Incidence, predictors and clinical outcomes of residual stenosis after aortic valve-in-valve

dc.citation.volumev. 104
dc.contributor.authorBleiziffer, Sabine
dc.contributor.authorErlebach, Magdalena
dc.contributor.authorSimonato, Matheus [UNIFESP]
dc.contributor.authorPibarot, Philippe
dc.contributor.authorWebb, John
dc.contributor.authorCapek, Lukas
dc.contributor.authorWindecker, Stephan
dc.contributor.authorGeorge, Isaac
dc.contributor.authorSinning, Jan-Malte
dc.contributor.authorHorlick, Eric
dc.contributor.authorNapodano, Massimo
dc.contributor.authorHolzhey, David M.
dc.contributor.authorPetursson, Petur
dc.contributor.authorCerillo, Alfredo
dc.contributor.authorBonaros, Nikolaos
dc.contributor.authorFerrari, Enrico
dc.contributor.authorCohen, Mauricio G.
dc.contributor.authorBaquero, Giselle
dc.contributor.authorJones, Tara L.
dc.contributor.authorKalra, Ankur
dc.contributor.authorReardon, Michael J.
dc.contributor.authorChhatriwalla, Adnan
dc.contributor.authorRibeiro, Vasco Gama
dc.contributor.authorAlnasser, Sami
dc.contributor.authorVan Mieghem, Nicolas M.
dc.contributor.authorRustenbach, Christian Joerg
dc.contributor.authorSchofer, Joachim
dc.contributor.authorGarcia, Santiago
dc.contributor.authorZeus, Tobias
dc.contributor.authorChampagnac, Didier
dc.contributor.authorBekeredjian, Raffi
dc.contributor.authorKornowski, Ran
dc.contributor.authorLange, Ruediger
dc.contributor.authorDvir, Danny
dc.description.abstractObjective We aimed to analyse the incidence of prosthesis-patient mismatch (PPM) and elevated gradients after aortic valve in valve (ViV), and to evaluate predictors and associations with clinical outcomes of this adverse event. Methods A total of 910 aortic ViV patients were investigated. Elevated residual gradients were defined as >= 20mm Hg. PPM was identified based on the indexed effective orifice area (EOA), measured by echocardiography, and patient body mass index (BMI). Moderate and severe PPM (cases) were defined by European Association of Cardiovascular Imaging (EACVI) criteria and compared with patients without PPM (controls). Results Moderate or greater PPM was found in 61% of the patients, and severe in 24.6%. Elevated residual gradients were found in 27.9%. Independent risk factors for the occurrence of lower indexed EOA and therefore severe PPM were higher gradients of the failed bioprosthesis at baseline (unstandardised beta -0.023en
dc.description.abstract95% CI -0.032 to -0.014en
dc.description.abstractP<0.001), a stented (vs a stentless) surgical bioprosthesis (unstandardised beta -0.11en
dc.description.abstract95% CI -0.161 to -0.071en
dc.description.abstractP<0.001), higher BMI (unstandardised beta -0.01en
dc.description.abstract95% CI -0.013 to -0.007en
dc.description.abstractP<0.001) and implantation of a SAPIEN/SAPIEN XT/SAPIEN 3 transcatheter device (unstandardised beta -0.064en
dc.description.abstract95% CI -0.095 to -0.032en
dc.description.abstractP<0.001). Neither severe PPM nor elevated gradients had an association with VARC II-defined outcomes or 1-year survival (90.9% severe vs 91.5% moderate vs 89.3% none, P=0.44). Conclusions Severe PPM and elevated gradients after aortic ViV are very common but were not associated with short-term survival and clinical outcomes. The long-term effect of poor post-ViV haemodynamics on clinical outcomes requires further evaluation.en
dc.description.affiliationUniv Washington, Seattle, WA 98195 USA
dc.description.affiliationTech Univ Munich, German Heart Ctr Munich, Dept Cardiovasc Surg, Insure Inst Translat Cardiac Surg, Munich, Germany
dc.description.affiliationTech Univ Munich, German Heart Ctr Munich, Dept Cardiovasc Surg, Munich, Germany
dc.description.affiliationUniv Fed Sao Paulo, Escola Paulista Med, Dept Surg, Div Cardiovasc Surg, Sao Paulo, Brazil
dc.description.affiliationSt Pauls Hosp, Ctr Heart Valve Innovat, Vancouver, BC, Canada
dc.description.affiliationLaval Univ, Inst Univ Cardiol & Pneumol Quebec, Dept Med, Quebec City, PQ, Canada
dc.description.affiliationUniv Hosp Bern, Bern, Switzerland
dc.description.affiliationColumbia Univ, New York, NY USA
dc.description.affiliationUniv Bonn, Bonn, Germany
dc.description.affiliationUniv Hlth Network, Peter Munk Cardiac Ctr, Toronto, ON, Canada
dc.description.affiliationUniv Padua, Padua, Italy
dc.description.affiliationUniv Leipzig, Leipzig, Germany
dc.description.affiliationSahlgrens Univ Hosp, Gothenburg, Sweden
dc.description.affiliationFdn Toscana Gabriele Monasterio, Pisa, Italy
dc.description.affiliationInnsbruck Med Univ, Innsbruck, Austria
dc.description.affiliationCardioctr Ticino, Lugano, Switzerland
dc.description.affiliationUniv Miami, Miami, FL USA
dc.description.affiliationSouthern Illinois Univ, Springfield, IL USA
dc.description.affiliationUniv Hosp Cleveland, Med Ctr, Harrington Heart & Vasc Inst, Cleveland, OH USA
dc.description.affiliationCase Western Reserve Univ, Sch Med, Dept Med, Div Cardiovasc Med, Cleveland, OH 44106 USA
dc.description.affiliationHouston Methodist, Houston, TX USA
dc.description.affiliationSt Lukes Mid Amer Heart Inst, Kansas City, MO USA
dc.description.affiliationCtr Hosp Vila Nova de Gaia, Vila Nova De Gaia, Portugal
dc.description.affiliationErasmus MC, Rotterdam, Netherlands
dc.description.affiliationUniv Hosp Cologne, Dept Cardiovasc Surg, Heartctr, Cologne, Germany
dc.description.affiliationAlbertinen Herzzentrum, Hamburg, Germany
dc.description.affiliationUniv Minnesota, Minneapolis VA Healthcare Syst, Minneapolis, MN USA
dc.description.affiliationUniv Hosp Duesseldorf, Dusseldorf, Germany
dc.description.affiliationClin Tonkin, Villeurbanne, France
dc.description.affiliationHeidelberg Univ, Heidelberg, Germany
dc.description.affiliationRabin Med Ctr, Petah Tiqwa, Israel
dc.description.affiliationUnifespUniv Fed Sao Paulo, Escola Paulista Med, Dept Surg, Div Cardiovasc Surg, Sao Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipEdwards Lifesciences
dc.description.sponsorshipVA Office of Research and Development
dc.description.sponsorshipBoston Scientific
dc.description.sponsorshipSt. Jude Medical
dc.description.sponsorshipEssential Medical
dc.identifier.citationHeart. London, v. 104, n. 10, p. 828-834, 2018.
dc.publisherBmj Publishing Group
dc.rightsAcesso restrito
dc.subjectvalve disease surgeryen
dc.subjecttranscatheter valve interventionsen
dc.subjectvalvular heart diseaseen
dc.subjectprosthetic heart valvesen
dc.titleIncidence, predictors and clinical outcomes of residual stenosis after aortic valve-in-valveen