic Valve Implantation ◽  
Aortic Insufficiency ◽  
Transcatheter Aortic Valve ◽  
Institutional Experience ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: We present our initial institutional experience with transaortic (TAo) transcatheter aortic valve implantation (TAVI) using a self-expanding aortic bioprosthesis. Methods: A total of 106 patients underwent TAo TAVI with Medtronic CoreValve through a small partial upper sternotomy. We focus our analysis on the overall perioperative results, procedural learning curve (first 30 patients), and midterm follow-up outcomes. Results: VARC-2 device success was achieved in 95 patients (89%), and there were no intraoperative deaths. Nine patients (8.4%) required a second valve and conversion to standard surgery was required in 2 patients (1.8%). The final aortic insufficiency was grade 0 in 65 patients (62%) and grade 1 in 39 (37%). Although patients treated in the TAo TAVI learning phase required a significantly longer radiation time and contrast agent use, device success (93.4% versus 88.2%; P = .7) and prostheses hemodynamics were similar. All-cause mortality at 30 days was 12% (13/106). At a median follow-up of 392 days (IQR: 216-494 days) estimated overall 1-year survival was 72%. No significant differences were reported in terms of 30-day and 1-year observed mortality, and estimated 1-year survival in the learning and later phase of TAo TAVI. Conclusion: TAo TAVI can be performed safely even in the very early phase of the learning curve. Although satisfactory results can be achieved from the beginning, a significant reduction in contrast agent use and radiological exposure are expected as the technique is mastered. Good hemodynamics have been documented and should be further improved with modifications achieved in the TAVI self-expandable valves technology.

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