Miniatura

Fitxers

PIIS0828282X25003319.pdf (1.06 MB)

Tipus de document

Article

Versió

Versió publicada

Data de publicació

2025-05-08

Llicència de publicació

cc-by (c) Asmarats, Lluís et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/223348

Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement

Títol de la revista

Autors

Director/Tutor

ISSN de la revista

Títol del volum

Recurs relacionat

https://doi.org/10.1016/j.cjca.2025.04.026

Resum

Background: Pre-existing mitral prosthesis raises technical challenges for transcatheter aortic valve replacement (TAVR) but has been scarcely studied. In this work we sought to compare outcomes of patients with previous surgical mitral valve prostheses undergoing TAVR with balloon-expandable valve (BEV) or self-expanding valve (SEV) systems. Methods: Patients from the Spanish TAVR registry with pre-existing surgical mitral prostheses were included in this investigation. The primary endpoints were Valve Academic Research Consortium-3 technical and device success, with analysis according to valve type. Transcatheter heart valve (THV) embolization, mitral valve impingement, THV performance, and pacemaker findings were also assessed. Results: A total of 243 patients were included (37% BEVs, 63% SEVs). Overall technical success was 95.9%. Thirty-day device success was higher in BEV patients (94.4% vs 85.0%, P = 0.036), mainly driven by fewer incidences of moderate residual aortic regurgitation (0% vs 5.9%, P = 0.028) and THV embolization (0% vs 3.9%, P = 0.087). BEV recipients exhibited higher mean transvalvular gradients (10.5 vs 8.1 mm Hg, P = 0.002) and lower rates of permanent pacemaker implantation (5.6% vs 15.7%, P = 0.023). There were no differences in mortality, bleeding, or readmission at 30 days. In the multivariate analysis, a mitroaortic distance of < 7 mm and lack of trans-esophageal echocardiography guidance were associated with increased device failure. Conclusions: In patients with pre-existing MV prostheses, TAVR was safe and effective regardless of the THV type. Nevertheless, the use of BEVs resulted in an increased rate of device success, driven by lesser THV embolization and residual aortic regurgitation.

Matèries

Pròtesis valvulars cardíaques, Cirurgia cardiovascular

Matèries (anglès)

Heart valve prosthesis, Cardiovascular surgery

Citació

Col·leccions

Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

Citació

ASMARATS, Lluís, JIMÉNEZ QUEVEDO, Pilar, AMAT SANTOS, Ignacio j., FERRER GRACÍA, Marí cruz, SARNAGO CEBADA, Fernando, ALONSO BRIALES, Juan h., OTEO DOMÍNGUEZ, Juan francisco, SERRA GARCÍA, Vicenç, MUNTANÉ CAROL, Guillem, VILALTA, Victoria, VAL, David del, PAN ÁLVAREZ OSSORIO, Manuel, TORRE HERNÁNDEZ, José maría de la, GARCÍA BLAS, Sergio, DÍEZ GIL, José luís, BERENGUER, Alberto, VALLE FERNÁNDEZ, Raquel del, NAVARRO DEL AMO, Felipe, ARTAIZ URDACI, Miguel, REGUEIRO, Ander, LÓPEZ PÉREZ, Manuel, MASSÓ VAN ROESSEL, Albert, PAREDES VÁZQUEZ, José g., FERNÁNDEZ CORDÓN, Clara, DIARTE DE MIGUEL, José antonio, MANEIRO MELÓN, Nicolás, PISERRA LÓPEZ, Alberto, FUENTE, Jorge de la, MUÑOZ, Juan, ROMAGUERA, Rafael, CARRILLO, Xavier, ALFONSO, Fernando, ALVARADO, Marco, VEIGA FERNÁNDEZ, Gabriela, MILLÁN, Xavier, NOMBELA FRANCO, Luis, ARZAMENDI, Dabit. Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement. _Canadian Journal of Cardiology_. 2025. Vol. 41, núm. 8, pàgs. 1480-1489. [consulta: 20 de gener de 2026]. ISSN: 1916-7075. [Disponible a: https://hdl.handle.net/2445/223348]

Exportar metadades

JSON - METS

Compartir registre