PMID- 31402161
OWN - NLM
STAT- MEDLINE
DCOM- 20201123
LR  - 20201123
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 299
DP  - 2020 Jan 15
TI  - Transcatheter aortic valve replacement outcomes in mixed aortic valve disease 
      compared to predominant aortic stenosis.
PG  - 209-214
LID - S0167-5273(19)31952-7 [pii]
LID - 10.1016/j.ijcard.2019.07.099 [doi]
AB  - BACKGROUND: MAVD, defined as severe aortic stenosis with moderate or severe 
      aortic regurgitation, is frequently encountered in clinical practice. However, 
      the data regarding TAVR outcomes in MAVD are sparse. We compared Transcatheter 
      Aortic Valve Replacement (TAVR) outcomes between Mixed Aortic Valve Disease 
      (MAVD) and Predominant Aortic Stenosis (PAS) patients. METHODS: Patients who 
      underwent TAVR at Mayo Clinic from February 7, 2012 to December 16, 2016 were 
      enrolled. The primary end point was all-cause mortality. Secondary end points 
      were central or paravalvular regurgitation, device success, and Valve Academic 
      Research Consortium (VARC)-2 defined post TAVR complications (access site 
      complications, bleedings, myocardial infarction, stroke, and cardiac arrest). 
      RESULTS: A total of 622 patients were enrolled. Mean age was 81 +/- 8.9 years, and 
      263 (42.3%) were female. Median follow-up duration was 1.5 years. One hundred and 
      sixteen patients (18.6%) had MAVD. Central or paravalvular leak was higher in 
      MAVD patients post-TAVR (15.5% vs 6.7%, P = 0.004). Device success and VARC-2 
      in-hospital complications were similar between the two groups. The cumulative 
      probability of survival at 3 years was 71.3% in MAVD patients vs. 62.6% in PAS 
      patients (Log-Rank P = 0.024). In a multi-variant logistic regression analysis, 
      MAVD was an independent negative predictor of all-cause mortality (HR = 0.53, 95% 
      CI 0.3-0.89, P = 0.015). CONCLUSIONS: A significant number of patients referred 
      for TAVR have MAVD disease. Despite higher rates of paravalvular regurgitation, 
      all-cause mortality at mid-term was lower in patients with MAVD compared with 
      those with PAS. Our results show the safety and efficacy of TAVR in MAVD 
      patients.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Heidari, Behnam
AU  - Heidari B
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Al-Hijji, Mohammed A
AU  - Al-Hijji MA
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Alkhouli, Mohamad A
AU  - Alkhouli MA
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Egbe, Alexander
AU  - Egbe A
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Welle, Garrett
AU  - Welle G
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Eleid, Mackram F
AU  - Eleid MF
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Singh, Mandeep
AU  - Singh M
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Gulati, Rajiv
AU  - Gulati R
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Rihal, Charanjit
AU  - Rihal C
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America.
FAU - Lerman, Amir
AU  - Lerman A
AD  - Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States 
      of America. Electronic address: lerman.amir@mayo.edu.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20190801
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Insufficiency/diagnostic imaging/*mortality/*surgery
MH  - Aortic Valve Stenosis/diagnostic imaging/*mortality/*surgery
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Transcatheter Aortic Valve Replacement/*mortality/trends
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Aortic regurgitation
OT  - Aortic stenosis
OT  - Heart valve diseases
OT  - Mixed aortic valve disease
OT  - Transcatheter aortic valve replacement
EDAT- 2019/08/14 06:00
MHDA- 2020/11/24 06:00
CRDT- 2019/08/13 06:00
PHST- 2019/04/12 00:00 [received]
PHST- 2019/07/29 00:00 [revised]
PHST- 2019/07/31 00:00 [accepted]
PHST- 2019/08/14 06:00 [pubmed]
PHST- 2020/11/24 06:00 [medline]
PHST- 2019/08/13 06:00 [entrez]
AID - S0167-5273(19)31952-7 [pii]
AID - 10.1016/j.ijcard.2019.07.099 [doi]
PST - ppublish
SO  - Int J Cardiol. 2020 Jan 15;299:209-214. doi: 10.1016/j.ijcard.2019.07.099. Epub 
      2019 Aug 1.