Details

Autor(en) / Beteiligte

• Vitanova, Keti
• Zaid, Syed
• Tang, Gilbert H.L.
• Kaneko, Tsuyoshi
• Bapat, Vinayak N.
• Modine, Thomas
• Denti, Paolo
• Saha, Shekhar
• Hagl, Christian
• Kiefer, Philipp
• Holzhey, David
• Noack, Thilo
• Borger, Michael A.
• Desai, Nimesh D.
• Bavaria, Joseph E.
• Voisine, MDPierre
• Mohammadi, Siamak
• Rodés-Cabau, Josep
• Harrington, Katherine B.
• Squiers, John J.
• Szerlip, Molly I.
• DiMaio, J. Michael
• Mack, Michael J.
• Rovin, Joshua
• Gennari, Marco
• Fukuhara, Shinichi
• Deeb, G. Michael
• Sengupta, Aditya
• Demers, Philippe
• Ibrahim, Reda
• Wyler von Ballmoos, Moritz
• Atkins, Marvin D.
• Kleiman, Neal S.
• Reardon, Michael J.
• Maisano, Francesco
• Bhadra, Oliver D.
• Conradi, Lenard
• Shults, Christian
• Satler, Lowell F.
• Waksman, Ron
• Pirelli, Luigi
• Brinster, Derek R.
• Algadheeb, Muhanad
• Chu, Michael W.A.
• Bagur, Rodrigo
• Ramlawi, Basel
• Grubb, Kendra J.
• Robinson, Newell B.
• Wang, Lin
• Petrossian, George A.
• Leroux, Lionel
• Doty, John R.
• Whisenant, Brian K.
• Kempfert, Joerg
• Unbehaun, Axel
• Rahim, Hussein
• Nazif, Tamim M.
• George, Isaac
• Geirsson, Arnar
• Forrest, John K.
• Vincent, Flavien
• Van Belle, Eric
• Koussa, Mohamad
• Goldberg, Joshua B.
• Ahmad, Hasan A.
• Ben Ali, Walid
• Andreas, Martin
• Werner, Paul
• Goel, Kashish
• Shah, Ashish S.
• Gelpi, Guido
• Ruel, Marc
• Al-Atassi, Talal
• Van Mieghem, Nicholas M.
• Hokken, Thijmen W.
• D'Onofrio, Augusto
• Tessari, Chiara
• Hirji, Sameer
• Shah, Pinak B.
• Belluschi, Igor
• Garatti, Andrea
• Bruschi, Giuseppe
• Ouzounian, Maral
• Pizano, Alejandro
• Di Eusanio, Marco
• Capestro, Filippo
• Taramasso, Maurizio
• Colli, Andrea
• Estevez-Loureiro, Rodrigo
• Pinon, Miguel A.
• Salinger, Michael H.
• Di Virgilio, Antonio
• Nguyen, Tom C.
• Lange, Rudiger

Titel

Aortic valve versus root surgery after failed transcatheter aortic valve replacement

Ist Teil von

• The Journal of thoracic and cardiovascular surgery, 2023-11, Vol.166 (5), p.1418-1430.e4

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2023

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• We sought to determine outcomes of aortic valve replacement (AVR) versus root replacement after transcatheter AVR (TAVR) explantation because they remain unknown. From November 2009 to September 2020, data from the EXPLANT-TAVR International Registry of patients who underwent TAVR explant were retrospectively reviewed, divided by AVR versus root replacement. After excluding explants performed during the same admission as the initial TAVR and concomitant procedures involving the other valves, 168 AVR cases were compared with 28 root replacements, and outcomes were reported at 30 days and 1 year. Among 196 patients (mean age, 73.5 ± 9.9 years) who had primary aortic valve intervention at TAVR explant, the median time from TAVR to surgical explant was 11.2 months (interquartile range, 4.4-32.9 months). Indications for explant were similar between the 2 groups. Compared with AVR, patients requiring root replacement had fewer comorbidities but more unfavorable anatomy for redo TAVR (52.6% vs 26.4%; P = .032), fewer urgent/emergency cases (32.1% vs 58.3%; P = .013), longer median interval from index TAVR to TAVR explant (17.6 vs 9.9 months; P = .047), and more concomitant ascending aortic replacement (58.8% vs 14.0%; P < .001). Median follow-up was 6.9 months (interquartile range, 1.4-21.6 months) after TAVR explant and 97.4% complete. Overall survival at follow-up was 81.2% with no differences between groups (log rank P = .54). In-hospital, 30-day, and 1-year mortality rates and stroke rates were not different between the 2 groups. In the EXPLANT-TAVR Registry, AVR and root replacement groups had different clinical characteristics, but no differences in short-term mortality and morbidities. Further investigations are necessary to identify patients at risk of root replacement in TAVR explant. Summary of the EXPLANT-TAVR International Registry. Among 196 patients across 42 centers who underwent surgical explantation for ranscatheter aortic valve replacement (TAVR) device failure, 14.3% who underwent aortic root replacement were compared with the remaining 85.7% who underwent aortic valve replacement (AVR). Concomitant root replacement during TAVR explant was not associated with worse outcomes compared with AVR alone, although this group had fewer comorbidities, with more elective cases. Further understanding of the procedural aspects on the decision for AVR versus root replacement will be important. IQR, Interquartile range; HR, ▪▪▪. [Display omitted]