Feasibility and Outcomes of Transcatheter Aortic Valve Implantation in High-Risk Patients With Stenotic Bicuspid Aortic Valves
Little is known about transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve stenosis, which usually represents a contraindication. The aim of this study was to assess the feasibility and the results of TAVI in this patient subset. Of 316 high-risk patients with severe...
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Veröffentlicht in: | The American journal of cardiology 2012-09, Vol.110 (6), p.877-883 |
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creator | Himbert, Dominique, MD Pontnau, Florence, MD Messika-Zeitoun, David, MD, PhD Descoutures, Fleur, MD Détaint, Delphine, MD Cueff, Caroline, MD Sordi, Martina, MD Laissy, Jean-Pierre, MD, PhD Alkhoder, Soleiman, MD Brochet, Eric, MD Iung, Bernard, MD Depoix, Jean-Pol, MD Nataf, Patrick, MD Vahanian, Alec, MD |
description | Little is known about transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve stenosis, which usually represents a contraindication. The aim of this study was to assess the feasibility and the results of TAVI in this patient subset. Of 316 high-risk patients with severe aortic stenosis who underwent TAVI from January 2009 to January 2012, 15 (5%) had documented bicuspid aortic valves. They were treated using a transarterial approach, using the Medtronic CoreValve system. Patients were aged 80 ± 10 years, in New York Heart Association functional classes III and IV. The mean aortic valve area was 0.8 ± 0.3 cm2 , and the mean gradient was 60 ± 19 mm Hg. The mean calcium score, calculated using multislice computed tomography, was 4,553 ± 1,872 arbitrary units. The procedure was successful in all but 1 patient. Major adverse events, according to Valvular Academic Research Consortium definitions, were encountered in 1 patient (death). The mean postimplantation prosthetic gradient was 11 ± 4 mm Hg, and ≤1+ periprosthetic leaks were observed in all but 2 patients. The mean prosthetic ellipticity index was 0.7 ± 0.2 at the level of the native annulus and 0.8 ± 0.2 at the level of the prosthetic leaflets. After a mean follow-up period of 8 ± 7 months, 1 patient had died from aortic dissection; there were no additional adverse events. All but 2 hospital survivors were in New York Heart Association class I or II. In conclusion, the present series suggests that transarterial Medtronic CoreValve implantation is feasible in selected patients with bicuspid aortic valve and may lead to short-term hemodynamic and clinical improvement. |
doi_str_mv | 10.1016/j.amjcard.2012.04.064 |
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The aim of this study was to assess the feasibility and the results of TAVI in this patient subset. Of 316 high-risk patients with severe aortic stenosis who underwent TAVI from January 2009 to January 2012, 15 (5%) had documented bicuspid aortic valves. They were treated using a transarterial approach, using the Medtronic CoreValve system. Patients were aged 80 ± 10 years, in New York Heart Association functional classes III and IV. The mean aortic valve area was 0.8 ± 0.3 cm2 , and the mean gradient was 60 ± 19 mm Hg. The mean calcium score, calculated using multislice computed tomography, was 4,553 ± 1,872 arbitrary units. The procedure was successful in all but 1 patient. Major adverse events, according to Valvular Academic Research Consortium definitions, were encountered in 1 patient (death). The mean postimplantation prosthetic gradient was 11 ± 4 mm Hg, and ≤1+ periprosthetic leaks were observed in all but 2 patients. The mean prosthetic ellipticity index was 0.7 ± 0.2 at the level of the native annulus and 0.8 ± 0.2 at the level of the prosthetic leaflets. After a mean follow-up period of 8 ± 7 months, 1 patient had died from aortic dissection; there were no additional adverse events. All but 2 hospital survivors were in New York Heart Association class I or II. In conclusion, the present series suggests that transarterial Medtronic CoreValve implantation is feasible in selected patients with bicuspid aortic valve and may lead to short-term hemodynamic and clinical improvement.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2012.04.064</identifier><identifier>PMID: 22677157</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Aortic Valve - pathology ; Aortic Valve - surgery ; Aortic Valve Stenosis - surgery ; Biological and medical sciences ; Cardiac Catheterization ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava ; Coronary vessels ; Endocardial and cardiac valvular diseases ; Feasibility Studies ; Female ; Heart ; Heart Valve Prosthesis Implantation - methods ; Humans ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Mitral Valve - surgery ; Multidetector Computed Tomography ; Postoperative Complications ; Prostheses ; Risk Factors ; Severity of Illness Index ; Surgery ; Tomography ; Treatment Outcome</subject><ispartof>The American journal of cardiology, 2012-09, Vol.110 (6), p.877-883</ispartof><rights>Elsevier Inc.</rights><rights>2012 Elsevier Inc.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Sep 15, 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c478t-72c78de260ab5adf1cd34654bde61a111155fdbebf2d3fa43121750c455302973</citedby><cites>FETCH-LOGICAL-c478t-72c78de260ab5adf1cd34654bde61a111155fdbebf2d3fa43121750c455302973</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914912013483$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26380828$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22677157$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Himbert, Dominique, MD</creatorcontrib><creatorcontrib>Pontnau, Florence, MD</creatorcontrib><creatorcontrib>Messika-Zeitoun, David, MD, PhD</creatorcontrib><creatorcontrib>Descoutures, Fleur, MD</creatorcontrib><creatorcontrib>Détaint, Delphine, MD</creatorcontrib><creatorcontrib>Cueff, Caroline, MD</creatorcontrib><creatorcontrib>Sordi, Martina, MD</creatorcontrib><creatorcontrib>Laissy, Jean-Pierre, MD, PhD</creatorcontrib><creatorcontrib>Alkhoder, Soleiman, MD</creatorcontrib><creatorcontrib>Brochet, Eric, MD</creatorcontrib><creatorcontrib>Iung, Bernard, MD</creatorcontrib><creatorcontrib>Depoix, Jean-Pol, MD</creatorcontrib><creatorcontrib>Nataf, Patrick, MD</creatorcontrib><creatorcontrib>Vahanian, Alec, MD</creatorcontrib><title>Feasibility and Outcomes of Transcatheter Aortic Valve Implantation in High-Risk Patients With Stenotic Bicuspid Aortic Valves</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Little is known about transcatheter aortic valve implantation (TAVI) in patients with bicuspid aortic valve stenosis, which usually represents a contraindication. The aim of this study was to assess the feasibility and the results of TAVI in this patient subset. Of 316 high-risk patients with severe aortic stenosis who underwent TAVI from January 2009 to January 2012, 15 (5%) had documented bicuspid aortic valves. They were treated using a transarterial approach, using the Medtronic CoreValve system. Patients were aged 80 ± 10 years, in New York Heart Association functional classes III and IV. The mean aortic valve area was 0.8 ± 0.3 cm2 , and the mean gradient was 60 ± 19 mm Hg. The mean calcium score, calculated using multislice computed tomography, was 4,553 ± 1,872 arbitrary units. The procedure was successful in all but 1 patient. Major adverse events, according to Valvular Academic Research Consortium definitions, were encountered in 1 patient (death). The mean postimplantation prosthetic gradient was 11 ± 4 mm Hg, and ≤1+ periprosthetic leaks were observed in all but 2 patients. The mean prosthetic ellipticity index was 0.7 ± 0.2 at the level of the native annulus and 0.8 ± 0.2 at the level of the prosthetic leaflets. After a mean follow-up period of 8 ± 7 months, 1 patient had died from aortic dissection; there were no additional adverse events. All but 2 hospital survivors were in New York Heart Association class I or II. In conclusion, the present series suggests that transarterial Medtronic CoreValve implantation is feasible in selected patients with bicuspid aortic valve and may lead to short-term hemodynamic and clinical improvement.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aortic Valve - pathology</subject><subject>Aortic Valve - surgery</subject><subject>Aortic Valve Stenosis - surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiac Catheterization</subject><subject>Cardiology</subject><subject>Cardiology. Vascular system</subject><subject>Cardiovascular</subject><subject>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</subject><subject>Coronary vessels</subject><subject>Endocardial and cardiac valvular diseases</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Humans</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve - surgery</subject><subject>Multidetector Computed Tomography</subject><subject>Postoperative Complications</subject><subject>Prostheses</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Surgery</subject><subject>Tomography</subject><subject>Treatment Outcome</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl1rFDEUhgdR7Lb6E5SACN7Mms_J7I2lltYWChVb9TJkkjNutvOxJpnC3vjbPcuuFntjbkLC874557wpileMzhll1fvV3PYrZ6Ofc8r4nMo5reSTYsZqvSjZgomnxYxSyssFk4uD4jClFR4ZU9Xz4oDzSmum9Kz4dQ42hSZ0IW-IHTy5nrIbe0hkbMlttENyNi8hQyQnY8zBkW-2uwdy2a87O2SbwziQMJCL8GNZfgnpjnzGOxhyIt9DXpKbDMO4lX0Mbkrr4P-xSS-KZ63tErzc70fF1_Oz29OL8ur60-XpyVXppK5zqbnTtQdeUdso61vmvJCVko2HilmGS6nWN9C03IvWSsE404o6qZSgfKHFUfFu57uO488JUjZ9SA467AHGKRlGha5UrRlD9M0jdDVOccDqkKqZVGjOkVI7ysUxpQitWcfQ27hByGwDMiuzD8hsAzJUGgwIda_37lPTg_-r-pMIAm_3gMXRdy1G4EJ64CpR05rXyB3vOMCx3QeIJjmcuwMfIrhs_Bj-W8qHRw6uC0PAR-9gA-mha5NQY262v2n7mRiaCFkL8Rts-cXp</recordid><startdate>20120915</startdate><enddate>20120915</enddate><creator>Himbert, Dominique, MD</creator><creator>Pontnau, Florence, MD</creator><creator>Messika-Zeitoun, David, MD, PhD</creator><creator>Descoutures, Fleur, MD</creator><creator>Détaint, Delphine, MD</creator><creator>Cueff, Caroline, MD</creator><creator>Sordi, Martina, MD</creator><creator>Laissy, Jean-Pierre, MD, PhD</creator><creator>Alkhoder, Soleiman, MD</creator><creator>Brochet, Eric, MD</creator><creator>Iung, Bernard, MD</creator><creator>Depoix, Jean-Pol, MD</creator><creator>Nataf, Patrick, MD</creator><creator>Vahanian, Alec, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120915</creationdate><title>Feasibility and Outcomes of Transcatheter Aortic Valve Implantation in High-Risk Patients With Stenotic Bicuspid Aortic Valves</title><author>Himbert, Dominique, MD ; Pontnau, Florence, MD ; Messika-Zeitoun, David, MD, PhD ; Descoutures, Fleur, MD ; Détaint, Delphine, MD ; Cueff, Caroline, MD ; Sordi, Martina, MD ; Laissy, Jean-Pierre, MD, PhD ; Alkhoder, Soleiman, MD ; Brochet, Eric, MD ; Iung, Bernard, MD ; Depoix, Jean-Pol, MD ; Nataf, Patrick, MD ; Vahanian, Alec, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c478t-72c78de260ab5adf1cd34654bde61a111155fdbebf2d3fa43121750c455302973</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aortic Valve - pathology</topic><topic>Aortic Valve - surgery</topic><topic>Aortic Valve Stenosis - surgery</topic><topic>Biological and medical sciences</topic><topic>Cardiac Catheterization</topic><topic>Cardiology</topic><topic>Cardiology. Vascular system</topic><topic>Cardiovascular</topic><topic>Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava</topic><topic>Coronary vessels</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Humans</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve - surgery</topic><topic>Multidetector Computed Tomography</topic><topic>Postoperative Complications</topic><topic>Prostheses</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Surgery</topic><topic>Tomography</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Himbert, Dominique, MD</creatorcontrib><creatorcontrib>Pontnau, Florence, MD</creatorcontrib><creatorcontrib>Messika-Zeitoun, David, MD, PhD</creatorcontrib><creatorcontrib>Descoutures, Fleur, MD</creatorcontrib><creatorcontrib>Détaint, Delphine, MD</creatorcontrib><creatorcontrib>Cueff, Caroline, MD</creatorcontrib><creatorcontrib>Sordi, Martina, MD</creatorcontrib><creatorcontrib>Laissy, Jean-Pierre, MD, PhD</creatorcontrib><creatorcontrib>Alkhoder, Soleiman, MD</creatorcontrib><creatorcontrib>Brochet, Eric, MD</creatorcontrib><creatorcontrib>Iung, Bernard, MD</creatorcontrib><creatorcontrib>Depoix, Jean-Pol, MD</creatorcontrib><creatorcontrib>Nataf, Patrick, MD</creatorcontrib><creatorcontrib>Vahanian, Alec, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Biochemistry Abstracts 1</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - 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The aim of this study was to assess the feasibility and the results of TAVI in this patient subset. Of 316 high-risk patients with severe aortic stenosis who underwent TAVI from January 2009 to January 2012, 15 (5%) had documented bicuspid aortic valves. They were treated using a transarterial approach, using the Medtronic CoreValve system. Patients were aged 80 ± 10 years, in New York Heart Association functional classes III and IV. The mean aortic valve area was 0.8 ± 0.3 cm2 , and the mean gradient was 60 ± 19 mm Hg. The mean calcium score, calculated using multislice computed tomography, was 4,553 ± 1,872 arbitrary units. The procedure was successful in all but 1 patient. Major adverse events, according to Valvular Academic Research Consortium definitions, were encountered in 1 patient (death). The mean postimplantation prosthetic gradient was 11 ± 4 mm Hg, and ≤1+ periprosthetic leaks were observed in all but 2 patients. The mean prosthetic ellipticity index was 0.7 ± 0.2 at the level of the native annulus and 0.8 ± 0.2 at the level of the prosthetic leaflets. After a mean follow-up period of 8 ± 7 months, 1 patient had died from aortic dissection; there were no additional adverse events. All but 2 hospital survivors were in New York Heart Association class I or II. In conclusion, the present series suggests that transarterial Medtronic CoreValve implantation is feasible in selected patients with bicuspid aortic valve and may lead to short-term hemodynamic and clinical improvement.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>22677157</pmid><doi>10.1016/j.amjcard.2012.04.064</doi><tpages>7</tpages></addata></record> |
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subjects | Aged Aged, 80 and over Aortic Valve - pathology Aortic Valve - surgery Aortic Valve Stenosis - surgery Biological and medical sciences Cardiac Catheterization Cardiology Cardiology. Vascular system Cardiovascular Congenital heart diseases. Malformations of the aorta, pulmonary vessels and vena cava Coronary vessels Endocardial and cardiac valvular diseases Feasibility Studies Female Heart Heart Valve Prosthesis Implantation - methods Humans Male Medical imaging Medical sciences Middle Aged Mitral Valve - surgery Multidetector Computed Tomography Postoperative Complications Prostheses Risk Factors Severity of Illness Index Surgery Tomography Treatment Outcome |
title | Feasibility and Outcomes of Transcatheter Aortic Valve Implantation in High-Risk Patients With Stenotic Bicuspid Aortic Valves |
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