Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis.
Journal article

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

  • Yoon SH Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California. Electronic address: yunsonhan@gmail.com.
  • Bleiziffer S Clinic for Cardiovascular Surgery, German Heart Center Munich, Germany.
  • De Backer O The Heart Centre, Rigshospitalet University Hospital, Copenhagen, Denmark.
  • Delgado V Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
  • Arai T Générale de Santé, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France.
  • Ziegelmueller J Clinic for Cardiovascular Surgery, German Heart Center Munich, Germany.
  • Barbanti M Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
  • Sharma R Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Perlman GY Department of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Khalique OK Columbia University Medical Center/New York Presbyterian Hospital, New York, New York.
  • Holy EW Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital of the Universities of Kiel, Hamburg, and Lübeck, Bad Segeberg, Germany.
  • Saraf S Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
  • Deuschl F Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany.
  • Fujita B Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Ruile P Department of Cardiology & Angiology II, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany.
  • Neumann FJ Department of Radiology, Section of Cardiovascular Radiology, University of Freiburg, Bad Krozingen, Germany.
  • Pache G Department of Radiology, Section of Cardiovascular Radiology, University of Freiburg, Bad Krozingen, Germany.
  • Takahashi M Department of Cardiology, Henri Mondor University Hospital, Créteil, France.
  • Kaneko H Heart Center Brandenburg in Bernau, Bernau, Germany.
  • Schmidt T Department of Cardiology, Asklepios Klink St. Georg, Hamburg, Germany.
  • Ohno Y Department of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Schofer N Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany.
  • Kong WKF Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, National University Heart Centre, Singapore.
  • Tay E Department of Cardiology, National University Heart Centre, Singapore.
  • Sugiyama D Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
  • Kawamori H Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Maeno Y Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Abramowitz Y Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Chakravarty T Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Nakamura M Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
  • Kuwata S University Heart Center, University Hospital Zurich, Zurich, Switzerland.
  • Yong G Division of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.
  • Kao HL Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • Lee M Division of Cardiology, Queen Elizabeth Hospital, Kowloon, Hong Kong.
  • Kim HS Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea.
  • Modine T Department of Cardiovascular Surgery, Hospital Cardiologique, Lille, France.
  • Wong SC Greenberg Division of Cardiology, New York-Presbyterian Hospital, Weil Cornell Medicine, New York, New York.
  • Bedgoni F Department of Cardiology, IRCCS Pol San Donato, San Donato Milanese, Milan, Italy.
  • Testa L Department of Cardiology, IRCCS Pol San Donato, San Donato Milanese, Milan, Italy.
  • Teiger E Department of Cardiology, Henri Mondor University Hospital, Créteil, France.
  • Butter C Heart Center Brandenburg in Bernau, Bernau, Germany.
  • Ensminger SM Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany.
  • Schaefer U Department of General and Interventional Cardiology, University Heart Center, Hamburg, Germany.
  • Dvir D Department of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Blanke P Department of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Leipsic J Department of Cardiology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Nietlispach F University Heart Center, University Hospital Zurich, Zurich, Switzerland.
  • Abdel-Wahab M Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital of the Universities of Kiel, Hamburg, and Lübeck, Bad Segeberg, Germany.
  • Chevalier B Générale de Santé, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France.
  • Tamburino C Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
  • Hildick-Smith D Sussex Cardiac Centre, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom.
  • Whisenant BK Division of Cardiovascular Diseases, Intermountain Heart Institute, Salt Lake City, Utah.
  • Park SJ Division of Cardiology, University of Ulsan, Asan Medical Center, Seoul, Korea.
  • Colombo A Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus & San Raffaele Scientific Institute, Milan, Italy San Raffaele Hospital, Milan, Italy.
  • Latib A Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus & San Raffaele Scientific Institute, Milan, Italy San Raffaele Hospital, Milan, Italy.
  • Kodali SK Columbia University Medical Center/New York Presbyterian Hospital, New York, New York.
  • Bax JJ Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
  • Søndergaard L The Heart Centre, Rigshospitalet University Hospital, Copenhagen, Denmark.
  • Webb JG Générale de Santé, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France.
  • Lefèvre T Générale de Santé, Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Massy, France.
  • Leon MB Columbia University Medical Center/New York Presbyterian Hospital, New York, New York.
  • Makkar R Department of Interventional Cardiology, Cedars-Sinai Heart Institute, Los Angeles, California.
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  • 2017-03-24
Published in:
  • Journal of the American College of Cardiology. - 2017
English 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.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://sonar.ch/global/documents/47894
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