Tomii, Daijiro; Okuno, Taishi; Heg, Dik; Lanz, Jonas; Praz, Fabien; Stortecky, Stefan; Windecker, Stephan; Pilgrim, Thomas (2022). Validation of the Valve Academic Research Consortium 3 Technical Success Definition in Patients Undergoing TAVR. JACC. Cardiovascular Interventions, 15(4), pp. 353-364. Elsevier 10.1016/j.jcin.2021.11.013
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OBJECTIVES
The authors aimed to investigate the rates, predictors, and prognostic impact of technical success in patients undergoing transcatheter aortic valve replacement (TAVR).
BACKGROUND
The Valve Academic Research Consortium 3 (VARC-3) has introduced a composite endpoint to assess the immediate technical success of TAVR.
METHODS
In the prospective Bern TAVR registry, patients were stratified according to VARC-3 technical success. Technical failure differentiated between vascular and cardiac complications.
RESULTS
In a total of 1,624 patients undergoing TAVR between March 2012 and December 2019, 1,435 (88.4%) patients had technical success. Among 189 patients with technical failure, 140 (8.6%) had vascular and 49 (3.0%) had cardiac technical failure. Female, larger device landing zone calcium volume, and the early term of the study period were associated with an increased risk for cardiac technical failure, whereas higher body mass index and the use of the Prostar (Abbott Vascular Inc) MANTA (Teleflex) (compared with the ProGlide [Abbott Vascular Inc]) were predictors of vascular technical failure. In multivariable analysis, technical failure conferred an increased risk for cardiovascular death or stroke (HR: 2.01; 95% CI: 1.37-2.95). The adverse effect remained when stratified to cardiac (HR: 2.62; 95% CI: 1.38-4.97) or vascular technical failure (HR: 1.95; 95% CI: 1.28-2.95) and limited to the periprocedural period (0-30 days: HR: 3.42 [95% CI: 2.05-5.69]; 30-360 days: HR: 1.36 [95% CI: 0.79-2.35]; P for interaction = 0.002).
CONCLUSIONS
Technical failure according to VARC-3 was observed in 1 of 10 patients undergoing TAVR and was associated with a 2-fold increased risk of the composite outcome at 1 year after TAVR. (Swiss TAVI Registry; NCT01368250).
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology 04 Faculty of Medicine > Pre-clinic Human Medicine > Department of Clinical Research (DCR) |
UniBE Contributor: |
Okuno, Taishi, Heg, Dierik Hans, Lanz, Jonas, Praz, Fabien Daniel, Stortecky, Stefan, Windecker, Stephan, Pilgrim, Thomas |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1876-7605 |
Publisher: |
Elsevier |
Language: |
English |
Submitter: |
Andrea Flükiger-Flückiger |
Date Deposited: |
14 Feb 2022 11:05 |
Last Modified: |
20 Feb 2024 14:16 |
Publisher DOI: |
10.1016/j.jcin.2021.11.013 |
PubMed ID: |
35093281 |
Additional Information: |
Tomii and Okuno contributed equally to this work. |
Uncontrolled Keywords: |
Valve Academic Research Consortium aortic stenosis technical success transcatheter aortic valve replacement |
BORIS DOI: |
10.48350/165120 |
URI: |
https://boris.unibe.ch/id/eprint/165120 |
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