Universität zu Köln

Pibarot, Philippe, Simonato, Matheus, Barbanti, Marco ORCID: 0000-0002-4903-5437, Linke, Axel, Kornowski, Ran, Rudolph, Tanja, Spence, Mark, Moat, Neil, Aldea, Gabriel, Mennuni, Marco ORCID: 0000-0002-3795-8787, Iadanza, Alessandro, Amrane, Hafid, Gaia, Diego ORCID: 0000-0003-3008-5343, Kim, Won-Keun, Napodano, Massimo, Baumbach, Hardy, Finkelstein, Ariel, Kobayashi, Junjiro, Brecker, Stephen, Don, Creighton, Cerillo, Alfredo, Unbehaun, Axel ORCID: 0000-0003-2851-695X, Attias, David, Nejjari, Mohammed, Jones, Noah, Fiorina, Claudia, Tchetche, Didier, Philippart, Raphael, Spargias, Konstantinos, Hernandez, Jose-Maria, Latib, Azeem ORCID: 0000-0001-9035-343X and Dvir, Danny (2018). Impact of Pre-Existing Prosthesis-Patient Mismatch on Survival Following Aortic Valve-in-Valve Procedures. JACC-Cardiovasc. Interv., 11 (2). S. 133 - 142. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1876-7605

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Abstract

OBJECTIVES The aim of this study was to determine whether the association of small label size of the surgical valve with increased mortality after transcatheter valve-in-valve (ViV) implantation is, at least in part, related to pre-existing prosthesis-patient mismatch (PPM) (i.e., a bioprosthesis that is too small in relation to body size). BACKGROUND Transcatheter ViV implantation is an alternative for the treatment of patients with degenerated bioprostheses. Small label size of the surgical valve has been associated with increased mortality after ViV implantation. METHODS Data from 1,168 patients included in the VIVID (Valve-in-Valve International Data) registry were analyzed. Pre-existing PPM of the surgical valve was determined using a reference value of effective orifice area for each given model and size of implanted prosthetic valve indexed for body surface area. Severe PPM was defined according to the criteria proposed by the Valve Academic Research Consortium 2: indexed effective orifice area <0.65 cm(2)/m(2) if body mass index is < 30 kg/m(2) and < 0.6 cm(2)/m(2) if BMI is >= 30 kg/m(2). The primary study endpoint was 1-year mortality. RESULTS Among the 1,168 patients included in the registry, 89 (7.6%) had pre-existing severe PPM. Patients with severe PPM had higher 30-day (10.3%, p = 0.01) and 1-year (unadjusted: 28.6%, p < 0.001; adjusted: 19.3%, p = 0.03) mortality rates compared with patients with no severe PPM (4.3%, 11.9%, and 10.9%, respectively). After adjusting for surgical valve label size, Society of Thoracic Surgeons score, renal failure, diabetes, and stentless surgical valves, presence of pre-existing severe PPM was associated with increased risk for 1-year mortality (odds ratio: 1.88; 95% confidence interval: 1.07 to 3.28; p = 0.03). Patients with severe PPM also more frequently harbored high post-procedural gradients (mean gradient >= 20 mm Hg). CONCLUSIONS Pre-existing PPM of the failed surgical valve is strongly and independently associated with increased risk for mortality following ViV implantation. (C) 2018 by the American College of Cardiology Foundation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Pibarot, Philippe UNSPECIFIED UNSPECIFIED UNSPECIFIED Simonato, Matheus UNSPECIFIED UNSPECIFIED UNSPECIFIED Barbanti, Marco UNSPECIFIED orcid.org/0000-0002-4903-5437 UNSPECIFIED Linke, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kornowski, Ran UNSPECIFIED UNSPECIFIED UNSPECIFIED Rudolph, Tanja UNSPECIFIED UNSPECIFIED UNSPECIFIED Spence, Mark UNSPECIFIED UNSPECIFIED UNSPECIFIED Moat, Neil UNSPECIFIED UNSPECIFIED UNSPECIFIED Aldea, Gabriel UNSPECIFIED UNSPECIFIED UNSPECIFIED Mennuni, Marco UNSPECIFIED orcid.org/0000-0002-3795-8787 UNSPECIFIED Iadanza, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Amrane, Hafid UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaia, Diego UNSPECIFIED orcid.org/0000-0003-3008-5343 UNSPECIFIED Kim, Won-Keun UNSPECIFIED UNSPECIFIED UNSPECIFIED Napodano, Massimo UNSPECIFIED UNSPECIFIED UNSPECIFIED Baumbach, Hardy UNSPECIFIED UNSPECIFIED UNSPECIFIED Finkelstein, Ariel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobayashi, Junjiro UNSPECIFIED UNSPECIFIED UNSPECIFIED Brecker, Stephen UNSPECIFIED UNSPECIFIED UNSPECIFIED Don, Creighton UNSPECIFIED UNSPECIFIED UNSPECIFIED Cerillo, Alfredo UNSPECIFIED UNSPECIFIED UNSPECIFIED Unbehaun, Axel UNSPECIFIED orcid.org/0000-0003-2851-695X UNSPECIFIED Attias, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Nejjari, Mohammed UNSPECIFIED UNSPECIFIED UNSPECIFIED Jones, Noah UNSPECIFIED UNSPECIFIED UNSPECIFIED Fiorina, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Tchetche, Didier UNSPECIFIED UNSPECIFIED UNSPECIFIED Philippart, Raphael UNSPECIFIED UNSPECIFIED UNSPECIFIED Spargias, Konstantinos UNSPECIFIED UNSPECIFIED UNSPECIFIED Hernandez, Jose-Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Latib, Azeem UNSPECIFIED orcid.org/0000-0001-9035-343X UNSPECIFIED Dvir, Danny UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-198605
DOI:	10.1016/j.jcin.2017.08.039
Journal or Publication Title:	JACC-Cardiovasc. Interv.
Volume:	11
Number:	2
Page Range:	S. 133 - 142
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1876-7605
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language BIOPROSTHETIC SURGICAL VALVES; HIGH-RISK PATIENTS; HEART-VALVES; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; TRANSCATHETER; REPLACEMENT; OUTCOMES; IMPLANTATION; STENOSIS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19860