Scholarlink

Background <p>The aim of this study was to analyse long-term valve function and all-cause mortality of patients undergoing transcatheter aortic valve replacement (TAVR) due to degenerated surgical aortic valve (SAV) bioprostheses.</p> Methods <p>In this single-center study, all consecutive patients undergoing TAVR between December 2012 and December 2020 were included. Long-term echocardiographic results, functional status and 5-year all-cause mortality were analysed in patients with TAV-in-SAV and native valve TAVR in a propensity score matched analysis.</p> Results <p>Out of 3423 patients who were eligible for the study, 136 experienced bioprosthetic valve dysfunction, whereas 3287 patients underwent native valve TAVR. After 2:1 propensity score matching, baseline characteristics without relation to prior SAVR were comparable between both groups. Regarding 5-year all-cause mortality, no difference was observed between patients with prior SAVR and native valve TAVR, in either unadjusted analysis, or after propensity score matching (corresponding hazard ratio: 0.95, 95% CI: 0.70–1.30, p = 0.75). In addition, while pressure gradients were higher in patients with TAV-in-SAV in long-term echocardiographic follow-up, moderate or severe hemodynamic valve deterioration did not occur more often in this group.</p> Conclusions <p>In this propensity score matched analysis, long-term all-cause mortality and echocardiographic valve function of patients with TAVR in prior bioprosthesis were comparable to patients with native valve TAVR.</p> Graphical Abstract <p>Central Illustration. Long-Term Results of Transcatheter Aortic Valve Replacement in degenerated Surgical Aortic Valves. Out of 3423 patients who were eligible for the study, 136 experienced bioprosthetic valve dysfunction, whereas 3287 patients underwent native valve TAVR. We performed 2:1 propensity score matching to overcome differences in baseline characteristics. While pressure gradients were higher in patients with TAV-in-SAV in long-term echocardiographic follow-up, moderate or severe hemodynamic valve deterioration did not occur more often in this group (left side). Regarding 5-year all-cause mortality, no difference was observed between patients with prior SAVR and native valve TAVR neither in unadjusted analysis, nor after propensity score matching (corresponding hazard ratio: 0.95, 95% CI: 0.70–1.30, p = 0.75) (right side). <i>SAV</i> surgical aortic valve, <i>TAVR</i> transcatheter aortic valve replacement</p> <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-term results of transcatheter aortic valve replacement in degenerated surgical aortic valves—a propensity score matched analysis

  • 期刊论文

  • 发表日期：

    2025年5月22日

查看全文
  • Kornelia Löw,
  • Julius Steffen,
  • Nike Knufinke,
  • Carolin Fröhlich,
  • Julius Fischer,
  • Magda Haum,
  • Hans Theiss,
  • Sven Peterss,
  • Konstantin Stark,
  • Jörg Hausleiter,
  • Steffen Massberg,
  • Simon Deseive

摘要

Background

The aim of this study was to analyse long-term valve function and all-cause mortality of patients undergoing transcatheter aortic valve replacement (TAVR) due to degenerated surgical aortic valve (SAV) bioprostheses.

Methods

In this single-center study, all consecutive patients undergoing TAVR between December 2012 and December 2020 were included. Long-term echocardiographic results, functional status and 5-year all-cause mortality were analysed in patients with TAV-in-SAV and native valve TAVR in a propensity score matched analysis.

Results

Out of 3423 patients who were eligible for the study, 136 experienced bioprosthetic valve dysfunction, whereas 3287 patients underwent native valve TAVR. After 2:1 propensity score matching, baseline characteristics without relation to prior SAVR were comparable between both groups. Regarding 5-year all-cause mortality, no difference was observed between patients with prior SAVR and native valve TAVR, in either unadjusted analysis, or after propensity score matching (corresponding hazard ratio: 0.95, 95% CI: 0.70–1.30, p = 0.75). In addition, while pressure gradients were higher in patients with TAV-in-SAV in long-term echocardiographic follow-up, moderate or severe hemodynamic valve deterioration did not occur more often in this group.

Conclusions

In this propensity score matched analysis, long-term all-cause mortality and echocardiographic valve function of patients with TAVR in prior bioprosthesis were comparable to patients with native valve TAVR.

Graphical Abstract

Central Illustration. Long-Term Results of Transcatheter Aortic Valve Replacement in degenerated Surgical Aortic Valves. Out of 3423 patients who were eligible for the study, 136 experienced bioprosthetic valve dysfunction, whereas 3287 patients underwent native valve TAVR. We performed 2:1 propensity score matching to overcome differences in baseline characteristics. While pressure gradients were higher in patients with TAV-in-SAV in long-term echocardiographic follow-up, moderate or severe hemodynamic valve deterioration did not occur more often in this group (left side). Regarding 5-year all-cause mortality, no difference was observed between patients with prior SAVR and native valve TAVR neither in unadjusted analysis, nor after propensity score matching (corresponding hazard ratio: 0.95, 95% CI: 0.70–1.30, p = 0.75) (right side). SAV surgical aortic valve, TAVR transcatheter aortic valve replacement