Valve‐in‐valve transcatheter aortic valve implantation with CoreValve/Evolut R© for degenerated small versus bigger bioprostheses. (28th February 2018)

• Record Type: Journal Article
• Authors: Scholtz, Smita; Piper, Cornelia; Horstkotte, Dieter; Gummert, Jan; Ensminger, Stephan M.; Börgermann, Jochen; Scholtz, Werner
• Is Part Of: Journal of interventional cardiology. Volume 31:Number 3(2018:Jun.)
• Page Start: 384
• Page End: 390
• Publication Date: 2018-02-28
• Subjects: aortic valve disease -- degenerated bioprosthesis -- transcatheter aortic valve implantation; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.1206
• DOI: 10.1111/joic.12498
• Languages: English
• ISSNs: 0896-4327

Abstract

Abstract : Objectives: We present our single center experience with Medtronic CoreValve and Evolut R regarding procedural outcome and 3 years follow‐up in patients with degenerated bioprostheses. Methods: From 1645 patients who underwent transfemoral TAVI at our institution between February 2009 and December 2016, 37 patients with degenerated bioprosthesis were treated with Medtronic CoreValve/Evolut R. All data concerning baseline characteristic, procedural outcomes and follow‐up were entered into a dedicated database. Results: Mean age was 83.9 ± 4.4 years and patients showed an average logistic EuroSCORE of 33.2 ± 16.7%. Successful ViV deployment was achieved in all cases, a permanent pacemaker was implanted in 16.2%, no periinterventional stroke and no coronary obstruction occurred. Mortality at 30 days was 2.7%, at 1‐year follow‐up 5.7% and at three years 13.5%. Depending on bioprosthesis size <23 mm versus ≥23 mm echocardiographic mean gradients post implantation were significantly higher in the smaller bioprostheses, 22.8 mmHg ± 9.4 mmHg versus 15.1 ± 7.1, P = 0.013. Conclusion: ViV‐TAVI with CoreValve/R is demonstrated to be safe and effective in terms of no coronary obstruction and very low mortality up to 3 years despite slightly higher mean transprosthetic gradients especially in very small bioprostheses.