Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry
Degeneration of mitral prostheses/rings may be treated by redo surgery, and, recently, by transcatheter valve-in-valve/ring implantation. This multicenter registry presents results of transcatheter valve-in-valve and repeat surgery for prostheses/rings degeneration. Data provided by 10 German heart...
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| Veröffentlicht in: | The Journal of thoracic and cardiovascular surgery 2024-03, Vol.167 (3), p.957-964 |
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| creator | Szlapka, Michal Hausmann, Harald Timm, Jürgen Bauer, Adrian Metz, Dietrich Pohling, Daniel Fritzsche, Dirk Gyoten, Takayuki Kuntze, Thomas Dörge, Hilmar Feyrer, Richard Brambate, Agrita Sodian, Ralf Buchholz, Stefan Sack, Falk Udo Höhn, Martina Fischlein, Theodor Eichinger, Walter Franke, Ulrich Nagib, Ragi |
| description | Degeneration of mitral prostheses/rings may be treated by redo surgery, and, recently, by transcatheter valve-in-valve/ring implantation. This multicenter registry presents results of transcatheter valve-in-valve and repeat surgery for prostheses/rings degeneration.
Data provided by 10 German heart centers underwent propensity score-matched retrospective analysis. The primary endpoint was 30-day/midterm mortality. Perioperative outcome was assessed according to the Mitral Valve Academic Research Consortium criteria. Further, the influence of moderate or greater tricuspid regurgitation (TR) on 30-day/midterm mortality was analyzed.
Between 2014 and 2019, 273 patients (79 transcatheter mitral valve-in-valve [TM-ViV] and 194 redo mitral valve replacement [Re-MVR]) underwent repeat procedure for mitral prosthesis/ring degeneration. Propensity score matching distinguished 79 patient pairs. European System for Cardiac Operative Risk Evaluation (EuroSCORE) II-predicted risk was 15.7 ± 13.7% in the TM-ViV group and 15.0% ± 12.7% in the Re-MVR group (P = .5336). TM-ViV patients were older (74.73 vs 72.2 years; P = .0030) and had higher incidence of atrial fibrillation (54 vs 40 patients; P = .0233). Severe TR incidence was similar (17.95% in TM-ViV vs 14.10%; P = .1741). Sixty-eight TM-ViV patients previously underwent mitral valve replacement, whereas 41 Re-MVR patients underwent valve repair (P |
| doi_str_mv | 10.1016/j.jtcvs.2022.07.032 |
| format | Article |
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Data provided by 10 German heart centers underwent propensity score-matched retrospective analysis. The primary endpoint was 30-day/midterm mortality. Perioperative outcome was assessed according to the Mitral Valve Academic Research Consortium criteria. Further, the influence of moderate or greater tricuspid regurgitation (TR) on 30-day/midterm mortality was analyzed.
Between 2014 and 2019, 273 patients (79 transcatheter mitral valve-in-valve [TM-ViV] and 194 redo mitral valve replacement [Re-MVR]) underwent repeat procedure for mitral prosthesis/ring degeneration. Propensity score matching distinguished 79 patient pairs. European System for Cardiac Operative Risk Evaluation (EuroSCORE) II-predicted risk was 15.7 ± 13.7% in the TM-ViV group and 15.0% ± 12.7% in the Re-MVR group (P = .5336). TM-ViV patients were older (74.73 vs 72.2 years; P = .0030) and had higher incidence of atrial fibrillation (54 vs 40 patients; P = .0233). Severe TR incidence was similar (17.95% in TM-ViV vs 14.10%; P = .1741). Sixty-eight TM-ViV patients previously underwent mitral valve replacement, whereas 41 Re-MVR patients underwent valve repair (P < .0001). Stenosis was the leading degeneration mechanism in 42 TM-ViV versus 22 Re-MVR patients (P < .0005). The 30-day/midterm mortality did not differ between groups. Moderate or greater TR was a predictor of total (odds ratio [OR], 4.36; P = .0011), 30-day (OR, 3.76; P = .0180), and midterm mortality (OR, 4.30; P = .0378), irrespective of group.
In both groups, observed mortality was less than predicted. Redo surgery enabled treatment of concomitant conditions, such as atrial fibrillation or TR. TR was shown to be a predictor of total, 30-day, and midterm mortality in both groups.</description><identifier>ISSN: 0022-5223</identifier><identifier>EISSN: 1097-685X</identifier><identifier>DOI: 10.1016/j.jtcvs.2022.07.032</identifier><identifier>PMID: 36088142</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Atrial Fibrillation - surgery ; Bioprosthesis ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation - methods ; Humans ; Mitral Valve - diagnostic imaging ; Mitral Valve - surgery ; mitral valve prosthesis/ring ; Prosthesis Failure ; prosthesis/ring degeneration ; redo mitral surgery ; Registries ; Reoperation ; Retrospective Studies ; Risk Factors ; Transcatheter Aortic Valve Replacement - methods ; transcatheter mitral valve in valve ; Treatment Outcome ; tricuspid regurgitation ; Tricuspid Valve Insufficiency - surgery</subject><ispartof>The Journal of thoracic and cardiovascular surgery, 2024-03, Vol.167 (3), p.957-964</ispartof><rights>2022 The American Association for Thoracic Surgery</rights><rights>Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-9c530006ce3aa1ecd62d887e0c2b04dd26669147d54c1adc11f2d8add975ea5a3</citedby><cites>FETCH-LOGICAL-c359t-9c530006ce3aa1ecd62d887e0c2b04dd26669147d54c1adc11f2d8add975ea5a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0022522322008315$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36088142$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Szlapka, Michal</creatorcontrib><creatorcontrib>Hausmann, Harald</creatorcontrib><creatorcontrib>Timm, Jürgen</creatorcontrib><creatorcontrib>Bauer, Adrian</creatorcontrib><creatorcontrib>Metz, Dietrich</creatorcontrib><creatorcontrib>Pohling, Daniel</creatorcontrib><creatorcontrib>Fritzsche, Dirk</creatorcontrib><creatorcontrib>Gyoten, Takayuki</creatorcontrib><creatorcontrib>Kuntze, Thomas</creatorcontrib><creatorcontrib>Dörge, Hilmar</creatorcontrib><creatorcontrib>Feyrer, Richard</creatorcontrib><creatorcontrib>Brambate, Agrita</creatorcontrib><creatorcontrib>Sodian, Ralf</creatorcontrib><creatorcontrib>Buchholz, Stefan</creatorcontrib><creatorcontrib>Sack, Falk Udo</creatorcontrib><creatorcontrib>Höhn, Martina</creatorcontrib><creatorcontrib>Fischlein, Theodor</creatorcontrib><creatorcontrib>Eichinger, Walter</creatorcontrib><creatorcontrib>Franke, Ulrich</creatorcontrib><creatorcontrib>Nagib, Ragi</creatorcontrib><creatorcontrib>Arbeitsgemeinschaft Leitender herzchirurgischer Krankenhausärzte e.V. (ALHK) Study Group</creatorcontrib><title>Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry</title><title>The Journal of thoracic and cardiovascular surgery</title><addtitle>J Thorac Cardiovasc Surg</addtitle><description>Degeneration of mitral prostheses/rings may be treated by redo surgery, and, recently, by transcatheter valve-in-valve/ring implantation. This multicenter registry presents results of transcatheter valve-in-valve and repeat surgery for prostheses/rings degeneration.
Data provided by 10 German heart centers underwent propensity score-matched retrospective analysis. The primary endpoint was 30-day/midterm mortality. Perioperative outcome was assessed according to the Mitral Valve Academic Research Consortium criteria. Further, the influence of moderate or greater tricuspid regurgitation (TR) on 30-day/midterm mortality was analyzed.
Between 2014 and 2019, 273 patients (79 transcatheter mitral valve-in-valve [TM-ViV] and 194 redo mitral valve replacement [Re-MVR]) underwent repeat procedure for mitral prosthesis/ring degeneration. Propensity score matching distinguished 79 patient pairs. European System for Cardiac Operative Risk Evaluation (EuroSCORE) II-predicted risk was 15.7 ± 13.7% in the TM-ViV group and 15.0% ± 12.7% in the Re-MVR group (P = .5336). TM-ViV patients were older (74.73 vs 72.2 years; P = .0030) and had higher incidence of atrial fibrillation (54 vs 40 patients; P = .0233). Severe TR incidence was similar (17.95% in TM-ViV vs 14.10%; P = .1741). Sixty-eight TM-ViV patients previously underwent mitral valve replacement, whereas 41 Re-MVR patients underwent valve repair (P < .0001). Stenosis was the leading degeneration mechanism in 42 TM-ViV versus 22 Re-MVR patients (P < .0005). The 30-day/midterm mortality did not differ between groups. Moderate or greater TR was a predictor of total (odds ratio [OR], 4.36; P = .0011), 30-day (OR, 3.76; P = .0180), and midterm mortality (OR, 4.30; P = .0378), irrespective of group.
In both groups, observed mortality was less than predicted. Redo surgery enabled treatment of concomitant conditions, such as atrial fibrillation or TR. TR was shown to be a predictor of total, 30-day, and midterm mortality in both groups.</description><subject>Atrial Fibrillation - surgery</subject><subject>Bioprosthesis</subject><subject>Heart Valve Prosthesis</subject><subject>Heart Valve Prosthesis Implantation - methods</subject><subject>Humans</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - surgery</subject><subject>mitral valve prosthesis/ring</subject><subject>Prosthesis Failure</subject><subject>prosthesis/ring degeneration</subject><subject>redo mitral surgery</subject><subject>Registries</subject><subject>Reoperation</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Transcatheter Aortic Valve Replacement - methods</subject><subject>transcatheter mitral valve in valve</subject><subject>Treatment Outcome</subject><subject>tricuspid regurgitation</subject><subject>Tricuspid Valve Insufficiency - surgery</subject><issn>0022-5223</issn><issn>1097-685X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1q3DAUhUVoSKZpn6BQtOzGjiRb_ll0UUKTFgLZJJCdUKQ7Ew22PL1XNsx75IGryaSFbroSSN895x4dxj5JUUohm8ttuU1uoVIJpUrRlqJSJ2wlRd8WTacf37GVyC-FVqo6Z--JtkKIVsj-jJ1Xjeg6WasVe7lHG8nZ9AwJkI8hoR34YocFeBh3g43JpjBFvgDSTNxNcYF4uMkYgp84zbgB3PP1hNzDBiKgTeD_ldrhRNmCgLiNnmOIG-IhcsvHeUjBZcnsjrAJlHD_gZ2u7UDw8e28YA_X3--vfhS3dzc_r77dFq7SfSp6p6ucqXFQWSvB-Ub5rmtBOPUkau9V0zS9rFuvayetd1KuM2C971sNVtvqgn056ub1fs1AyYyBHAw5NUwzGdVK1Wkt6jqj1RF1OQkhrM0Ow2hxb6QwhzrM1rzWYQ51GNGaXEee-vxmMD-N4P_O_Pn_DHw9ApBjLgHQkAsQHfiA4JLxU_ivwW9FvKI1</recordid><startdate>202403</startdate><enddate>202403</enddate><creator>Szlapka, Michal</creator><creator>Hausmann, Harald</creator><creator>Timm, Jürgen</creator><creator>Bauer, Adrian</creator><creator>Metz, Dietrich</creator><creator>Pohling, Daniel</creator><creator>Fritzsche, Dirk</creator><creator>Gyoten, Takayuki</creator><creator>Kuntze, Thomas</creator><creator>Dörge, Hilmar</creator><creator>Feyrer, Richard</creator><creator>Brambate, Agrita</creator><creator>Sodian, Ralf</creator><creator>Buchholz, Stefan</creator><creator>Sack, Falk Udo</creator><creator>Höhn, Martina</creator><creator>Fischlein, Theodor</creator><creator>Eichinger, Walter</creator><creator>Franke, Ulrich</creator><creator>Nagib, Ragi</creator><general>Elsevier Inc</general><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>7X8</scope></search><sort><creationdate>202403</creationdate><title>Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry</title><author>Szlapka, Michal ; Hausmann, Harald ; Timm, Jürgen ; Bauer, Adrian ; Metz, Dietrich ; Pohling, Daniel ; Fritzsche, Dirk ; Gyoten, Takayuki ; Kuntze, Thomas ; Dörge, Hilmar ; Feyrer, Richard ; Brambate, Agrita ; Sodian, Ralf ; Buchholz, Stefan ; Sack, Falk Udo ; Höhn, Martina ; Fischlein, Theodor ; Eichinger, Walter ; Franke, Ulrich ; Nagib, Ragi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-9c530006ce3aa1ecd62d887e0c2b04dd26669147d54c1adc11f2d8add975ea5a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Atrial Fibrillation - surgery</topic><topic>Bioprosthesis</topic><topic>Heart Valve Prosthesis</topic><topic>Heart Valve Prosthesis Implantation - methods</topic><topic>Humans</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - surgery</topic><topic>mitral valve prosthesis/ring</topic><topic>Prosthesis Failure</topic><topic>prosthesis/ring degeneration</topic><topic>redo mitral surgery</topic><topic>Registries</topic><topic>Reoperation</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Transcatheter Aortic Valve Replacement - methods</topic><topic>transcatheter mitral valve in valve</topic><topic>Treatment Outcome</topic><topic>tricuspid regurgitation</topic><topic>Tricuspid Valve Insufficiency - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Szlapka, Michal</creatorcontrib><creatorcontrib>Hausmann, Harald</creatorcontrib><creatorcontrib>Timm, Jürgen</creatorcontrib><creatorcontrib>Bauer, Adrian</creatorcontrib><creatorcontrib>Metz, Dietrich</creatorcontrib><creatorcontrib>Pohling, Daniel</creatorcontrib><creatorcontrib>Fritzsche, Dirk</creatorcontrib><creatorcontrib>Gyoten, Takayuki</creatorcontrib><creatorcontrib>Kuntze, Thomas</creatorcontrib><creatorcontrib>Dörge, Hilmar</creatorcontrib><creatorcontrib>Feyrer, Richard</creatorcontrib><creatorcontrib>Brambate, Agrita</creatorcontrib><creatorcontrib>Sodian, Ralf</creatorcontrib><creatorcontrib>Buchholz, Stefan</creatorcontrib><creatorcontrib>Sack, Falk Udo</creatorcontrib><creatorcontrib>Höhn, Martina</creatorcontrib><creatorcontrib>Fischlein, Theodor</creatorcontrib><creatorcontrib>Eichinger, Walter</creatorcontrib><creatorcontrib>Franke, Ulrich</creatorcontrib><creatorcontrib>Nagib, Ragi</creatorcontrib><creatorcontrib>Arbeitsgemeinschaft Leitender herzchirurgischer Krankenhausärzte e.V. (ALHK) Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Szlapka, Michal</au><au>Hausmann, Harald</au><au>Timm, Jürgen</au><au>Bauer, Adrian</au><au>Metz, Dietrich</au><au>Pohling, Daniel</au><au>Fritzsche, Dirk</au><au>Gyoten, Takayuki</au><au>Kuntze, Thomas</au><au>Dörge, Hilmar</au><au>Feyrer, Richard</au><au>Brambate, Agrita</au><au>Sodian, Ralf</au><au>Buchholz, Stefan</au><au>Sack, Falk Udo</au><au>Höhn, Martina</au><au>Fischlein, Theodor</au><au>Eichinger, Walter</au><au>Franke, Ulrich</au><au>Nagib, Ragi</au><aucorp>Arbeitsgemeinschaft Leitender herzchirurgischer Krankenhausärzte e.V. (ALHK) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry</atitle><jtitle>The Journal of thoracic and cardiovascular surgery</jtitle><addtitle>J Thorac Cardiovasc Surg</addtitle><date>2024-03</date><risdate>2024</risdate><volume>167</volume><issue>3</issue><spage>957</spage><epage>964</epage><pages>957-964</pages><issn>0022-5223</issn><eissn>1097-685X</eissn><abstract>Degeneration of mitral prostheses/rings may be treated by redo surgery, and, recently, by transcatheter valve-in-valve/ring implantation. This multicenter registry presents results of transcatheter valve-in-valve and repeat surgery for prostheses/rings degeneration.
Data provided by 10 German heart centers underwent propensity score-matched retrospective analysis. The primary endpoint was 30-day/midterm mortality. Perioperative outcome was assessed according to the Mitral Valve Academic Research Consortium criteria. Further, the influence of moderate or greater tricuspid regurgitation (TR) on 30-day/midterm mortality was analyzed.
Between 2014 and 2019, 273 patients (79 transcatheter mitral valve-in-valve [TM-ViV] and 194 redo mitral valve replacement [Re-MVR]) underwent repeat procedure for mitral prosthesis/ring degeneration. Propensity score matching distinguished 79 patient pairs. European System for Cardiac Operative Risk Evaluation (EuroSCORE) II-predicted risk was 15.7 ± 13.7% in the TM-ViV group and 15.0% ± 12.7% in the Re-MVR group (P = .5336). TM-ViV patients were older (74.73 vs 72.2 years; P = .0030) and had higher incidence of atrial fibrillation (54 vs 40 patients; P = .0233). Severe TR incidence was similar (17.95% in TM-ViV vs 14.10%; P = .1741). Sixty-eight TM-ViV patients previously underwent mitral valve replacement, whereas 41 Re-MVR patients underwent valve repair (P < .0001). Stenosis was the leading degeneration mechanism in 42 TM-ViV versus 22 Re-MVR patients (P < .0005). The 30-day/midterm mortality did not differ between groups. Moderate or greater TR was a predictor of total (odds ratio [OR], 4.36; P = .0011), 30-day (OR, 3.76; P = .0180), and midterm mortality (OR, 4.30; P = .0378), irrespective of group.
In both groups, observed mortality was less than predicted. Redo surgery enabled treatment of concomitant conditions, such as atrial fibrillation or TR. TR was shown to be a predictor of total, 30-day, and midterm mortality in both groups.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36088142</pmid><doi>10.1016/j.jtcvs.2022.07.032</doi><tpages>8</tpages></addata></record> |
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| ispartof | The Journal of thoracic and cardiovascular surgery, 2024-03, Vol.167 (3), p.957-964 |
| issn | 0022-5223 1097-685X |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Atrial Fibrillation - surgery Bioprosthesis Heart Valve Prosthesis Heart Valve Prosthesis Implantation - methods Humans Mitral Valve - diagnostic imaging Mitral Valve - surgery mitral valve prosthesis/ring Prosthesis Failure prosthesis/ring degeneration redo mitral surgery Registries Reoperation Retrospective Studies Risk Factors Transcatheter Aortic Valve Replacement - methods transcatheter mitral valve in valve Treatment Outcome tricuspid regurgitation Tricuspid Valve Insufficiency - surgery |
| title | Transcatheter mitral valve implantation versus conventional redo surgery for degenerated mitral valve prostheses and rings in a multicenter registry |
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