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01-10-2021 | Aortic Valve Replacement | IM - ORIGINAL

Long-term echocardiographic findings after TAVR: 5-year follow-up in 400 consecutive patients

Authors: Miroslava Stolcova, Francesco Meucci, Carolina Moretti, Niccolò Chiriatti, Chiara Marcelli, Alessio Mattesini, Nevio Taglieri, Francesca Ristalli, Nazzareno Galiè, Tullio Palmerini, Carlo Di Mario, Francesco Saia

Published in: Internal and Emergency Medicine | Issue 7/2021

Abstract

A little is known about long-term hemodynamic performance of the transcatheter heart valves (THVs). The aim of the present study was to assess hemodynamic outcome, structural valve deterioration (SVD) and bioprosthetic valve failure (BVF) in patients treated with transcatheter aortic valve replacement (TAVR) five or more years ago. All consecutive patients treated at Bologna and Florence University Hospitals with TAVR between January 2008 and December 2013 were analyzed in a retrospective registry with regards to demographic, procedural and outcome data as well as follow-up data on mortality and echocardiographic characteristics. Standardized definitions were used to define outcomes and durability of the THVs. 400 patients were included in the study, mostly treated with transfemoral TAVR (71.8%), using first generation balloon-expandable (37%) or self-expanding (63%) devices. The 1-year mortality was 21.8% (87 patients) and 5-year mortality was 53.8% (215 patients). Median follow-up was 45.5 months (14.0–68.9) totaling 1516.7 patient/years, with the longest follow-up being 10.25 years. At least one follow-up echocardiogram was available for 320 patients (80%), SVD occurred in 19 of these patients (5.94%): moderate in 17 patients (5.31%) and severe in two patients (0.63%). The hemodynamic presentation was stenosis in most of the cases (12 patients). Late BVF was registered in 10 patients (3.13%) and this was mainly driven by transcatheter paravalvular leak closure (six patients) with subsequent good long-term outcome. Our results confirm that TAVR appears to be a long-lasting treatment strategy with low rates of structural valve degeneration and valve failure.

Baumgartner H, Falk V, Bax JJ, De Bonis M, Hamm C, Holm PJ, Iung B, Lancellotti P, Lansac E, Rodriguez Munoz D, Rosenhek R, Sjogren J, Tornos Mas P, Vahanian A, Walther T, Wendler O, Windecker S, Group ESCSD (2017) Zamorano JL 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J 38:2739–2791CrossRef

Mack MJ, Leon MB, Thourani VH, Makkar R, Kodali SK, Russo M, Kapadia SR, Malaisrie SC, Cohen DJ, Pibarot P, Leipsic J, Hahn RT, Blanke P, Williams MR, McCabe JM, Brown DL, Babaliaros V, Goldman S, Szeto WY, Genereux P, Pershad A, Pocock SJ, Alu MC, Webb JG, Smith CR, Investigators P (2019) Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients. N Engl J Med 380:1695–1705CrossRef

Popma JJ, Deeb GM, Yakubov SJ, Mumtaz M, Gada H, O'Hair D, Bajwa T, Heiser JC, Merhi W, Kleiman NS, Askew J, Sorajja P, Rovin J, Chetcuti SJ, Adams DH, Teirstein PS, Zorn GL, 3rd, Forrest JK, Tchetche D, Resar J, Walton A, Piazza N, Ramlawi B, Robinson N, Petrossian G, Gleason TG, Oh JK, Boulware MJ, Qiao H, Mugglin AS, Reardon MJ and Evolut Low Risk Trial I. Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients. N Engl J Med. 2019;380:1706–1715.

Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM, Webb JG, Douglas PS, Anderson WN, Blackstone EH, Kodali SK, Makkar RR, Fontana GP, Kapadia S, Bavaria J, Hahn RT, Thourani VH, Babaliaros V, Pichard A, Herrmann HC, Brown DL, Williams M, Akin J, Davidson MJ (2015) Svensson LG and investigators Pt. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 385:2477–2484CrossRef

Deeb GM, Reardon MJ, Chetcuti S, Patel HJ, Grossman PM, Yakubov SJ, Kleiman NS, Coselli JS, Gleason TG, Lee JS, Hermiller JB Jr, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Maini B, Mumtaz M, Conte J, Resar J, Aharonian V, Pfeffer T, Oh JK, Qiao H, Adams DH, Popma JJ, CoreValve USCI (2016) 3-year outcomes in high-risk patients who underwent surgical or transcatheter aortic valve replacement. J Am Coll Cardiol 67:2565–2574CrossRef

Gleason TG, Reardon MJ, Popma JJ, Deeb GM, Yakubov SJ, Lee JS, Kleiman NS, Chetcuti S, Hermiller JB Jr, Heiser J, Merhi W, Zorn GL 3rd, Tadros P, Robinson N, Petrossian G, Hughes GC, Harrison JK, Conte JV, Mumtaz M, Oh JK, Huang J (2018) Adams DH and CoreValve USPHRTCI. 5-year outcomes of self-expanding transcatheter versus surgical aortic valve replacement in high-risk patients. J Am Coll Cardiol 72:2687–2696CrossRef

Toggweiler S, Humphries KH, Lee M, Binder RK, Moss RR, Freeman M, Ye J, Cheung A, Wood DA, Webb JG (2013) 5-year outcome after transcatheter aortic valve implantation. J Am Coll Cardiol 61:413–419CrossRef

Barbanti M, Petronio AS, Ettori F, Latib A, Bedogni F, De Marco F, Poli A, Boschetti C, De Carlo M, Fiorina C, Colombo A, Brambilla N, Bruschi G, Martina P, Pandolfi C, Giannini C, Curello S, Sgroi C, Gulino S, Patane M, Ohno Y, Tamburino C, Attizzani GF, Imme S, Gentili A, Tamburino C (2015) 5-year outcomes after transcatheter aortic valve implantation with corevalve prosthesis. JACC Cardiovasc Interv 8:1084–1091CrossRef

Barbanti M, Costa G, Zappulla P, Todaro D, Picci A, Rapisarda G, Di Simone E, Sicuso R, Buccheri S, Gulino S, Pilato G, La Spina K, D’Arrigo P, Valvo R, Indelicato A, Giannazzo D, Imme S, Tamburino C, Patane M, Sgroi C, Giuffrida A, Trovato D, Monte IP, Deste W, Capranzano P, Capodanno D, Tamburino C (2018) Incidence of long-term structural valve dysfunction and bioprosthetic valve failure after transcatheter aortic valve replacement. J Am Heart Assoc 7:e008440CrossRef

10.

Orvin K, Zekry SB, Morelli O, Barabash IM, Segev A, Danenberg H, Assali A, Guetta V, Assa HV, Zeniou V, Lotan C, Sagie A, Gilon D, Feinberg MS, Shapira Y, Kornowski R (2019) Long-term functional and structural durability of bioprosthetic valves placed in the aortic valve position via percutaneous rout in Israel. Am J Cardiol 124:1748–1756CrossRef

11.

Capodanno D, Petronio AS, Prendergast B, Eltchaninoff H, Vahanian A, Modine T, Lancellotti P, Sondergaard L, Ludman PF, Tamburino C, Piazza N, Hancock J, Mehilli J, Byrne RA, Baumbach A, Kappetein AP, Windecker S, Bax J, Haude M (2017) Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 38:3382–3390CrossRef

12.

Cribier A, Eltchaninoff H, Tron C, Bauer F, Agatiello C, Nercolini D, Tapiero S, Litzler PY, Bessou JP, Babaliaros V (2006) Treatment of calcific aortic stenosis with the percutaneous heart valve: mid-term follow-up from the initial feasibility studies: the French experience. J Am Coll Cardiol 47:1214–1223CrossRef

13.

Tamburino C, Capodanno D, Mule M, Scarabelli M, Cammalleri V, Barbanti M, Calafiore A, Ussia G (2009) Procedural success and 30-day clinical outcomes after percutaneous aortic valve replacement using current third-generation self-expanding CoreValve prosthesis. J Invasive Cardiol 21:93–98PubMed

14.

Kempfert J, Rastan AJ, Beyersdorf F, Schonburg M, Schuler G, Sorg S, Mohr FW, Walther T (2011) Trans-apical aortic valve implantation using a new self-expandable bioprosthesis: initial outcomes. Eur J Cardiothorac Surg 40:1114–1119CrossRef

15.

Treede H, Rastan A, Ferrari M, Ensminger S, Figulla HR, Mohr FW (2012) JenaValve. EuroIntervention 8(8):Q88-93CrossRef

16.

Saia F, Palmerini T, Compagnone M, Battistini P, Moretti C, Taglieri N, Marcelli C, Bruno AG, Ghetti G, Corsini A, Bacchi Reggiani ML, Marrozzini C, Rapezzi C (2020) Coronary artery disease and reasonably incomplete coronary revascularization in high-risk patients undergoing transcatheter aortic valve implantation. Catheter Cardiovasc Interv 95:19–27CrossRef

17.

Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L (1999) Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg 15:816–822 ((discussion 822–3))CrossRef

18.

Kappetein AP, Head SJ, Genereux P, Piazza N, van Mieghem NM, Blackstone EH, Brott TG, Cohen DJ, Cutlip DE, van Es GA, Hahn RT, Kirtane AJ, Krucoff MW, Kodali S, Mack MJ, Mehran R, Rodes-Cabau J, Vranckx P, Webb JG, Windecker S, Serruys PW, Leon MB (2012) Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document. J Am Coll Cardiol 60:1438–1454CrossRef

19.

Ludman PF, Moat N, de Belder MA, Blackman DJ, Duncan A, Banya W, MacCarthy PA, Cunningham D, Wendler O, Marlee D, Hildick-Smith D, Young CP, Kovac J, Uren NG, Spyt T, Trivedi U, Howell J, Gray H, Committee UTS and the National Institute for Cardiovascular Outcomes R (2015) Transcatheter aortic valve implantation in the United Kingdom: temporal trends, predictors of outcome, and 6-year follow-up: a report from the UK Transcatheter Aortic Valve Implantation (TAVI) Registry, 2007 to 2012. Circulation 131:1181–1190CrossRef

20.

Testa L, Latib A, Brambilla N, De Marco F, Fiorina C, Adamo M, Giannini C, Angelillis M, Barbanti M, Sgroi C, Poli A, Ferrara E, Bruschi G, Russo CF, Matteo M, De Felice F, Musto C, Curello S, Colombo A, Tamburino C, Petronio AS and Bedogni F (2020) Long-term clinical outcome and performance of transcatheter aortic valve replacement with a self-expandable bioprosthesis. Eur Heart J

21.

Eltchaninoff H, Durand E, Avinee G, Tron C, Litzler PY, Bauer F, Dacher JN, Werhlin C, Bouhzam N, Bettinger N, Candolfi P, Cribier A (2018) Assessment of structural valve deterioration of transcatheter aortic bioprosthetic balloon-expandable valves using the new European consensus definition. EuroIntervention 14:e264–e271CrossRef

22.

Blackman DJ, Saraf S, MacCarthy PA, Myat A, Anderson SG, Malkin CJ, Cunnington MS, Somers K, Brennan P, Manoharan G, Parker J, Aldalati O, Brecker SJ, Dowling C, Hoole SP, Dorman S, Mullen M, Kennon S, Jerrum M, Chandrala P, Roberts DH, Tay J, Doshi SN, Ludman PF, Fairbairn TA, Crowe J, Levy RD, Banning AP, Ruparelia N, Spence MS, Hildick-Smith D (2019) Long-term durability of transcatheter aortic valve prostheses. J Am Coll Cardiol 73:537–545CrossRef

23.

Murray MI, Hofmann E, De Rosa R, Mas-Peiro S, Seppelt P, Walther T, Zeiher AM, Fichtlscherer S, Vasa-Nicotera M (2020) Hemodynamic outcome and valve durability beyond five years after transcatheter aortic valve replacement. J Invasive Cardiol 32:82–87PubMed

24.

Sondergaard L, Ihlemann N, Capodanno D, Jorgensen TH, Nissen H, Kjeldsen BJ, Chang Y, Steinbruchel DA, Olsen PS, Petronio AS, Thyregod HGH (2019) Durability of transcatheter and surgical bioprosthetic aortic valves in patients at lower surgical risk. J Am Coll Cardiol 73:546–553CrossRef

25.

Saia F, Martinez C, Gafoor S, Singh V, Ciuca C, Hofmann I, Marrozzini C, Tan J, Webb J, Sievert H, Marzocchi A, O’Neill WW (2015) Long-term outcomes of percutaneous paravalvular regurgitation closure after transcatheter aortic valve replacement: a multicenter experience. JACC Cardiovasc Interv 8:681–688CrossRef

Title: Long-term echocardiographic findings after TAVR: 5-year follow-up in 400 consecutive patients
Authors: Miroslava Stolcova
Francesco Meucci
Carolina Moretti
Niccolò Chiriatti
Chiara Marcelli
Alessio Mattesini
Nevio Taglieri
Francesca Ristalli
Nazzareno Galiè
Tullio Palmerini
Carlo Di Mario
Francesco Saia
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: Aortic Valve Replacement
Aortic Valve Replacement
Aortic Valve Replacement
Published in: Internal and Emergency Medicine / Issue 7/2021
Print ISSN: 1828-0447
Electronic ISSN: 1970-9366
DOI: https://doi.org/10.1007/s11739-021-02689-w

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