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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Two-year outcomes after transcatheter aortic valve-in-valve implantation in degenerated surgical valves
Catheterization and Cardiovascular Interventions, Volume 100, No. 5, Year 2022
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Description
Background: Transcatheter aortic valve-in-valve implantation (ViV-TAVI) has emerged in recent years as a safe alternative to redo surgery in high-risk patients. Although early results are encouraging, data beyond short-term outcomes are lacking. Herein, we aimed to assess the 2-year outcomes after ViV-TAVI. Methods: Patients undergoing ViV-TAVI for degenerated surgical valves between 2013 and 2019 at the Cleveland Clinic were reviewed. The coprimary endpoints were all-cause mortality and congestive heart failure (CHF) hospitalizations. We used time-to-event analyses to assess the primary outcomes. Further, we measured the changes in transvalvular gradients and the incidence of structural valve deterioration (SVD). Results: One hundred and eighty-eight patients were studied (mean age = 76 years; 65% males). At 2 years of follow-up, all-cause mortality and CHF hospitalizations occurred in 15 (8%) and 28 (14.9%) patients, respectively. On multivariable analysis, the postprocedural length of stay was a significant predictor for both all-cause mortality (hazard ratio [HR] = 1.1; 95% confidence interval [CI]: 1.01, 1.19) and CHF hospitalization (HR = 1.16; 95% CI: 1.07, 1.27). However, the internal diameter of the surgical valve was not associated with significant differences in both primary endpoints. For hemodynamic outcomes, nine patients (4.8%) developed SVD. The mean and peak transvalvular pressure gradients remained stable over the follow-up period. Conclusion: ViV-TAVI for degenerated surgical valves was associated with favorable 2-year clinical and hemodynamic outcomes. Further studies are needed to better understand the role of ViV-TAVI as a treatment option in the life management of aortic valve disease. © 2022 Wiley Periodicals LLC.
Authors & Co-Authors
Abushouk, Abdelrahman Ibrahim
United States, Cleveland
Cleveland Clinic Foundation
Abdelfattah, Omar M.
United States, Cleveland
Cleveland Clinic Foundation
Gad, Mohamed M.
United States, Cleveland
Cleveland Clinic Foundation
Saad, Anas M.
United States, Cleveland
Cleveland Clinic Foundation
Hariri, Essa H.
United States, Cleveland
Cleveland Clinic Foundation
Puri, Rishi
United States, Cleveland
Cleveland Clinic Foundation
Yun, Jamesj J.
United States, Cleveland
Cleveland Clinic Foundation
Burns, Daniel J.P.
United States, Cleveland
Cleveland Clinic Foundation
Unai, Shinya
United States, Cleveland
Cleveland Clinic Foundation
Harb, Serge C.
United States, Cleveland
Cleveland Clinic Foundation
Krishnaswamy, Amar
United States, Cleveland
Cleveland Clinic Foundation
Johnston, Douglas R.
United States, Cleveland
Cleveland Clinic Foundation
Kapadia, Samir R.
United States, Cleveland
Cleveland Clinic Foundation
Statistics
Authors: 13
Affiliations: 1
Identifiers
Doi:
10.1002/ccd.30388
ISSN:
15221946
Research Areas
Environmental
Health System And Policy
Study Design
Cohort Study