Details

Autor(en) / Beteiligte

• Kim, Won-Keun
• Schäfer, Ulrich
• Tchetche, Didier
• Nef, Holger
• Arnold, Martin
• Avanzas, Pablo
• Rudolph, Tanja
• Scholtz, Smita
• Barbanti, Marco
• Kempfert, Jörg
• Mangieri, Antonio
• Lauten, Alexander
• Frerker, Christian
• Yoon, Sung-Han
• Holzamer, Andreas
• Praz, Fabien
• De Backer, Ole
• Toggweiler, Stefan
• Blumenstein, Johannes
• Purita, Paola
• Tarantini, Giuseppe
• Thilo, Christian
• Wolf, Alexander
• Husser, Oliver
• Pellegrini, Costanza
• Burgdorf, Christof
• Antolin, Rosa Ana Hernandez
• Díaz, Victor A Jiménez
• Liebetrau, Christoph
• Schofer, Niklas
• Möllmann, Helge
• Eggebrecht, Holger
• Sondergaard, Lars
• Walther, Thomas
• Pilgrim, Thomas
• Hilker, Michael
• Makkar, Raj
• Unbehaun, Axel
• Börgermann, Jochen
• Moris, Cesar
• Achenbach, Stephan
• Dörr, Oliver
• Brochado, Bruno
• Conradi, Lenard
• Hamm, Christian W

Titel

Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration)

Ist Teil von

• European heart journal, 2019-10, Vol.40 (38), p.3156-3165

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2019

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Aims Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort. Methods and results We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 ± 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective. Conclusion Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.