Five-year outcomes of mild paravalvular regurgitation after transcatheter aortic valve implantation.
Journal
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
ISSN: 1969-6213
Titre abrégé: EuroIntervention
Pays: France
ID NLM: 101251040
Informations de publication
Date de publication:
15 May 2022
15 May 2022
Historique:
pubmed:
22
12
2021
medline:
18
5
2022
entrez:
21
12
2021
Statut:
ppublish
Résumé
Mild paravalvular regurgitation (PVR) remains a frequent and underappreciated adverse event after transcatheter aortic valve implantation (TAVI) despite remarkable progress in device technology and implantation technique. This study sought to investigate the impact of mild PVR after TAVI on five-year clinical outcomes. In a prospective TAVI registry, PVR prior to discharge was retrospectively assessed in an echocardiographic core laboratory. Patients with ≥moderate PVR were excluded. Mild PVR was categorised into mild and mild-to-moderate PVR using a recently proposed unifying 5-class grading scheme. A total of 1,128 patients undergoing TAVI between 2007 and 2015 were enrolled. Of these, 560 patients had mild PVR, including 433 with mild (5-class) PVR and 127 with mild-to-moderate PVR. Patients with mild PVR were older (83 years vs 82 years, p=0.013) and had a higher surgical risk compared to patients with none/trace PVR (STS-PROM: 6.49±4.68 vs 5.41±3.48, p<0.001). At five years, patients with mild PVR had a higher risk of mortality than those with none/trace PVR (54.6% vs 43.8%; HR Mild PVR was associated with an increased risk of mortality at five years after TAVI. The detrimental effect was primarily driven by mild-to-moderate PVR using the 5-class grading scheme. https://www. gov. NCT01368250.
Sections du résumé
BACKGROUND
BACKGROUND
Mild paravalvular regurgitation (PVR) remains a frequent and underappreciated adverse event after transcatheter aortic valve implantation (TAVI) despite remarkable progress in device technology and implantation technique.
AIMS
OBJECTIVE
This study sought to investigate the impact of mild PVR after TAVI on five-year clinical outcomes.
METHODS
METHODS
In a prospective TAVI registry, PVR prior to discharge was retrospectively assessed in an echocardiographic core laboratory. Patients with ≥moderate PVR were excluded. Mild PVR was categorised into mild and mild-to-moderate PVR using a recently proposed unifying 5-class grading scheme.
RESULTS
RESULTS
A total of 1,128 patients undergoing TAVI between 2007 and 2015 were enrolled. Of these, 560 patients had mild PVR, including 433 with mild (5-class) PVR and 127 with mild-to-moderate PVR. Patients with mild PVR were older (83 years vs 82 years, p=0.013) and had a higher surgical risk compared to patients with none/trace PVR (STS-PROM: 6.49±4.68 vs 5.41±3.48, p<0.001). At five years, patients with mild PVR had a higher risk of mortality than those with none/trace PVR (54.6% vs 43.8%; HR
CONCLUSIONS
CONCLUSIONS
Mild PVR was associated with an increased risk of mortality at five years after TAVI. The detrimental effect was primarily driven by mild-to-moderate PVR using the 5-class grading scheme.
CLINICAL TRIAL REGISTRATION
BACKGROUND
https://www.
CLINICALTRIALS
RESULTS
gov. NCT01368250.
Identifiants
pubmed: 34930717
pii: EIJ-D-21-00784
doi: 10.4244/EIJ-D-21-00784
pmc: PMC9904370
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT01368250']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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