Usefulness of Transcatheter Aortic Valve Implantation for Treatment of Pure Native Aortic Valve Regurgitation.

De Backer, Ole; Pilgrim, Thomas; Simonato, Matheus; Mackensen, G Burkhard; Fiorina, Claudia; Veulemanns, Verena; Cerillo, Alfredo; Schofer, Joachim; Amabile, Nicolas; Achkouty, Guy; Schäfer, Ulrich; Deutsch, Marcus-André; Sinning, Jan-Malte; Rahman, Mohammed S; Sawaya, Fadi J; Hildick-Smith, David; Hernandez, Jose Maria; Kim, Won-Keun; Lefevre, Thierry; Seiffert, Moritz; ... (2018). Usefulness of Transcatheter Aortic Valve Implantation for Treatment of Pure Native Aortic Valve Regurgitation. The American journal of cardiology, 122(6), pp. 1028-1035. Elsevier 10.1016/j.amjcard.2018.05.044

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Patients with pure native aortic valve regurgitation (NAVR) and increased surgical risk are often denied surgery. This retrospective study aimed to evaluate the "off-label" use of transcatheter heart valves (THV) for the treatment of NAVR. A total of 254 high surgical risk patients with NAVR (age 74 ± 12 years, Society of Thoracic Surgeons risk score 6.6 ± 6.2%) underwent transcatheter aortic valve implantation (TAVI) with early generation (43%) or newer generation (57%) devices at 46 different sites. Device success was significantly higher in patients treated with newer as compared with early generation THV (82% vs 47%, p <0.001). The difference was driven by lower rates of device malpositioning (9% vs 33%) and aortic regurgitation (AR) ≥ moderate (4% vs 31%) and translated into higher clinical efficacy at 30 days in patients treated with newer as compared with early generation THV (72% vs 56%, p = 0.041). Both THV under- and oversizing were associated with an increased risk of THV malpositioning. In conclusion, TAVI is a feasible treatment strategy in selected high-risk patients with NAVR but is associated with a considerable risk of THV malpositioning and residual AR. Although newer-generation THV are associated with better outcomes, novel devices for the treatment of NAVR are warranted.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1879-1913

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

07 Mar 2019 11:34

Last Modified:

05 Dec 2019 06:28

Publisher DOI:

10.1016/j.amjcard.2018.05.044

PubMed ID:

30072124

BORIS DOI:

10.7892/boris.125221

URI:

https://boris.unibe.ch/id/eprint/125221

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