Université d'Auvergne Clermont1 | CNRS

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Comparison of outcomes after one-versus-two transcatheter aortic valve implantation during a same procedure (from the FRANCE2 Registry).

TitleComparison of outcomes after one-versus-two transcatheter aortic valve implantation during a same procedure (from the FRANCE2 Registry).
Publication TypeJournal Article
Year of Publication2015
AuthorsClerfond, G., B. Pereira, A. Innorta, P. Motreff, M. Gilard, M. Laskar, H. Eltchaninoff, B. Iung, P. Leprince, E. Teiger, K. Chevreul, A. Prat, M. Lievre, A. Leguerrier, P. Donzeau-Gouge, J. Fajadet, and G. Souteyrand
JournalThe American journal of cardiology
Volume115
Issue9
Pagination1273-80
Date Published2015 May 1
ISSN1879-1913
KeywordsAged, Aged, 80 and over, Aortic Valve Stenosis, Female, Follow-Up Studies, Heart Valve Prosthesis, Humans, Male, Prosthesis Failure, Registries, Retrospective Studies, Survival Rate, Transcatheter Aortic Valve Replacement, Treatment Outcome
Abstract

Analysis of the causes, outcomes, and mortality of patients with severe symptomatic aortic stenosis requiring the implantation of 2 valves during transcatheter aortic valve implantation was conducted from the French Aortic National CoreValve and Edwards 2 (FRANCE2) registry. Pre- and postprocedural data from 3,919 patients from January 2010 to December 2011 (CoreValve or Edwards) were collated and analyzed. Characteristics of patients requiring immediate second valve procedures were compared with those of the other patients. The 72 patients (1.8%) who underwent implantation of a second valve were studied. Indications were device malpositioning (72%) and embolization (28%). Clinical and echocardiographic characteristics of patients receiving 2 valves were comparable with those of the other patients. The 2-year survival rate was 51.7% for patients with 2 valves as opposed to 62.3% for those with 1 valve (p<0.001). The need for a second valve was an independent predictor of all-cause (hazard ratio 2.32, 95% confidence interval 1.50 to 3.60, p<0.001) and cardiovascular (hazard ratio 2.64, 95% confidence interval 1.35 to 5.15, p<0.001) mortality at 2 years. During follow-up, clinical and echocardiographic data remained similar between the 2 groups. In conclusion, in the FRANCE2 study, the main causes for second valve implantation during the same procedure were malpositioning and embolization. Although the procedure was feasible, it was accompanied by excess mortality. Valve hemodynamic status was preserved during the course of follow-up.

DOI10.1016/j.amjcard.2015.01.560
Alternate JournalAm. J. Cardiol.