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Transcatheter aortic valve-in-valve implantation to treat aortic Para-valvular regurgitation after TAVI

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  1. Coronary Access Following Redo TAVR: Impact of THV Design, Implant Technique, and Cell Misalignment

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  2. Neo-Commissural Alignment During Transcatheter Aortic Valve Replacement: The LACRCO Algorithm

    Research output: Contribution to journalJournal articlepeer-review

  • Uri Landes
  • Olga Morelli
  • Haim Danenberg
  • Janarthanan Sathananthan
  • Ole De Backer
  • Lars Sondergaard
  • Mohamed Abdel-Wahab
  • Sung-Han Yoon
  • Raj R Makkar
  • Holger Thiele
  • Won-Keun Kim
  • Christian Hamm
  • Mayra Guerrero
  • Josep Rodés-Cabau
  • Taishi Okuno
  • Thomas Pilgrim
  • Antonio Mangieri
  • Nicolas M Van Mieghem
  • Didier Tchétché
  • Wolfgang H Schoels
  • Marco Barbanti
  • Jan-Malte Sinning
  • Alfonso Ielasi
  • Giuseppe Tarantini
  • Federico De Marco
  • Ariel Finkelstein
  • Horst Sievert
  • Martin Andreas
  • Azeem Latib
  • Rebecca Godfrey
  • David Hildick-Smith
  • Lisa Manevich
  • Ran Kornowski
  • Tamim M Nazif
  • Martin B Leon
  • John G Webb
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BACKGROUND: Para-valvular regurgitation (PVR) after transcatheter aortic valve (TAV) implantation is associated with increased mortality. Redo-TAVI may be applied to treat PVR, yet with unknown efficacy. We thought to assess redo-TAVI efficacy in reducing PVR using the Redo-TAVI registry (45 centers; 600 TAV-in-TAV cases).

METHODS: Patients were excluded if redo-TAVI was done urgently (N = 253), for isolated TAV stenosis (N = 107) or if regurgitation location at presentation remained undetermined (N = 123). The study group of patients with PVR (N = 70) were compared against patients with intra-valvular regurgitation (IVR) (N = 41). Echocardiographic examinations of 67 (60%) patients were reassessed in a core-lab for data accuracy validation.

RESULTS: Core-lab examination validated the jet location in 66 (98.5%) patients. At 30 days, the rate of residual AR ≥ moderate was 7 (10%) in the PVR cohort vs. 1 (2.4%) in the IVR cohort, p = 0.137. The rate of procedural success was 53 (75.7%) vs. 33 (80.5%), p = 0.561; procedural safety 51 (72.8%) vs. 31 (75.6%), p = 0.727; and mortality 2 (2.9%) vs. 1 (2.4%), p = 0.896 at 30 days and 7 (18.6%) vs. 2 (11.5%), p = 0.671 at 1 year, respectively. Of patients with residual PVR ≥ moderate at 30 days, 5/7 occurred after implanting balloon-expandable in self-expanding TAV and 2/7 after balloon-expandable in balloon-expandable TAV.

CONCLUSIONS: This study puts in perspective redo-TAVI efficacy and limitations to treat PVR after TAVI. Patient selection for this and other therapies for PVR needs further investigation.

Original languageEnglish
JournalInternational Journal of Cardiology
Volume364
Pages (from-to)31-34
Number of pages4
ISSN0167-5273
DOIs
Publication statusPublished - 1 Oct 2022

Bibliographical note

Copyright © 2022. Published by Elsevier B.V.

    Research areas

  • Aortic Valve Insufficiency/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Aortic Valve/diagnostic imaging, Heart Valve Diseases/surgery, Heart Valve Prosthesis, Humans, Prosthesis Design, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome

ID: 78591263