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

DOI
Publisher DOI
PubMed ID
30072124
Abstract
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.
Date Issued
2018-09-15
Publication Type
Article
Subject(s)
Language(s)
en
Author(s)
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
Bleiziffer, Sabine
Petronio, Anna Sonia
Van Mieghem, Nicolas
Taramasso, Maurizio
Søndergaard, Lars
Latib, Azeem
Dvir, Danny
Additional Credits
Journal
The American journal of cardiology
Publisher
Elsevier
ISSN
1879-1913
Access(Rights)
restricted
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