Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis

SH Yoon; S Bleiziffer; O De Backer; V Delgado; T Arai; J Ziegelmueller; M Barbanti; R Sharma; GY Perlman; OK Khalique; EW Holy; S Saraf; F Deuschl; B Fujita; P Ruile; FJ Neumann; G Pache; M Takahashi; H Kaneko; T Schmidt; Y Ohno; N Schofer; WKF Kong; E Tay; D Sugiyama; H Kawamori; Y Maeno; Y Abramowitz; T Chakravarty; M Nakamura; S Kuwata; G Yong; HL Kao; M Lee; HS Kim; T Modine; SC Wong; F Bedgoni; L Testa; E Teiger; C Butter; SM Ensminger; U Schaefer; D Dvir; P Blanke; J Leipsic; F Nietlispach; M Abdel-Wahab; B Chevalier; C Tamburino; D Hildick-Smith; BK Whisenant; SJ Park; A Colombo; A Latib; SK Kodali; JJ Bax; L Søndergaard; JG Webb; T Lefèvre; MB Leon; R Makkar

doi:10.1016/j.jacc.2017.03.017

Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis

SH Yoon, S Bleiziffer, O De Backer, V Delgado, T Arai, J Ziegelmueller, M Barbanti, R Sharma, GY Perlman, OK Khalique, EW Holy, S Saraf, F Deuschl, B Fujita, P Ruile, FJ Neumann, G Pache, M Takahashi, H Kaneko, T SchmidtY Ohno, N Schofer, WKF Kong, E Tay, D Sugiyama, H Kawamori, Y Maeno, Y Abramowitz, T Chakravarty, M Nakamura, S Kuwata, G Yong, HL Kao, M Lee, HS Kim, T Modine, SC Wong, F Bedgoni, L Testa, E Teiger, C Butter, SM Ensminger, U Schaefer, D Dvir, P Blanke, J Leipsic, F Nietlispach, M Abdel-Wahab, B Chevalier, C Tamburino, D Hildick-Smith, BK Whisenant, SJ Park, A Colombo, A Latib, SK Kodali, JJ Bax, L Søndergaard, JG Webb, T Lefèvre, MB Leon, R Makkar

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

Abstract

Background Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). Objectives This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry. Methods Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria. Results Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28). Conclusions Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices. © 2017 The Authors

Original language	English
Pages (from-to)	2579-2589
Number of pages	11
Journal	Journal of the American College of Cardiology
Volume	69
Issue number	21
DOIs	https://doi.org/10.1016/j.jacc.2017.03.017
Publication status	Published - 2017

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Yoon, SH., Bleiziffer, S., De Backer, O., Delgado, V., Arai, T., Ziegelmueller, J., Barbanti, M., Sharma, R., Perlman, GY., Khalique, OK., Holy, EW., Saraf, S., Deuschl, F., Fujita, B., Ruile, P., Neumann, FJ., Pache, G., Takahashi, M., Kaneko, H., ... Makkar, R. (2017). Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis. Journal of the American College of Cardiology, 69(21), 2579-2589. https://doi.org/10.1016/j.jacc.2017.03.017

Yoon, SH, Bleiziffer, S, De Backer, O, Delgado, V, Arai, T, Ziegelmueller, J, Barbanti, M, Sharma, R, Perlman, GY, Khalique, OK, Holy, EW, Saraf, S, Deuschl, F, Fujita, B, Ruile, P, Neumann, FJ, Pache, G, Takahashi, M, Kaneko, H, Schmidt, T, Ohno, Y, Schofer, N, Kong, WKF, Tay, E, Sugiyama, D, Kawamori, H, Maeno, Y, Abramowitz, Y, Chakravarty, T, Nakamura, M, Kuwata, S, Yong, G, Kao, HL, Lee, M, Kim, HS, Modine, T, Wong, SC, Bedgoni, F, Testa, L, Teiger, E, Butter, C, Ensminger, SM, Schaefer, U, Dvir, D, Blanke, P, Leipsic, J, Nietlispach, F, Abdel-Wahab, M, Chevalier, B, Tamburino, C, Hildick-Smith, D, Whisenant, BK, Park, SJ, Colombo, A, Latib, A, Kodali, SK, Bax, JJ, Søndergaard, L, Webb, JG, Lefèvre, T, Leon, MB & Makkar, R 2017, 'Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis', Journal of the American College of Cardiology, vol. 69, no. 21, pp. 2579-2589. https://doi.org/10.1016/j.jacc.2017.03.017

@article{5f91b982fc3544f1aa9646c86e80eda5,

title = "Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis",

abstract = "Background Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). Objectives This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry. Methods Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria. Results Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28). Conclusions Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices. {\textcopyright} 2017 The Authors",

author = "SH Yoon and S Bleiziffer and {De Backer}, O and V Delgado and T Arai and J Ziegelmueller and M Barbanti and R Sharma and GY Perlman and OK Khalique and EW Holy and S Saraf and F Deuschl and B Fujita and P Ruile and FJ Neumann and G Pache and M Takahashi and H Kaneko and T Schmidt and Y Ohno and N Schofer and WKF Kong and E Tay and D Sugiyama and H Kawamori and Y Maeno and Y Abramowitz and T Chakravarty and M Nakamura and S Kuwata and G Yong and HL Kao and M Lee and HS Kim and T Modine and SC Wong and F Bedgoni and L Testa and E Teiger and C Butter and SM Ensminger and U Schaefer and D Dvir and P Blanke and J Leipsic and F Nietlispach and M Abdel-Wahab and B Chevalier and C Tamburino and D Hildick-Smith and BK Whisenant and SJ Park and A Colombo and A Latib and SK Kodali and JJ Bax and L S{\o}ndergaard and JG Webb and T Lef{\`e}vre and MB Leon and R Makkar",

year = "2017",

doi = "10.1016/j.jacc.2017.03.017",

language = "English",

volume = "69",

pages = "2579--2589",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier USA",

number = "21",

}

TY - JOUR

T1 - Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis

AU - Yoon, SH

AU - Bleiziffer, S

AU - De Backer, O

AU - Delgado, V

AU - Arai, T

AU - Ziegelmueller, J

AU - Barbanti, M

AU - Sharma, R

AU - Perlman, GY

AU - Khalique, OK

AU - Holy, EW

AU - Saraf, S

AU - Deuschl, F

AU - Fujita, B

AU - Ruile, P

AU - Neumann, FJ

AU - Pache, G

AU - Takahashi, M

AU - Kaneko, H

AU - Schmidt, T

AU - Ohno, Y

AU - Schofer, N

AU - Kong, WKF

AU - Tay, E

AU - Sugiyama, D

AU - Kawamori, H

AU - Maeno, Y

AU - Abramowitz, Y

AU - Chakravarty, T

AU - Nakamura, M

AU - Kuwata, S

AU - Yong, G

AU - Kao, HL

AU - Lee, M

AU - Kim, HS

AU - Modine, T

AU - Wong, SC

AU - Bedgoni, F

AU - Testa, L

AU - Teiger, E

AU - Butter, C

AU - Ensminger, SM

AU - Schaefer, U

AU - Dvir, D

AU - Blanke, P

AU - Leipsic, J

AU - Nietlispach, F

AU - Abdel-Wahab, M

AU - Chevalier, B

AU - Tamburino, C

AU - Hildick-Smith, D

AU - Whisenant, BK

AU - Park, SJ

AU - Colombo, A

AU - Latib, A

AU - Kodali, SK

AU - Bax, JJ

AU - Søndergaard, L

AU - Webb, JG

AU - Lefèvre, T

AU - Leon, MB

AU - Makkar, R

PY - 2017

Y1 - 2017

N2 - Background Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). Objectives This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry. Methods Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria. Results Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28). Conclusions Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices. © 2017 The Authors

AB - Background Transcatheter aortic valve replacement (TAVR) is being increasingly performed in patients with bicuspid aortic valve stenosis (AS). Objectives This study sought to compare the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS from the Bicuspid AS TAVR multicenter registry. Methods Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity score matching, assembling 546 pairs of patients with similar baseline characteristics. Procedural and clinical outcomes were recorded according to Valve Academic Research Consortium-2 criteria. Results Compared with patients with tricuspid AS, patients with bicuspid AS had more frequent conversion to surgery (2.0% vs. 0.2%; p = 0.006) and a significantly lower device success rate (85.3% vs. 91.4%; p = 0.002). Early-generation devices were implanted in 320 patients with bicuspid and 321 patients with tricuspid AS, whereas new-generation devices were implanted in 226 and 225 patients with bicuspid and tricuspid AS, respectively. Within the group receiving early-generation devices, bicuspid AS had more frequent aortic root injury (4.5% vs. 0.0%; p = 0.015) when receiving the balloon-expanding device, and moderate-to-severe paravalvular leak (19.4% vs. 10.5%; p = 0.02) when receiving the self-expanding device. Among patients with new-generation devices, however, procedural results were comparable across different prostheses. The cumulative all-cause mortality rates at 2 years were comparable between bicuspid and tricuspid AS (17.2% vs. 19.4%; p = 0.28). Conclusions Compared with tricuspid AS, TAVR in bicuspid AS was associated with a similar prognosis, but lower device success rate. Procedural differences were observed in patients treated with the early-generation devices, whereas no differences were observed with the new-generation devices. © 2017 The Authors

U2 - 10.1016/j.jacc.2017.03.017

DO - 10.1016/j.jacc.2017.03.017

M3 - Article

SN - 0735-1097

VL - 69

SP - 2579

EP - 2589

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

IS - 21

ER -

Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis

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