Journal Article Multicenter Study Observational Study Ppublish 21 citations
PubMed: 40044295 DOI: 10.1016/j.jacc.2024.11.048
Predictors of Outcomes of Reintervention After Transcatheter Aortic Valve Replacement: FRANCE 2 and FRANCE TAVI Registries.
J Am Coll Cardiol 85(9):896-907
Authors: Eric Durand, Hélène Eltchaninoff, Didier Tchetche, Thomas Levesque, Cristian Garmendia, Bernard Iung, Hakim Benamer, Guillaume Cayla, Eric Van Belle, Philippe Commeau, Herve Le Breton, Thomas Cuisset, Mariama Akodad, Jean-Philippe Verhoye, Sylvain Beurtheret, Florence du Chayla, Manon Leclere, Martine Gilard, Nicolas Dumonteil
Affiliations
- University Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000, Rouen, France.
- University Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000, Rouen, France.
- Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse, France.
- University Rouen Normandie, Inserm U1096, CHU Rouen, Department of Cardiology, F-76000, Rouen, France; Division of Interventional Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
- Cardiology Department, Bichat-Claude Bernard University Hospital, APHP, Paris, France.
- Institut Cardiovasculaire Paris-Sud (ICPS), Hôpital Jacques Cartier, Ramsay-Santé, Massy, France.
- Cardiology Department, Nîmes University Hospital, Montpellier University, ACTION Study Group, Nîmes, France.
- Institut Coeur et Poumon, CHU Lille, Lille, France.
- Polyclinique Les Fleurs, Ollioules, France.
- Cardiologie, CHU de RENNES, LTSI UMR1099, INSERM, Université de Rennes, Rennes, France.
- Département de Cardiologie, Centre Hospitalier Universitaire de Timone, Marseille, France.
- Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
- Department of Cardiac Surgery, Saint Joseph Hospital, Marseille, France.
- Clinityx, Paris, France.
- Faculté de Médecine de Brest, Brest, France.
Abstract
BACKGROUND
In a context of extending transcatheter aortic valve replacement (TAVR) to patients with a longer life expectancy, it is important to better document the incidence and outcomes of reintervention.
OBJECTIVES
The authors sought to evaluate the incidence, predictive factors, and long-term outcomes of surgical (explant TAVR) or transcatheter (redo TAVR) reintervention after TAVR.
METHODS
Patients who had a TAVR between 2010 and 2022 recorded in the FRANCE 2 and FRANCE TAVI registries were included in the analysis. Cumulative incidence of early (≤1 year) and late (>1 year) reintervention was assessed using the Kalbfleisch and Prentice method to account for all-cause death as a competing risk. Patients who had reintervention for infective endocarditis were excluded. Long-term mortality was evaluated using Kaplan-Meier analysis.
RESULTS
Among 72,850 patients included, the cumulative incidence of overall reintervention at 8 years was 1.7% including 591 patients who had redo TAVR and 111 patients who required explant TAVR with a low incidence of Bentall intervention. Reintervention occurred mostly early in 62.1% of cases and was more frequent in patients who had a mean aortic gradient >20 mm Hg immediately after index TAVR. Age and mean aortic gradient before TAVR and mean aortic gradient >20 mm Hg, aortic regurgitation ≥ grade 2, and percutaneous coronary intervention after TAVR were predictive of reintervention. Six-year mortality was high but was similar in patients who had early and late reintervention (76.2% vs 64.0%; P = 0.77).
CONCLUSIONS
Reintervention after TAVR remains rare and was mostly performed early after the procedure and by redo TAVR. Further studies are warranted, particularly in younger patients with longer life expectancy.
MeSH
Registries, Mortality, Aortic Valve Stenosis, Incidence, Life Expectancy, Cardiology, Aortic Valve, Transcatheter Aortic Valve Replacement