Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement
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...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2025 |
| País: | España |
| Recursos: | Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| Repositório: | Recercat. Dipósit de la Recerca de Catalunya |
| OAI Identifier: | oai:recercat.cat:2445/223348 |
| Acesso em linha: | https://hdl.handle.net/2445/223348 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Pròtesis valvulars cardíaques Cirurgia cardiovascular Heart valve prosthesis Cardiovascular surgery |
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Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacementAsmarats, LluísJiménez Quevedo, PilarAmat Santos, Ignacio J.Ferrer Gracía, Marí CruzSarnago Cebada, FernandoAlonso Briales, Juan H.Oteo Domínguez, Juan FranciscoSerra García, VicençMuntané Carol, GuillemVilalta, VictoriaVal, David delPan Álvarez Ossorio, ManuelTorre Hernández, José María de laGarcía Blas, SergioDíez Gil, José LuísBerenguer, AlbertoValle Fernández, Raquel delNavarro del Amo, FelipeArtaiz Urdaci, MiguelRegueiro, AnderLópez Pérez, ManuelMassó Van Roessel, AlbertParedes Vázquez, José G.Fernández Cordón, ClaraDiarte de Miguel, José AntonioManeiro Melón, NicolásPiserra López, AlbertoFuente, Jorge de laMuñoz, JuanRomaguera, RafaelCarrillo, XavierAlfonso, FernandoAlvarado, MarcoVeiga Fernández, GabrielaMillán, XavierNombela Franco, LuisArzamendi, DabitPròtesis valvulars cardíaquesCirurgia cardiovascularHeart valve prosthesisCardiovascular surgeryBackground: 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.Elsevier BV2025202520252025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion10 p.application/pdfhttps://hdl.handle.net/2445/223348Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.1016/j.cjca.2025.04.026Canadian Journal of Cardiology, 2025, vol. 41, num. 8, p. 1480-1489https://doi.org/10.1016/j.cjca.2025.04.026cc-by (c) Asmarats, Lluís et al., 2025http://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2233482026-05-29T05:05:01Z |
| dc.title.none.fl_str_mv |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| title |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| spellingShingle |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement Asmarats, Lluís Pròtesis valvulars cardíaques Cirurgia cardiovascular Heart valve prosthesis Cardiovascular surgery |
| title_short |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| title_full |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| title_fullStr |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| title_full_unstemmed |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| title_sort |
Balloon-expandable versus self-expanding valves in patients with prior surgical mitral valve replacement undergoing transcatheter aortic valve replacement |
| dc.creator.none.fl_str_mv |
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 |
| author |
Asmarats, Lluís |
| author_facet |
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 |
| author_role |
author |
| author2 |
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 |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Pròtesis valvulars cardíaques Cirurgia cardiovascular Heart valve prosthesis Cardiovascular surgery |
| topic |
Pròtesis valvulars cardíaques Cirurgia cardiovascular Heart valve prosthesis Cardiovascular surgery |
| description |
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. |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025 2025 2025 2025 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://hdl.handle.net/2445/223348 |
| url |
https://hdl.handle.net/2445/223348 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
Reproducció del document publicat a: https://doi.org/10.1016/j.cjca.2025.04.026 Canadian Journal of Cardiology, 2025, vol. 41, num. 8, p. 1480-1489 https://doi.org/10.1016/j.cjca.2025.04.026 |
| dc.rights.none.fl_str_mv |
cc-by (c) Asmarats, Lluís et al., 2025 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess |
| rights_invalid_str_mv |
cc-by (c) Asmarats, Lluís et al., 2025 http://creativecommons.org/licenses/by/3.0/es/ |
| eu_rights_str_mv |
openAccess |
| dc.format.none.fl_str_mv |
10 p. application/pdf |
| dc.publisher.none.fl_str_mv |
Elsevier BV |
| publisher.none.fl_str_mv |
Elsevier BV |
| dc.source.none.fl_str_mv |
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) reponame:Recercat. Dipósit de la Recerca de Catalunya instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
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Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya) |
| reponame_str |
Recercat. Dipósit de la Recerca de Catalunya |
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Recercat. Dipósit de la Recerca de Catalunya |
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1869413488152018944 |
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15.228081 |