Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Apr;10(4):e004392.
doi: 10.1161/CIRCINTERVENTIONS.116.004392.

Matched Comparison of Self-Expanding Transcatheter Heart Valves for the Treatment of Failed Aortic Surgical Bioprosthesis: Insights From the Valve-in-Valve International Data Registry (VIVID)

Sami Alnasser  1 , Asim N Cheema  2 , Matheus Simonato  1 , Marco Barbanti  1 , Jeremy Edwards  1 , Ran Kornowski  1 , Eric Horlick  1 , Harindra C Wijeysundera  1 , Luca Testa  1 , Francesco Bedogni  1 , Hafid Amrane  1 , Thomas Walther  1 , Marc Pelletier  1 , Azeem Latib  1 , Jean-Claude Laborde  1 , David Hildick-Smith  1 , Won-Keun Kim  1 , Didier Tchetche  1 , Marco Agrifoglio  1 , Jan-Malte Sinning  1 , Ad J van Boven  1 , Joëlle Kefer  1 , Christian Frerker  1 , Nicolas M van Mieghem  1 , Axel Linke  1 , Stephen Worthley  1 , Anita Asgar  1 , Carmelo Sgroi  1 , Mina Aziz  1 , Haim D Danenberg  1 , Marino Labinaz  1 , Ganesh Manoharan  1 , Anson Cheung  1 , John G Webb  1 , Danny Dvir  2 ; Valve-in-Valve International Data Registry Investigators
Affiliations
Comparative Study

Matched Comparison of Self-Expanding Transcatheter Heart Valves for the Treatment of Failed Aortic Surgical Bioprosthesis: Insights From the Valve-in-Valve International Data Registry (VIVID)

Sami Alnasser et al. Circ Cardiovasc Interv. 2017 Apr.

Abstract

Background: Transcatheter valve-in-valve implantation is an established therapy for high-risk patients with failed surgical aortic bioprosthesis. There are limited data comparing outcomes of valve-in-valve implantation using different transcatheter heart valves (THV).

Methods and results: Patients included in the Valve-in-Valve International Data registry (VIVID) and treated with self-expanding THV devices were analyzed using centralized core laboratory blinded to clinical events. St. Jude Medical Portico versus Medtronic CoreValve were compared in a 1:2 fashion after propensity score matching. A total of 162 patients, Portico- (n=54) and CoreValve- (n=108) based valve-in-valve procedures comprised the study population with no significant difference in baseline characteristics (age, 79±8.2 years; 60% women; mean STS [Society of Thoracic Surgery] score 8.1±5.5%). Postimplantation, CoreValve was associated with a larger effective orifice area (1.67 versus 1.31 cm2; P=0.001), lower mean gradient (14±7.5 versus 17±7.5 mm Hg; P=0.02), and lower core laboratory-adjudicated moderate-to-severe aortic insufficiency (4.2% versus 13.7%; P=0.04), compared with Portico. Procedural complications including THV malpositioning, second THV requirement, or coronary obstruction were not significantly different between the 2 groups. Survival and stroke rates at 30 days were similar, but overall mortality at 1 year was higher among patients treated with Portico compared with CoreValve (22.6% versus 9.1%; P=0.03).

Conclusions: In this first matched comparison of THVs for valve-in-valve implantations, Portico and CoreValve demonstrated differences in postprocedural hemodynamics and long-term clinical outcomes. Although this could be related to THV design characteristics, the impact of other procedural factors cannot be excluded and require further evaluation.

Keywords: aortic valve; bioprosthesis; hemodynamic; transcatheter aortic valve replacement.

PubMed Disclaimer

MeSH terms

LinkOut - more resources