Validation of the Valve Academic Research Consortium 3 Technical Success Definition in Patients Undergoing TAVR.

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

[img] Text
Tomii_JACCCardiovascInterv_2022.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (1MB) | Request a copy
[img]
Preview
Text
Tomii_JACCCardiovascInterv_2022_AAM.pdf - Accepted Version
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (1MB) | Preview
[img]
Preview
Text
Tomii_JACCCardiovascInterv_2022_supplmat.pdf - Supplemental Material
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (561kB) | Preview

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

Actions (login required)

Edit item Edit item
Provide Feedback