One-year safety and efficacy profile of transcatheter aortic valve-in-valve implantation with the portico system

Matteo Casenghi; Riccardo Gorla; Antonio Popolo Rubbio; Federico De Marco; Nedy Brambilla; Mauro Agnifili; Luca Testa; Francesco Bedogni

doi:10.1002/ccd.29353

One-year safety and efficacy profile of transcatheter aortic valve-in-valve implantation with the portico system

Matteo Casenghi, Riccardo Gorla, Antonio Popolo Rubbio, Federico De Marco, Nedy Brambilla, Mauro Agnifili, Luca Testa, Francesco Bedogni

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVE: This study sought to investigate the procedural and mid-term outcomes of transcatheter aortic valve implantation for failed surgical bioprostheses (TAVI-ViV) with Portico device.

BACKGROUND: Limited evidence coming from early experience on Portico system does not allow to fully assess safety and efficacy of this device in this ViV patients.

METHODS: From January 2016 up to June 2019, 56 consecutive patients undergoing TAVI-ViV with Portico were prospectively included in our institutional TAVI database.

RESULTS: The prevalent mechanism of failure was stenosis (58.9%); true internal diameter (ID) was <21 mm in 71.4% of cases. Device success rate were 69.6% with 14 (25%) patients showing a residual gradient ≥20 mmHg, 2 (3.6%) a PVL ≥ moderate and 1 (1.8%) required a second THV implantation due to device embolization. At 1-year follow-up 5 patients (8.9%) died whereas moderate SVD was reported in 2 (3.6%). Patients with a post-procedural mean gradient ≥20 mmHg showed a significantly higher rate of CV hospitalization (21.4% vs. 2.4%, p = .02) whereas no differences in procedural and 1-year outcomes were noticed according to true ID diameter or degeneration mode. Chimney stenting (ChT) was performed in 23 (41%) patients without significant differences in procedural and 1-year outcomes compared to non-ChT group.

CONCLUSIONS: TAVI-ViV with Portico valve was associated with good procedural and 1-year outcomes, even in patients with features of high procedural and anatomical complexity.

Original language	English
Journal	Catheterization and Cardiovascular Interventions
DOIs	https://doi.org/10.1002/ccd.29353
Publication status	E-pub ahead of print - Nov 6 2020

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10.1002/ccd.29353

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@article{660b9df0feca41f5be93b4a30c03f8ef,

title = "One-year safety and efficacy profile of transcatheter aortic valve-in-valve implantation with the portico system",

abstract = "OBJECTIVE: This study sought to investigate the procedural and mid-term outcomes of transcatheter aortic valve implantation for failed surgical bioprostheses (TAVI-ViV) with Portico device.BACKGROUND: Limited evidence coming from early experience on Portico system does not allow to fully assess safety and efficacy of this device in this ViV patients.METHODS: From January 2016 up to June 2019, 56 consecutive patients undergoing TAVI-ViV with Portico were prospectively included in our institutional TAVI database.RESULTS: The prevalent mechanism of failure was stenosis (58.9%); true internal diameter (ID) was <21 mm in 71.4% of cases. Device success rate were 69.6% with 14 (25%) patients showing a residual gradient ≥20 mmHg, 2 (3.6%) a PVL ≥ moderate and 1 (1.8%) required a second THV implantation due to device embolization. At 1-year follow-up 5 patients (8.9%) died whereas moderate SVD was reported in 2 (3.6%). Patients with a post-procedural mean gradient ≥20 mmHg showed a significantly higher rate of CV hospitalization (21.4% vs. 2.4%, p = .02) whereas no differences in procedural and 1-year outcomes were noticed according to true ID diameter or degeneration mode. Chimney stenting (ChT) was performed in 23 (41%) patients without significant differences in procedural and 1-year outcomes compared to non-ChT group.CONCLUSIONS: TAVI-ViV with Portico valve was associated with good procedural and 1-year outcomes, even in patients with features of high procedural and anatomical complexity.",

author = "Matteo Casenghi and Riccardo Gorla and {Popolo Rubbio}, Antonio and {De Marco}, Federico and Nedy Brambilla and Mauro Agnifili and Luca Testa and Francesco Bedogni",

note = "{\textcopyright} 2020 Wiley Periodicals LLC.",

year = "2020",

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doi = "10.1002/ccd.29353",

language = "English",

journal = "Catheterization and Cardiovascular Interventions",

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T1 - One-year safety and efficacy profile of transcatheter aortic valve-in-valve implantation with the portico system

AU - Casenghi, Matteo

AU - Gorla, Riccardo

AU - Popolo Rubbio, Antonio

AU - De Marco, Federico

AU - Brambilla, Nedy

AU - Agnifili, Mauro

AU - Testa, Luca

AU - Bedogni, Francesco

PY - 2020/11/6

Y1 - 2020/11/6

N2 - OBJECTIVE: This study sought to investigate the procedural and mid-term outcomes of transcatheter aortic valve implantation for failed surgical bioprostheses (TAVI-ViV) with Portico device.BACKGROUND: Limited evidence coming from early experience on Portico system does not allow to fully assess safety and efficacy of this device in this ViV patients.METHODS: From January 2016 up to June 2019, 56 consecutive patients undergoing TAVI-ViV with Portico were prospectively included in our institutional TAVI database.RESULTS: The prevalent mechanism of failure was stenosis (58.9%); true internal diameter (ID) was <21 mm in 71.4% of cases. Device success rate were 69.6% with 14 (25%) patients showing a residual gradient ≥20 mmHg, 2 (3.6%) a PVL ≥ moderate and 1 (1.8%) required a second THV implantation due to device embolization. At 1-year follow-up 5 patients (8.9%) died whereas moderate SVD was reported in 2 (3.6%). Patients with a post-procedural mean gradient ≥20 mmHg showed a significantly higher rate of CV hospitalization (21.4% vs. 2.4%, p = .02) whereas no differences in procedural and 1-year outcomes were noticed according to true ID diameter or degeneration mode. Chimney stenting (ChT) was performed in 23 (41%) patients without significant differences in procedural and 1-year outcomes compared to non-ChT group.CONCLUSIONS: TAVI-ViV with Portico valve was associated with good procedural and 1-year outcomes, even in patients with features of high procedural and anatomical complexity.

AB - OBJECTIVE: This study sought to investigate the procedural and mid-term outcomes of transcatheter aortic valve implantation for failed surgical bioprostheses (TAVI-ViV) with Portico device.BACKGROUND: Limited evidence coming from early experience on Portico system does not allow to fully assess safety and efficacy of this device in this ViV patients.METHODS: From January 2016 up to June 2019, 56 consecutive patients undergoing TAVI-ViV with Portico were prospectively included in our institutional TAVI database.RESULTS: The prevalent mechanism of failure was stenosis (58.9%); true internal diameter (ID) was <21 mm in 71.4% of cases. Device success rate were 69.6% with 14 (25%) patients showing a residual gradient ≥20 mmHg, 2 (3.6%) a PVL ≥ moderate and 1 (1.8%) required a second THV implantation due to device embolization. At 1-year follow-up 5 patients (8.9%) died whereas moderate SVD was reported in 2 (3.6%). Patients with a post-procedural mean gradient ≥20 mmHg showed a significantly higher rate of CV hospitalization (21.4% vs. 2.4%, p = .02) whereas no differences in procedural and 1-year outcomes were noticed according to true ID diameter or degeneration mode. Chimney stenting (ChT) was performed in 23 (41%) patients without significant differences in procedural and 1-year outcomes compared to non-ChT group.CONCLUSIONS: TAVI-ViV with Portico valve was associated with good procedural and 1-year outcomes, even in patients with features of high procedural and anatomical complexity.

U2 - 10.1002/ccd.29353

DO - 10.1002/ccd.29353

M3 - Article

C2 - 33155757

SN - 1522-1946

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

ER -

One-year safety and efficacy profile of transcatheter aortic valve-in-valve implantation with the portico system

Abstract

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