https://doi.org/10.4081/monaldi.2023.2546
Redo aortic valve replacement versus valve-in-valve trans-catheter aortic valve implantation: a UK propensity-matched analysis
Submitted: February 8, 2023
Accepted: March 21, 2023
Published: April 19, 2023
Accepted: March 21, 2023
Abstract Views: 2029
PDF: 568
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
This study sought to compare the morbidity and mortality of redo aortic valve replacement (redo-AVR) versus valve-in-valve trans-catheter aortic valve implantation (valve-in-valve TAVI) for patients with a failing bioprosthetic valve. A multicenter UK retrospective study of redo-AVR or valve-in-valve TAVI for patients referred for redo aortic valve intervention due to a degenerated aortic bioprosthesis. Propensity score matching was performed for confounding factors. From July 2005 to April 2021, 911 patients underwent redo-AVR and 411 patients underwent valve-in-valve TAVI. There were 125 pairs for analysis after propensity score matching. The mean age was 75.2±8.5 years. In-hospital mortality was 7.2% (n=9) for redo-AVR versus 0 for valve-in-valve TAVI, p=0.002. Surgical patients suffered more post-operative complications, including intra-aortic balloon pump support (p=0.02), early re-operation (p<0.001), arrhythmias (p<0.001), respiratory and neurological complications (p=0.02 and p=0.03) and multi-organ failure (p=0.01). The valve-in-valve TAVI group had a shorter intensive care unit and hospital stay (p<0.001 for both). However, moderate aortic regurgitation at discharge and higher post-procedural gradients were more common after valve-in-valve TAVI (p<0.001 for both). Survival probabilities in patients who were successfully discharged from the hospital were similar after valve-in-valve TAVI and redo-AVR over the 6-year follow-up (log-rank p=0.26). In elderly patients with a degenerated aortic bioprosthesis, valve-in-valve TAVI provides better early outcomes as opposed to redo-AVR, although there was no difference in mid-term survival in patients successfully discharged from the hospital.
Onorati F, Biancari F, De Feo M, et al. Mid-term results of aortic valve surgery in redo scenarios in the current practice: results from the multicentre European RECORD (REdo Cardiac operation research database) initiative. Eur J Cardiothorac Surg 2015;47:269-80.
Maganti M, Rao V, Armstrong S, et al. Redo valvular surgery in elderly patients. Ann Thorac Surg 2009;87:521-5.
Stachon P, Kaier K, Zirlik A, et al. Risk-adjusted comparison of in-hospital outcomes of transcatheter and surgical aortic valve replacement. J Am Heart Assoc 2019;8:e011504.
Smith CR, Leon MB, Mack MJ, et al. Transcatheter versus surgical aortic valve replacement in high-risk patients. N Engl J Med 2011;364:2187-98.
Kodali SK, Williams MR, Smith CR, et al. Two-year outcomes after transcatheter or surgical aortic-valve replacement. N Engl J Med 2012;366:1686-95.
Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Rev Esp Cardiol 2022;75:524.
Jones JM, O'kane H, Gladstone DJ, et al. Repeat heart valve surgery - risk factors for operative mortality?. J Thorac Cardiovasc Surg 2001;122:913-8.
Akins CW, Buckley MJ, Daggett WM, et al. Risk of preoperative valve replacement for failed mitral and aortic bioprostheses. Ann Thorac Surg 1998;65:1545-52.
Jamieson WRE, Burr LH, Miyagishima RT, et al. Reoperation for bioprosthetic aortic structural failure - risk assessment. Eur J Cardiothorac Surg 2003;24:873-8.
Chmielak Z, Dabrowski M, Tyczynski P, et al. Transcatheter aortic valve replacement in patients with previous mitral valve replacement. A systematic study. Postepy Kardiol Interwencyjnej 2020;16:177-83.
Bruschi G, De Marco F, Barosi A, et al. Self-expandable transcatheter aortic valve implantation for aortic stenosis after mitral valve surgery. Interact Cardiovasc Thorac Surg 2013;17:90-5.
Hulman M, Bena M, Artemious P, et al. Transaortic approach for transcatheter aortic valve replacement with other concomitant cardiac procedures in high-risk patients. J Card Surg 2016;31:493-7.
Erlebach M, Wottke M, Deutsch MA, et al. Redo aortic valve surgery versus transcatheter valve-in-valve implantation for failing surgical bioprosthetic valves: consecutive patients in a single-center setting. J Thorac Dis 2015;7:1494-500.
Giordano V, Kar A, Flapan A, et al. Alternative treatment option for high risk surgical candidates after previous cardiac surgery: the Scottish national TAVI programme experience. J Cardiothorac Surg 2015;10:A236.
Papadopoulos N, Schiller N, Fichtlscherer S, et al. Propensity matched analysis of longterm outcomes following transcatheter based aortic valve implantation versus classic aortic valve replacement in patients with previous cardiac surgery. J Cardiothorac Surg 2014;9:99.
Deharo P, Bisson A, Herbert J, et al. Transcatheter valve-in-valve aortic valve replacement as an alternative to surgical re-replacement. J Am Coll Cardiol 2020;76:489-99.
Tam DY, Dharma C, Rocha RV, et al Transcatheter ViV versus redo surgical AVR for the management of failed biological prosthesis: early and late outcomes in a propensity-matched cohort. JACC Cardiovasc Interv 2020;13:765-74.
Patel PM, Chious E, Cao Y, et al. Isolated redo-aortic valve replacement versus valve-in-valve transcatheter valve replacement. Ann Thorac Surg 2021;112:539-45.
Wilbring M, Tugtekin SM, Alexious K, et al. Transapical transcatheter aortic valve implantation vs conventional aortic valve replacement in high-risk patients with previous cardiac surgery: a propensity-score analysis. Eur J Cardiothorac Surg 2013;44:42-7.
Moat NE, Ludman P, de Belder MA, et al. Long-term outcomes after transcatheter aortic valve implantation in high-risk patients with severe aortic stenosis: the UK TAVI (United Kingdom transcatheter aortic valve implantation) registry. J Am Coll Cardiol 2011;58:2130-8.
Dvir D, Webb J, Brecker S, et al. Transcatheter aortic valve replacement for degenerative bioprosthetic surgical valves: results from the global valve-in-valve registry. Circulation 2012;126:2335-44.
Pravda NS, Kornowski R, Levi A, et al. 5 year outcomes of patients with aortic structural valve deterioration treated with transcatheter valve in valve - a single centre prospective registry. Front Cardiovasc Med 2021;9:713341.
Abushouk AIA, Abdelfattah O, Saad A, et al. Predictors of procedural success in patients with degenerated surgical valves undergoing transcatheter aortic valve-in-valve implantation. Front Cardiovasc Med 2021;24:718835.
Akodad M, Meilhac A, Lefevre T, et al. Hemodynamic performances and clinical outcomes in patients undergoing valve-in-valve versus native transcatheter aortic valve implantation. Am J Cardiol 2019;124:90-7.
Tang GHL, Sengupta A, Alexis SL, et al. Outcomes of prosthesis-patient mismatch following supra-annular transcatheter aortic valve replacement: from the STS/ACC TVT Registry. JACC Cardiovasc Interv 2021;14:964-76.
Sedeek AF, Greason KL, Sandhu GS, et al. Transcatheter valve-in-valve vs surgical replacement of failing stented aortic biological valves. Ann Thorac Surg 2019;108:424-30.
Balsam LB, Grossi EA, Greenhouse DG, et al. Reoperative valve surgery in the elderly: predictors of risk and longterm survival. Ann Thorac Surg 2010;90:1195-200.
Gotzmann M, Lindstaedt M, Mugge A. From pressure overload to volume overload: aortic regurgitation after transcatheter aortic valve implantation. Am Heart J 2012;163:903-11.
Ethics Approval
Institutional review board approval was granted in all participating centers (ethics approval number 1845).How to Cite
Gatta, Francesca, Yama Haqzad, George Gradinariu, Pietro Giorgio Malvindi, Zubair Khalid, Rona L. Suelo-Calanao, Nader Moawad, et al. 2023. “Redo Aortic Valve Replacement <i>versus< i> Valve-in-Valve Trans-Catheter Aortic Valve Implantation: A UK Propensity-Matched Analysis”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2546.
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