BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the standard of care for management of high-risk patients with aortic stenosis. Limited data is available regarding the performance of TAVI in patients with native aortic valve regurgitation (NAVR).Methods and Results: We performed a systematic review from 2002 to 2016. The primary outcome was device success as per VARC-2 criteria. Secondary endpoints included procedural complications, and 30-day and 1-year mortality rates. A total of 175 patients were included from 31 studies. Device success was reported in 86.3% of patients - with device failure driven by moderate aortic regurgitation (AR ≥3+) and/or need for a second device. Procedural complications were rare, with no procedural deaths, myocardial infarctions or annular ruptures reported. Procedural safety was acceptable with a low 30-day incidence of stroke (1.5%). The 30-day and 1-year overall mortality rates were 9.6% and 20.0% (cardiovascular death, 3.8% and 10.1%, respectively). Patients receiving 2nd-generation valves demonstrated similar safety profiles with greater device success compared with 1st-generation valves (96.2% vs. 78.4%). This was driven by the higher incidence of second-valve implantation (23.4% vs. 1.7%) and significant paravalvular leak (8.3% vs. 0.0%). CONCLUSIONS: TAVI demonstrates acceptable safety and efficacy in high-risk patients with severe NAVR. Second-generation valves may afford a similar safety profile with improved device success. Dedicated studies are needed to definitively establish the efficacy of TAVI in this population.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the standard of care for management of high-risk patients with aortic stenosis. Limited data is available regarding the performance of TAVI in patients with native aortic valve regurgitation (NAVR).Methods and Results: We performed a systematic review from 2002 to 2016. The primary outcome was device success as per VARC-2 criteria. Secondary endpoints included procedural complications, and 30-day and 1-year mortality rates. A total of 175 patients were included from 31 studies. Device success was reported in 86.3% of patients - with device failure driven by moderate aortic regurgitation (AR ≥3+) and/or need for a second device. Procedural complications were rare, with no procedural deaths, myocardial infarctions or annular ruptures reported. Procedural safety was acceptable with a low 30-day incidence of stroke (1.5%). The 30-day and 1-year overall mortality rates were 9.6% and 20.0% (cardiovascular death, 3.8% and 10.1%, respectively). Patients receiving 2nd-generation valves demonstrated similar safety profiles with greater device success compared with 1st-generation valves (96.2% vs. 78.4%). This was driven by the higher incidence of second-valve implantation (23.4% vs. 1.7%) and significant paravalvular leak (8.3% vs. 0.0%). CONCLUSIONS: TAVI demonstrates acceptable safety and efficacy in high-risk patients with severe NAVR. Second-generation valves may afford a similar safety profile with improved device success. Dedicated studies are needed to definitively establish the efficacy of TAVI in this population.
Authors: Erica L Soong; Yi Jing Ong; Jamie S Y Ho; Nichola W S Chew; William K F Kong; Tiong-Cheng Yeo; Ping Chai; Edgar L W Tay; Kent Tan; Yinghao Lim; Ivandito Kuntjoro; Ching-Hui Sia Journal: AsiaIntervention Date: 2021-12
Authors: Yvonne Schneeberger; Moritz Seiffert; Andreas Schaefer; Oliver D Bhadra; Niklas Schofer; Simon Pecha; Dirk Westermann; Stefan Blankenberg; Hermann Reichenspurner; Lenard Conradi Journal: Front Cardiovasc Med Date: 2022-01-25
Authors: Paola Angela Maria Purita; Luisa Salido Tahoces; Chiara Fraccaro; Luca Nai Fovino; Won-Keun Kim; Cláudio Espada-Guerreiro; Ole De Backer; Morritz Seiffert; Luis Nombela-Franco; Raul Moreno Gomez; Antonio Mangieri; Anna Franzone; Francesco Bedogni; Fausto Castriota; Tiziana Attisano; Lars Søndergaard; Rosana Hernandez Antolin; Giuseppe Tarantini Journal: Int J Cardiol Heart Vasc Date: 2020-02-12