Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

Won-Keun Kim; Ulrich Schäfer; Didier Tchetche; Holger Nef; Martin Arnold; Pablo Avanzas; Tanja Rudolph; Smita Scholtz; Marco Barbanti; Jörg Kempfert; Antonio Mangieri; Alexander Lauten; Christian Frerker; Sung-Han Yoon; Andreas Holzamer; Fabien Praz; Ole De Backer; Stefan Toggweiler; Johannes Blumenstein; Paola Purita; Giuseppe Tarantini; Christian Thilo; Alexander Wolf; Oliver Husser; Costanza Pellegrini; Christof Burgdorf; Rosa Ana Hernandez Antolin; Victor A Jiménez Díaz; Christoph Liebetrau; Niklas Schofer; Helge Möllmann; Holger Eggebrecht; Lars Sondergaard; Thomas Walther; Thomas Pilgrim; Michael Hilker; Raj Makkar; Axel Unbehaun; Jochen Börgermann; Cesar Moris; Stephan Achenbach; Oliver Dörr; Bruno Brochado; Lenard Conradi; Christian W Hamm

doi:10.1093/eurheartj/ehz429

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

Won-Keun Kim, Ulrich Schäfer, Didier Tchetche, Holger Nef, Martin Arnold, Pablo Avanzas, Tanja Rudolph, Smita Scholtz, Marco Barbanti, Jörg Kempfert, Antonio Mangieri, Alexander Lauten, Christian Frerker, Sung-Han Yoon, Andreas Holzamer, Fabien Praz, Ole De Backer, Stefan Toggweiler, Johannes Blumenstein, Paola PuritaGiuseppe Tarantini, Christian Thilo, Alexander Wolf, Oliver Husser, Costanza Pellegrini, Christof Burgdorf, Rosa Ana Hernandez Antolin, Victor A Jiménez Díaz, Christoph Liebetrau, Niklas Schofer, Helge Möllmann, Holger Eggebrecht, Lars Sondergaard, Thomas Walther, Thomas Pilgrim, Michael Hilker, Raj Makkar, Axel Unbehaun, Jochen Börgermann, Cesar Moris, Stephan Achenbach, Oliver Dörr, Bruno Brochado, Lenard Conradi, Christian W Hamm

Department of Cardiology

142 Citations (Scopus)

Abstract

AIMS: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort.

METHODS AND RESULTS: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective.

CONCLUSION: Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

Original language	English
Journal	European Heart Journal
Volume	40
Issue number	38
Pages (from-to)	3156-3165
Number of pages	10
ISSN	0195-668X
DOIs	https://doi.org/10.1093/eurheartj/ehz429
Publication status	Published - 7 Oct 2019

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Kim, W.-K., Schäfer, U., Tchetche, D., Nef, H., Arnold, M., Avanzas, P., Rudolph, T., Scholtz, S., Barbanti, M., Kempfert, J., Mangieri, A., Lauten, A., Frerker, C., Yoon, S.-H., Holzamer, A., Praz, F., De Backer, O., Toggweiler, S., Blumenstein, J., ... Hamm, C. W. (2019). Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration). European Heart Journal, 40(38), 3156-3165. https://doi.org/10.1093/eurheartj/ehz429

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration). / Kim, Won-Keun; Schäfer, Ulrich; Tchetche, Didier et al.
In: European Heart Journal, Vol. 40, No. 38, 07.10.2019, p. 3156-3165.

Research output: Contribution to journal › Journal article › Research › peer-review

Kim, W-K, Schäfer, U, Tchetche, D, Nef, H, Arnold, M, Avanzas, P, Rudolph, T, Scholtz, S, Barbanti, M, Kempfert, J, Mangieri, A, Lauten, A, Frerker, C, Yoon, S-H, Holzamer, A, Praz, F, De Backer, O, Toggweiler, S, Blumenstein, J, Purita, P, Tarantini, G, Thilo, C, Wolf, A, Husser, O, Pellegrini, C, Burgdorf, C, Antolin, RAH, Díaz, VAJ, Liebetrau, C, Schofer, N, Möllmann, H, Eggebrecht, H, Sondergaard, L, Walther, T, Pilgrim, T, Hilker, M, Makkar, R, Unbehaun, A, Börgermann, J, Moris, C, Achenbach, S, Dörr, O, Brochado, B, Conradi, L & Hamm, CW 2019, 'Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)', European Heart Journal, vol. 40, no. 38, pp. 3156-3165. https://doi.org/10.1093/eurheartj/ehz429

@article{c8841837361a4faa8c67701a2312da99,

title = "Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)",

abstract = "AIMS: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort.METHODS AND RESULTS: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92\%) TAVI cases (age 80.8 ± 7.3 years; 53.8\% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0\%), multiple valve implantations (83.2\%), and conversion to surgery (19.0\%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6\% vs. 4.9\%; P < 0.001) and after 1 year (30.5\% vs. 16.6\%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6\% vs. 2.8\%; P < 0.001), but not at 1 year (4.6\% vs. 1.9\%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective.CONCLUSION: Transcatheter valve embolization and migration occurred in approximately 1\% and was associated with increased morbidity and mortality.",

author = "Won-Keun Kim and Ulrich Sch{\"a}fer and Didier Tchetche and Holger Nef and Martin Arnold and Pablo Avanzas and Tanja Rudolph and Smita Scholtz and Marco Barbanti and J{\"o}rg Kempfert and Antonio Mangieri and Alexander Lauten and Christian Frerker and Sung-Han Yoon and Andreas Holzamer and Fabien Praz and \{De Backer\}, Ole and Stefan Toggweiler and Johannes Blumenstein and Paola Purita and Giuseppe Tarantini and Christian Thilo and Alexander Wolf and Oliver Husser and Costanza Pellegrini and Christof Burgdorf and Antolin, \{Rosa Ana Hernandez\} and D{\'i}az, \{Victor A Jim{\'e}nez\} and Christoph Liebetrau and Niklas Schofer and Helge M{\"o}llmann and Holger Eggebrecht and Lars Sondergaard and Thomas Walther and Thomas Pilgrim and Michael Hilker and Raj Makkar and Axel Unbehaun and Jochen B{\"o}rgermann and Cesar Moris and Stephan Achenbach and Oliver D{\"o}rr and Bruno Brochado and Lenard Conradi and Hamm, \{Christian W\}",

year = "2019",

month = oct,

day = "7",

doi = "10.1093/eurheartj/ehz429",

language = "English",

volume = "40",

pages = "3156--3165",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "38",

}

TY - JOUR

T1 - Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration

T2 - the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

AU - Kim, Won-Keun

AU - Schäfer, Ulrich

AU - Tchetche, Didier

AU - Nef, Holger

AU - Arnold, Martin

AU - Avanzas, Pablo

AU - Rudolph, Tanja

AU - Scholtz, Smita

AU - Barbanti, Marco

AU - Kempfert, Jörg

AU - Mangieri, Antonio

AU - Lauten, Alexander

AU - Frerker, Christian

AU - Yoon, Sung-Han

AU - Holzamer, Andreas

AU - Praz, Fabien

AU - De Backer, Ole

AU - Toggweiler, Stefan

AU - Blumenstein, Johannes

AU - Purita, Paola

AU - Tarantini, Giuseppe

AU - Thilo, Christian

AU - Wolf, Alexander

AU - Husser, Oliver

AU - Pellegrini, Costanza

AU - Burgdorf, Christof

AU - Antolin, Rosa Ana Hernandez

AU - Díaz, Victor A Jiménez

AU - Liebetrau, Christoph

AU - Schofer, Niklas

AU - Möllmann, Helge

AU - Eggebrecht, Holger

AU - Sondergaard, Lars

AU - Walther, Thomas

AU - Pilgrim, Thomas

AU - Hilker, Michael

AU - Makkar, Raj

AU - Unbehaun, Axel

AU - Börgermann, Jochen

AU - Moris, Cesar

AU - Achenbach, Stephan

AU - Dörr, Oliver

AU - Brochado, Bruno

AU - Conradi, Lenard

AU - Hamm, Christian W

PY - 2019/10/7

Y1 - 2019/10/7

N2 - AIMS: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort.METHODS AND RESULTS: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective.CONCLUSION: Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

AB - AIMS: Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort.METHODS AND RESULTS: We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective.CONCLUSION: Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

UR - https://www.scopus.com/pages/publications/85072993397

U2 - 10.1093/eurheartj/ehz429

DO - 10.1093/eurheartj/ehz429

M3 - Journal article

C2 - 31230081

SN - 0195-668X

VL - 40

SP - 3156

EP - 3165

JO - European Heart Journal

JF - European Heart Journal

IS - 38

ER -

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

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