Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement-Reference-Cited by-同舟云学术

Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement

Published:2021-01-12 Issue:2 Volume:143 Page:104-116
ISSN:0009-7322
Container-title:Circulation
language:en
Short-container-title:Circulation

Author:

Simonato Matheus¹²,Whisenant Brian³,Ribeiro Henrique Barbosa⁴,Webb John G.⁵,Kornowski Ran⁶,Guerrero Mayra⁷,Wijeysundera Harindra⁸,Søndergaard Lars⁹,De Backer Ole⁹^ORCID,Villablanca Pedro¹⁰,Rihal Charanjit⁷,Eleid Mackram⁷^ORCID,Kempfert Jörg¹¹,Unbehaun Axel¹¹,Erlebach Magdalena¹²,Casselman Filip¹³,Adam Matti¹⁴,Montorfano Matteo¹⁵,Ancona Marco¹⁵^ORCID,Saia Francesco¹⁶,Ubben Timm¹⁷,Meincke Felix¹⁷,Napodano Massimo¹⁸,Codner Pablo⁶,Schofer Joachim¹⁹,Pelletier Marc²⁰,Cheung Anson⁵,Shuvy Mony²¹,Palma José Honório²⁴,Gaia Diego Felipe²,Duncan Alison²²,Hildick-Smith David²³,Veulemans Verena²⁴^ORCID,Sinning Jan-Malte²⁵,Arbel Yaron²⁶,Testa Luca²⁷,de Weger Arend²⁸,Eltchaninoff Helene²⁹,Hemery Thibault²⁹,Landes Uri⁵,Tchetche Didier³⁰,Dumonteil Nicolas³⁰,Rodés-Cabau Josep³¹^ORCID,Kim Won-Keun³²,Spargias Konstantinos³³,Kourkoveli Panagiota³³,Ben-Yehuda Ori¹³⁴,Teles Rui Campante³⁵^ORCID,Barbanti Marco³⁶,Fiorina Claudia³⁷,Thukkani Arun³⁸,Mackensen G. Burkhard³⁹,Jones Noah⁴⁰,Presbitero Patrizia⁴¹,Petronio Anna Sonia⁴²,Allali Abdelhakim⁴³^ORCID,Champagnac Didier⁴⁴,Bleiziffer Sabine⁴⁵,Rudolph Tanja,Iadanza Alessandro⁴⁶^ORCID,Salizzoni Stefano⁴⁷^ORCID,Agrifoglio Marco⁴⁸,Nombela-Franco Luis⁴⁹,Bonaros Nikolaos⁵⁰,Kass Malek⁵¹,Bruschi Giuseppe⁵²,Amabile Nicolas⁵³,Chhatriwalla Adnan⁵⁴^ORCID,Messina Antonio⁵⁵^ORCID,Hirji Sameer A.⁵⁶,Andreas Martin⁵⁷,Welsh Robert⁵⁸,Schoels Wolfgang⁵⁹,Hellig Farrel⁶⁰,Windecker Stephan⁶¹^ORCID,Stortecky Stefan⁶¹,Maisano Francesco⁶²,Stone Gregg W.¹⁶³,Dvir Danny^ORCID

Affiliation:

1. The Cardiovascular Research Foundation, New York (M.Simonato, G.W.S., O.B-Y.).

2. Escola Paulista de Medicina – Universidade Federal de São Paulo, São Paulo, Brazil (M.Simonato, J.H.P., D.F.G.).

3. Intermountain Healthcare, Murray, UT (B.W.).

4. Instituto do Coração da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil (H.B.R., J.H.P.).

5. St. Paul’s Hospital, Vancouver, Canada (J.G.W., A.Cheung, U.L.).

6. Rabin Medical Center, Petah Tikva, Israel (R.K., P.C.).

7. Mayo Clinic, Rochester, MN (M.G., C.R., M.Eleid).

8. Sunnybrook Hospital, Toronto, Canada (H.W).

9. Rigshospitalet, Copenhagen, Denmark (L.S., O.DB.).

10. Henry Ford Hospital, Detroit, MI (P.V.).

11. Deutsches Herzzentrum Berlin, Berlin, Germany (J.K., A.U.).

12. Deutsches Herzzentrum München, Munich, Germany (M.Erlebach).

13. Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium (F.C.).

14. Uniklinik Köln, Köln, Germany (M.Adam).

15. I.R.C.C.S. Ospedale San Raffaele, Milan, Italy (M.M., M.Ancona).

16. Policlinico Sant’Orsola-Malpighi, Bologna, Italy (F.S.).

17. Asklepios Klinik St. Georg, Hamburg, Germany (T.U., F.Meincke).

18. Università degli Studi di Padova, Padova, Italy (M.N.).

19. Medizinisches Versorgungszentrum, Hamburg, Germany (J.S.).

20. University Hospitals Harrington Heart and Vascular Institute, Cleveland, OH (M.P.).

21. Hadassah Medical Center, Jerusalem, Israel (M.Shuvy).

22. The Royal Brompton Hospital, London, United Kingdom (A.D.).

23. Brighton and Sussex University Hospitals, Brighton, United Kingdom (D.H-S.).

24. Universitätsklinikum Düsseldorf, Düsseldorf, Germany (V.V.).

25. Universitätsklinikum Bonn, Bonn, Germany (J-M.S.).

26. Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel (Y.A.).

27. I.R.C.C.S. Policlinico San Donato, Milan, Italy (L.T.).

28. Leids Universitair Medisch Centrum, Leiden, the Netherlands (A.d.W.).

29. Rouen University Hospital, Rouen, France (H.E., T.H.).

30. Clinique Pasteur, Toulouse, France (D.T., N.D.).

31. Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Canada (J.R-C.).

32. Kerckhoff-Klinik, Bad Nauheim, Germany (W-K.K.).

33. Hygeia Hospital, Athens, Greece (K.S., P.K.).

34. University of California San Diego (O.B-Y.).

35. Hospital de Santa Cruz, Lisboa, Portugal (R.C.T.).

36. Università degli Studi di Catania, Catania, Italy (M.B.).

37. Spedali Civili Brescia, Brescia, Italy (C.F.).

38. Central Maine Healthcare, Lewiston (A.T.).

39. University of Washington, Seattle (G.B.M.).

40. Mount Carmel Health System, Columbus, OH (N.J.).

41. Humanitas, Milan, Italy (P.P.).

42. Università di Pisa, Pisa, Italy (A.S.P.).

43. Segeberger Kliniken, Bad Segeberg, Germany (A.A.).

44. Cardiologie Tonkin, Villeurbanne, France (D.C.).

45. Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany (S.B.).

46. Azienda Ospedaliera Universitaria Senese, Siena, Italy (A.I.).

47. Città della Salute e della Scienza - “Molinette” Hospital, Torino, Italy (S.Salizzoni).

48. Centro Cardiologico Monzino, Milan, Italy (M.Agrifoglio).

49. Hospital Clínico San Carlos, Madrid, Spain (L.N-F.).

50. Medizinische Universität Innsbruck, Innsbruck, Austria (N.B.).

51. University of Manitoba, Winnipeg, Canada (M.K.).

52. Ospedale Niguarda Ca’ Granda, Milan, Italy (G.B.).

53. Institut Mutualiste Montsouris, Paris, France (N.A.).

54. Saint Luke’s Mid America Heart Institute, Kansas City, MO (A.Chhatriwalla).

55. Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy (A.M.).

56. Brigham and Women’s Hospital, Boston, MA (S.A.H.).

57. Medizinische Universität Wien, Vienna, Austria (M.Andreas).

58. University of Alberta, Edmonton, Canada (R.W.W).

59. Evangelisches Klinikum Niederrhein, Duisburg, Germany (W.S.).

60. Sunninghill Hospital, Johannesburg, South Africa (F.H.).

61. Inselspital, Bern, Switzerland (S.W., S.Stortecky).

62. Universitätsspital Zürich, Zurich, Switzerland (F.Maisano).

63. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York (G.W.S.).

Abstract

Background: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. Methods: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient ≥10 mm Hg and significant residual mitral regurgitation (MR) as ≥ moderate. Results: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5±12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76–996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510–1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR ( P <0.001). Mean gradient across the mitral valve postprocedure was 5.7±2.8 mm Hg (≥5 mm Hg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients ( P =0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P <0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P =0.02). The rates of Mitral Valve Academic Research Consortium–defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P =0.01), mostly related to having postprocedural mean gradient ≥5 mm Hg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74–12.56; P =0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88–21.53; P <0.001) were both independently associated with repeat mitral valve replacement. Conclusions: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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