Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve
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Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve. / Giordano, Arturo; Mas-Peiro, Silvia; Fichtlscherer, Stephan; Schaefer, Andreas; Beyer, Martin; Maisano, Francesco; Ascione, Guido; Buzzatti, Nicola; Teles, Rui; Brito, João; Albuquerque, Francisco; Sondergaard, Lars; Vanhaverbeke, Maarten; Quagliana, Angelo; Costa, Giuliano; Barbanti, Marco; Ferraro, Paolo; Morello, Alberto; Cimmino, Michele; Albanese, Michele; Pepe, Martino; Bardi, Luca; Giordano, Salvatore; Cittadini, Antonio; Corcione, Nicola; Biondi-Zoccai, Giuseppe.
I: Clinical Research in Cardiology, Bind 113, 2024, s. 86–93.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve
AU - Giordano, Arturo
AU - Mas-Peiro, Silvia
AU - Fichtlscherer, Stephan
AU - Schaefer, Andreas
AU - Beyer, Martin
AU - Maisano, Francesco
AU - Ascione, Guido
AU - Buzzatti, Nicola
AU - Teles, Rui
AU - Brito, João
AU - Albuquerque, Francisco
AU - Sondergaard, Lars
AU - Vanhaverbeke, Maarten
AU - Quagliana, Angelo
AU - Costa, Giuliano
AU - Barbanti, Marco
AU - Ferraro, Paolo
AU - Morello, Alberto
AU - Cimmino, Michele
AU - Albanese, Michele
AU - Pepe, Martino
AU - Bardi, Luca
AU - Giordano, Salvatore
AU - Cittadini, Antonio
AU - Corcione, Nicola
AU - Biondi-Zoccai, Giuseppe
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2024
Y1 - 2024
N2 - Aim: Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic valve stenosis in elderly patients, but there is uncertainty on their long-term effectiveness. We aimed to assess the long-term outcome of patients undergoing TAVI with the Portico valve. Methods: We retrospectively collected the data on patients in whom TAVI with Portico was attempted from 7 high-volume centres. Only patients theoretically eligible for 3 or more years of follow-up were included. Clinical outcomes, including death, stroke, myocardial infarction, reintervention for valve degeneration and hemodynamic valve performance were systematically assessed. Results: A total of 803 patients were included, with 504 (62.8%) women, mean age of 82 years, median EuroSCORE II of 3.1%, and 386 (48.1%) subjects at low/moderate risk. The median follow-up was 3.0 years (3.0; 4.0). The composite of death, stroke, myocardial infarction, and reintervention for valve degeneration occurred in 37.5% (95% confidence interval: 34.1–40.9%), with all-cause death in 35.1% (31.8–38.4%), stroke in 3.4% (1.3–3.4%), myocardial infarction in 1.0% (0.3–1.5%), and reintervention for valve degeneration in 1.1% (0.6–2.1%). The mean aortic valve gradient at follow-up was 8.1 ± 4.6 mmHg, and at least moderate aortic regurgitation was present in 9.1% (6.7–12.3%). Independent predictors of major adverse events or death were: peripheral artery disease, chronic obstructive pulmonary disease, estimated glomerular filtration rate, atrial fibrillation, prior pacemaker implantation, EuroSCORE II, and reduced left ventricular ejection fraction (all p < 0.05). Conclusions: Portico use is associated with favorable long-term clinical outcomes. Clinical outcomes were largely impacted by baseline risk factors and surgical risk.
AB - Aim: Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic valve stenosis in elderly patients, but there is uncertainty on their long-term effectiveness. We aimed to assess the long-term outcome of patients undergoing TAVI with the Portico valve. Methods: We retrospectively collected the data on patients in whom TAVI with Portico was attempted from 7 high-volume centres. Only patients theoretically eligible for 3 or more years of follow-up were included. Clinical outcomes, including death, stroke, myocardial infarction, reintervention for valve degeneration and hemodynamic valve performance were systematically assessed. Results: A total of 803 patients were included, with 504 (62.8%) women, mean age of 82 years, median EuroSCORE II of 3.1%, and 386 (48.1%) subjects at low/moderate risk. The median follow-up was 3.0 years (3.0; 4.0). The composite of death, stroke, myocardial infarction, and reintervention for valve degeneration occurred in 37.5% (95% confidence interval: 34.1–40.9%), with all-cause death in 35.1% (31.8–38.4%), stroke in 3.4% (1.3–3.4%), myocardial infarction in 1.0% (0.3–1.5%), and reintervention for valve degeneration in 1.1% (0.6–2.1%). The mean aortic valve gradient at follow-up was 8.1 ± 4.6 mmHg, and at least moderate aortic regurgitation was present in 9.1% (6.7–12.3%). Independent predictors of major adverse events or death were: peripheral artery disease, chronic obstructive pulmonary disease, estimated glomerular filtration rate, atrial fibrillation, prior pacemaker implantation, EuroSCORE II, and reduced left ventricular ejection fraction (all p < 0.05). Conclusions: Portico use is associated with favorable long-term clinical outcomes. Clinical outcomes were largely impacted by baseline risk factors and surgical risk.
KW - Aortic stenosis
KW - Portico
KW - Transcatheter aortic valve implantation
KW - Transcatheter aortic valve replacement
U2 - 10.1007/s00392-023-02252-x
DO - 10.1007/s00392-023-02252-x
M3 - Journal article
C2 - 37391628
AN - SCOPUS:85163739955
VL - 113
SP - 86
EP - 93
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
SN - 1861-0684
ER -
ID: 363358195