Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid?Aortic?Valve Stenosis

Yoon, Sung-Han; Bleiziffer, Sabine; De Backer, Ole; Delgado, Victoria; Arai, Takahide; Ziegelmueller, Johannes; Barbanti, Marco; Sharma, Rahul; Perlman, Gidon Y; Khalique, Omar K; Holy, Erik W; Saraf, Smriti; Deuschl, Florian; Fujita, Buntaro; Ruile, Philipp; Neumann, Franz-Josef; Pache, Gregor; Takahashi, Masao; Kaneko, Hidehiro; Schmidt, Tobias; Ohno, Yohei; Schofer, Niklas; Kong, William K F; Tay, Edgar; Sugiyama, Daisuke; Kawamori, Hiroyuki; Maeno, Yoshio; Abramowitz, Yigal; Chakravarty, Tarun; Nakamura, Mamoo; Kuwata, Shingo; Yong, Gerald; Kao, Hsien-Li; Lee, Michael; Kim, Hyo-Soo; Modine, Thomas; Wong, S Chiu; Bedgoni, Francesco; Testa, Luca; Teiger, Emmanuel; Butter, Christian; Ensminger, Stephan M; Schaefer, Ulrich; Dvir, Danny; Blanke, Philipp; Leipsic, Jonathon; Nietlispach, Fabian; Abdel-Wahab, Mohamed; Chevalier, Bernard; Tamburino, Corrado; Hildick-Smith, David; Whisenant, Brian K; Park, Seung-Jung; Colombo, Antonio; Latib, Azeem; Kodali, Susheel K; Bax, Jeroen J; Sondergaard, Lars; Webb, John G; Lefevre, Thierry; Leon, Martin B; Makkar, Raj
Journal of the American College of Cardiology
2017May ; 69 ( 21 ) :2579-2589.
저자 상세정보
Yoon, Sung-Han -
Bleiziffer, Sabine -
De Backer, Ole -
Delgado, Victoria -
Arai, Takahide -
Ziegelmueller, Johannes -
Barbanti, Marco -
Sharma, Rahul -
Perlman, Gidon Y -
Khalique, Omar K -
Holy, Erik W -
Saraf, Smriti -
Deuschl, Florian -
Fujita, Buntaro -
Ruile, Philipp -
Neumann, Franz-Josef -
Pache, Gregor -
Takahashi, Masao -
Kaneko, Hidehiro -
Schmidt, Tobias -
Ohno, Yohei -
Schofer, Niklas -
Kong, William K F -
Tay, Edgar -
Sugiyama, Daisuke -
Kawamori, Hiroyuki -
Maeno, Yoshio -
Abramowitz, Yigal -
Chakravarty, Tarun -
Nakamura, Mamoo -
Kuwata, Shingo -
Yong, Gerald -
Kao, Hsien-Li -
Lee, Michael -
Kim, Hyo-Soo -
Modine, Thomas -
Wong, S Chiu -
Bedgoni, Francesco -
Testa, Luca -
Teiger, Emmanuel -
Butter, Christian -
Ensminger, Stephan M -
Schaefer, Ulrich -
Dvir, Danny -
Blanke, Philipp -
Leipsic, Jonathon -
Nietlispach, Fabian -
Abdel-Wahab, Mohamed -
Chevalier, Bernard -
Tamburino, Corrado -
Hildick-Smith, David -
Whisenant, Brian K -
Park, Seung-Jung -
Colombo, Antonio -
Latib, Azeem -
Kodali, Susheel K -
Bax, Jeroen J -
Sondergaard, Lars -
Webb, John G -
Lefevre, Thierry -
Leon, Martin B -
Makkar, Raj -
ABSTRACT
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). OBJECTIVES: This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry.

METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria.

RESULTS: Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p?= 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p?= 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p?= 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p?= 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p?= 0.28).

CONCLUSIONS: Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas?no?differences were observed with the new-generation devices. CI - Copyright ??2017 The Authors. Published by Elsevier Inc. All rights reserved.
aortic stenosis; bicuspid aortic valve; transcatheter aortic valve implantation.
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1016/j.jacc.2017.03.017
KCD코드
ICD 03
건강보험코드