PMID- 31678084
OWN - NLM
STAT- MEDLINE
DCOM- 20200921
LR  - 20200921
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Linking)
VI  - 12
IP  - 22
DP  - 2019 Nov 25
TI  - Outcomes of Transcatheter Aortic Valve Replacement in Mixed Aortic Valve Disease.
PG  - 2299-2306
LID - S1936-8798(19)31343-3 [pii]
LID - 10.1016/j.jcin.2019.06.020 [doi]
AB  - OBJECTIVES: The aim of this study was to compare outcomes after transcatheter 
      aortic valve replacement (TAVR) in patients with pure aortic stenosis (AS) (i.e., 
      no or trivial associated aortic regurgitation [AR]) with those in patients with 
      AS and mild or more severe AR (i.e., mixed aortic valve disease [MAVD]). 
      BACKGROUND: TAVR is indicated in treating patients with severe AS. Limited data 
      exist regarding the outcomes of TAVR in patients with MAVD. METHODS: A total of 
      1,133 patients who underwent TAVR between January 2014 and December 2017 were 
      included. The primary outcome was all-cause mortality. The comparison was 
      adjusted to account for post-TAVR AR development in both groups. The secondary 
      outcomes included composite endpoints of early safety and clinical efficacy as 
      specified in the Valve Academic Research Consortium-2 criteria. Variables were 
      compared using Mann-Whitney, chi-square, and Fisher exact tests, while 
      Kaplan-Meier analyses were used to compare survival. RESULTS: A total of 688 
      patients (61%) had MAVD (median age 83 years , 43% women). Among these, 17% 
      developed mild, 2% moderate, and <1% severe post-TAVR AR. Overall, patients with 
      MAVD had better survival compared with patients with pure AS (p = 0.03). Among 
      patients who developed post-TAVR AR, those in the MAVD group had better survival 
      (p = 0.04). In contrast, in patients who did not develop post-TAVR AR, pre-TAVR 
      AR did not improve survival (p = 0.11). CONCLUSIONS: Patients with MAVD who 
      underwent TAVR had better survival compared with patients with pure AS. This is 
      explained by the better survival of patients with MAVD who developed post-TAVR 
      AR, likely due to left ventricular adaptation to AR.
CI  - Copyright (c) 2019. Published by Elsevier Inc.
FAU - Chahine, Johnny
AU  - Chahine J
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Kadri, Amer N
AU  - Kadri AN
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Gajulapalli, Rama D
AU  - Gajulapalli RD
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Krishnaswamy, Amar
AU  - Krishnaswamy A
AD  - Department of Cardiovascular Medicine, Aortic Valve Center, Heart and Vascular 
      Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Mick, Stephanie
AU  - Mick S
AD  - Department of Thoracic and Cardiovascular Surgery, Aortic Valve Center, Heart and 
      Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Perez, Oscar
AU  - Perez O
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Lak, Hassan
AU  - Lak H
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Nair, Raunak M
AU  - Nair RM
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Montane, Bryce
AU  - Montane B
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Tak, James
AU  - Tak J
AD  - Department of Medicine, Cleveland Clinic, Cleveland, Ohio.
FAU - Tuzcu, E Murat
AU  - Tuzcu EM
AD  - Department of Cardiovascular Medicine, Aortic Valve Center, Heart and Vascular 
      Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Griffin, Brian
AU  - Griffin B
AD  - Department of Cardiovascular Medicine, Aortic Valve Center, Heart and Vascular 
      Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Svensson, Lars G
AU  - Svensson LG
AD  - Department of Thoracic and Cardiovascular Surgery, Aortic Valve Center, Heart and 
      Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Harb, Serge C
AU  - Harb SC
AD  - Department of Cardiovascular Medicine, Aortic Valve Center, Heart and Vascular 
      Institute, Cleveland Clinic, Cleveland, Ohio.
FAU - Kapadia, Samir R
AU  - Kapadia SR
AD  - Department of Cardiovascular Medicine, Aortic Valve Center, Heart and Vascular 
      Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: 
      kapadis@ccf.org.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20191030
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
SB  - IM
CIN - JACC Cardiovasc Interv. 2019 Nov 25;12(22):2307-2308. PMID: 31678085
CIN - JACC Cardiovasc Interv. 2020 Feb 24;13(4):534. PMID: 32081245
CIN - JACC Cardiovasc Interv. 2020 Feb 24;13(4):535. PMID: 32081247
MH  - Adaptation, Physiological
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve/diagnostic imaging/physiopathology/*surgery
MH  - Aortic Valve Insufficiency/diagnostic imaging/mortality/physiopathology/*surgery
MH  - Aortic Valve Stenosis/diagnostic imaging/mortality/physiopathology/*surgery
MH  - Cause of Death
MH  - Female
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - *Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - aortic regurgitation
OT  - aortic stenosis
OT  - mixed aortic valve disease
OT  - paravalvular regurgitation
OT  - transcatheter aortic valve replacement
EDAT- 2019/11/05 06:00
MHDA- 2020/09/22 06:00
CRDT- 2019/11/04 06:00
PHST- 2019/04/01 00:00 [received]
PHST- 2019/05/28 00:00 [revised]
PHST- 2019/06/06 00:00 [accepted]
PHST- 2019/11/05 06:00 [pubmed]
PHST- 2020/09/22 06:00 [medline]
PHST- 2019/11/04 06:00 [entrez]
AID - S1936-8798(19)31343-3 [pii]
AID - 10.1016/j.jcin.2019.06.020 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2019 Nov 25;12(22):2299-2306. doi: 
      10.1016/j.jcin.2019.06.020. Epub 2019 Oct 30.