AI Article Synopsis
- Transcatheter aortic valve implantation (AViV) was studied in 100 low- and intermediate-risk patients with bioprosthetic valve failure, focusing on safety and effectiveness over a year.
- Primary outcomes showed a very low rate of complications, with only 2.1% experiencing strokes and no deaths within the year.
- Significant improvements were observed in patient health metrics, such as reduced functional class and lower heart valve pressure gradients, indicating that AViV could be a viable treatment option for this patient group, pending further long-term studies.
Article Abstract
Background: Transcatheter aortic valve implantation is safe and effective for high-risk patients with bioprosthetic valve failure (BVF) but has not been studied in low- and intermediate-risk patients. One year outcomes of the PARTNER 3 Aortic Valve-in-valve (AViV) Study were evaluated.
Methods: This prospective, single-arm, multicenter study enrolled 100 patients from 29 sites with surgical BVF. The primary endpoint was a composite of all-cause mortality and stroke at 1 year. The key secondary outcomes included mean gradient, functional capacity, and rehospitalization (valve-related, procedure-related, or heart failure related).
Results: A total of 97 patients underwent AViV with a balloon-expandable valve from 2017 to 2019. Patients were 79.4% male with a mean age of 67.1 years and Society of Thoracic Surgeons score of 2.9%. The primary endpoint occurred in 2 patients (2.1%) who had strokes; there was no mortality at 1 year. Five patients (5.2%) had valve thrombosis events, and 9 patients (9.3%) had rehospitalizations, including 2 (2.1%) for strokes, 1 (1.0%) for heart failure, and 6 (6.2%) for aortic valve reinterventions (3 explants, 3 balloon dilations, and 1 percutaneous paravalvular regurgitation closure). From baseline to 1 year, New York Heart Association class III/IV decreased from 43.3% to 4.5%, mean gradient from 39.1 ± 18.2 mm Hg to 19.7 ± 7.6 mm Hg, and ≥moderate aortic regurgitation from 41.1% to 1.1%.
Conclusions: AViV with a balloon-expandable valve improved hemodynamic and functional status at 1 year and can provide an additional therapeutic option in selected low- or intermediate-risk patients with surgical BVF, although longer term follow-up is necessary.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10242574 | PMC |
| http://dx.doi.org/10.1016/j.shj.2022.100077 | DOI Listing |
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