Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis

Marco Spaziano; Darren Mylotte; Pascal Thériault-Lauzier; Ole De Backer; Lars Søndergaard; Johan Bosmans; Nicolas Debry; Thomas Modine; Marco Barbanti; Corrado Tamburino; Jan-Malte Sinning; Eberhard Grube; Georg Nickenig; Fritz Mellert; Sabine Bleiziffer; Rüdiger Lange; Benoit de Varennes; Kevin Lachapelle; Giuseppe Martucci; Nicolo Piazza

doi:10.4244/EIJ-D-16-00303

Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis

Marco Spaziano, Darren Mylotte, Pascal Thériault-Lauzier, Ole De Backer, Lars Søndergaard, Johan Bosmans, Nicolas Debry, Thomas Modine, Marco Barbanti, Corrado Tamburino, Jan-Malte Sinning, Eberhard Grube, Georg Nickenig, Fritz Mellert, Sabine Bleiziffer, Rüdiger Lange, Benoit de Varennes, Kevin Lachapelle, Giuseppe Martucci, Nicolo Piazza

Department of Clinical Medicine

29 Citations (Scopus)

Abstract

AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV-in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aimed to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching.

METHODS AND RESULTS: Patients from seven centres in Europe and Canada who had undergone either TAV-in-SAV (n=79) or redo-SAVR (n=126) were identified. Significant independent predictors used for propensity scoring were age, NYHA functional class, number of prior cardiac surgeries, urgent procedure, pulmonary hypertension, and COPD grade. Using a calliper range of ±0.05, a total of 78 well-matched patient pairs were found. All-cause mortality was similar between groups at 30 days (6.4% redo-SAVR vs. 3.9% TAV-in-SAV; p=0.49) and one year (13.1% redo-SAVR vs. 12.3% TAV-in-SAV; p=0.80). Both groups also showed similar incidences of stroke (0% redo-SAVR vs. 1.3% TAV-in-SAV; p=1.0) and new pacemaker implantation (10.3% redo-SAVR vs. 10.3% TAV-in-SAV; p=1.0). The incidence of acute kidney injury requiring dialysis was numerically lower in the TAV-in-SAV group (11.5% redo-SAVR vs. 3.8% TAV-in-SAV; p=0.13). The TAV-in-SAV group had a significantly shorter median total hospital stay (12 days redo-SAVR vs. 9 days TAV-in-SAV; p=0.001).

CONCLUSIONS: Patients with aortic bioprosthesis failure treated with either redo-SAVR or TAV-in-SAV have similar 30-day and one-year clinical outcomes.

Original language	English
Journal	EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume	13
Issue number	10
Pages (from-to)	1149-1156
Number of pages	8
ISSN	1774-024X
DOIs	https://doi.org/10.4244/EIJ-D-16-00303
Publication status	Published - 20 Nov 2017

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Spaziano, M., Mylotte, D., Thériault-Lauzier, P., De Backer, O., Søndergaard, L., Bosmans, J., Debry, N., Modine, T., Barbanti, M., Tamburino, C., Sinning, J-M., Grube, E., Nickenig, G., Mellert, F., Bleiziffer, S., Lange, R., de Varennes, B., Lachapelle, K., Martucci, G., & Piazza, N. (2017). Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 13(10), 1149-1156. https://doi.org/10.4244/EIJ-D-16-00303

Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses : a multicentre propensity score analysis. / Spaziano, Marco; Mylotte, Darren; Thériault-Lauzier, Pascal et al.

In: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, Vol. 13, No. 10, 20.11.2017, p. 1149-1156.

Research output: Contribution to journal › Journal article › Research › peer-review

Spaziano, M, Mylotte, D, Thériault-Lauzier, P, De Backer, O, Søndergaard, L, Bosmans, J, Debry, N, Modine, T, Barbanti, M, Tamburino, C, Sinning, J-M, Grube, E, Nickenig, G, Mellert, F, Bleiziffer, S, Lange, R, de Varennes, B, Lachapelle, K, Martucci, G & Piazza, N 2017, 'Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis', EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, vol. 13, no. 10, pp. 1149-1156. https://doi.org/10.4244/EIJ-D-16-00303

Spaziano M, Mylotte D, Thériault-Lauzier P, De Backer O, Søndergaard L, Bosmans J et al. Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2017 Nov 20;13(10):1149-1156. doi: 10.4244/EIJ-D-16-00303

Spaziano, Marco ; Mylotte, Darren ; Thériault-Lauzier, Pascal et al. / Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses : a multicentre propensity score analysis. In: EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2017 ; Vol. 13, No. 10. pp. 1149-1156.

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title = "Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis",

abstract = "AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV-in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aimed to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching.METHODS AND RESULTS: Patients from seven centres in Europe and Canada who had undergone either TAV-in-SAV (n=79) or redo-SAVR (n=126) were identified. Significant independent predictors used for propensity scoring were age, NYHA functional class, number of prior cardiac surgeries, urgent procedure, pulmonary hypertension, and COPD grade. Using a calliper range of ±0.05, a total of 78 well-matched patient pairs were found. All-cause mortality was similar between groups at 30 days (6.4% redo-SAVR vs. 3.9% TAV-in-SAV; p=0.49) and one year (13.1% redo-SAVR vs. 12.3% TAV-in-SAV; p=0.80). Both groups also showed similar incidences of stroke (0% redo-SAVR vs. 1.3% TAV-in-SAV; p=1.0) and new pacemaker implantation (10.3% redo-SAVR vs. 10.3% TAV-in-SAV; p=1.0). The incidence of acute kidney injury requiring dialysis was numerically lower in the TAV-in-SAV group (11.5% redo-SAVR vs. 3.8% TAV-in-SAV; p=0.13). The TAV-in-SAV group had a significantly shorter median total hospital stay (12 days redo-SAVR vs. 9 days TAV-in-SAV; p=0.001).CONCLUSIONS: Patients with aortic bioprosthesis failure treated with either redo-SAVR or TAV-in-SAV have similar 30-day and one-year clinical outcomes.",

author = "Marco Spaziano and Darren Mylotte and Pascal Th{\'e}riault-Lauzier and {De Backer}, Ole and Lars S{\o}ndergaard and Johan Bosmans and Nicolas Debry and Thomas Modine and Marco Barbanti and Corrado Tamburino and Jan-Malte Sinning and Eberhard Grube and Georg Nickenig and Fritz Mellert and Sabine Bleiziffer and R{\"u}diger Lange and {de Varennes}, Benoit and Kevin Lachapelle and Giuseppe Martucci and Nicolo Piazza",

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doi = "10.4244/EIJ-D-16-00303",

language = "English",

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T1 - Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses

T2 - a multicentre propensity score analysis

AU - Spaziano, Marco

AU - Mylotte, Darren

AU - Thériault-Lauzier, Pascal

AU - De Backer, Ole

AU - Søndergaard, Lars

AU - Bosmans, Johan

AU - Debry, Nicolas

AU - Modine, Thomas

AU - Barbanti, Marco

AU - Tamburino, Corrado

AU - Sinning, Jan-Malte

AU - Grube, Eberhard

AU - Nickenig, Georg

AU - Mellert, Fritz

AU - Bleiziffer, Sabine

AU - Lange, Rüdiger

AU - de Varennes, Benoit

AU - Lachapelle, Kevin

AU - Martucci, Giuseppe

AU - Piazza, Nicolo

PY - 2017/11/20

Y1 - 2017/11/20

N2 - AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV-in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aimed to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching.METHODS AND RESULTS: Patients from seven centres in Europe and Canada who had undergone either TAV-in-SAV (n=79) or redo-SAVR (n=126) were identified. Significant independent predictors used for propensity scoring were age, NYHA functional class, number of prior cardiac surgeries, urgent procedure, pulmonary hypertension, and COPD grade. Using a calliper range of ±0.05, a total of 78 well-matched patient pairs were found. All-cause mortality was similar between groups at 30 days (6.4% redo-SAVR vs. 3.9% TAV-in-SAV; p=0.49) and one year (13.1% redo-SAVR vs. 12.3% TAV-in-SAV; p=0.80). Both groups also showed similar incidences of stroke (0% redo-SAVR vs. 1.3% TAV-in-SAV; p=1.0) and new pacemaker implantation (10.3% redo-SAVR vs. 10.3% TAV-in-SAV; p=1.0). The incidence of acute kidney injury requiring dialysis was numerically lower in the TAV-in-SAV group (11.5% redo-SAVR vs. 3.8% TAV-in-SAV; p=0.13). The TAV-in-SAV group had a significantly shorter median total hospital stay (12 days redo-SAVR vs. 9 days TAV-in-SAV; p=0.001).CONCLUSIONS: Patients with aortic bioprosthesis failure treated with either redo-SAVR or TAV-in-SAV have similar 30-day and one-year clinical outcomes.

AB - AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV-in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aimed to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching.METHODS AND RESULTS: Patients from seven centres in Europe and Canada who had undergone either TAV-in-SAV (n=79) or redo-SAVR (n=126) were identified. Significant independent predictors used for propensity scoring were age, NYHA functional class, number of prior cardiac surgeries, urgent procedure, pulmonary hypertension, and COPD grade. Using a calliper range of ±0.05, a total of 78 well-matched patient pairs were found. All-cause mortality was similar between groups at 30 days (6.4% redo-SAVR vs. 3.9% TAV-in-SAV; p=0.49) and one year (13.1% redo-SAVR vs. 12.3% TAV-in-SAV; p=0.80). Both groups also showed similar incidences of stroke (0% redo-SAVR vs. 1.3% TAV-in-SAV; p=1.0) and new pacemaker implantation (10.3% redo-SAVR vs. 10.3% TAV-in-SAV; p=1.0). The incidence of acute kidney injury requiring dialysis was numerically lower in the TAV-in-SAV group (11.5% redo-SAVR vs. 3.8% TAV-in-SAV; p=0.13). The TAV-in-SAV group had a significantly shorter median total hospital stay (12 days redo-SAVR vs. 9 days TAV-in-SAV; p=0.001).CONCLUSIONS: Patients with aortic bioprosthesis failure treated with either redo-SAVR or TAV-in-SAV have similar 30-day and one-year clinical outcomes.

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DO - 10.4244/EIJ-D-16-00303

M3 - Journal article

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EP - 1156

JO - EuroIntervention

JF - EuroIntervention

IS - 10

ER -

Transcatheter aortic valve implantation versus redo surgery for failing surgical aortic bioprostheses: a multicentre propensity score analysis

Abstract

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