Cristina Giannini, Davide Capodanno, Gabor G Toth, Stephan Windecker, Stefanie Schüpke, Daniel J Blackman, Stéphane Noble, Hélène Eltchaninoff, Claudia Fiorina, Alaide Chieffo, Antonio L Bartorelli, Albrecht Schmidt, Ole De Backer, Martine Gilard, Elizabeth Curtis, Guillaume L'Official, Erwan Donal, Cécile Laroche, Bernard Prendergast, Anna Sonia Petronio, On Behalf The European Valve Durability Tavi Registry Investigators
{"title":"TAVI后的长期结构阀门恶化：来自EORP ESC阀门耐久性TAVI登记的见解。","authors":"Cristina Giannini, Davide Capodanno, Gabor G Toth, Stephan Windecker, Stefanie Schüpke, Daniel J Blackman, Stéphane Noble, Hélène Eltchaninoff, Claudia Fiorina, Alaide Chieffo, Antonio L Bartorelli, Albrecht Schmidt, Ole De Backer, Martine Gilard, Elizabeth Curtis, Guillaume L'Official, Erwan Donal, Cécile Laroche, Bernard Prendergast, Anna Sonia Petronio, On Behalf The European Valve Durability Tavi Registry Investigators","doi":"10.4244/EIJ-D-24-00662","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Valve durability is a key consideration as the patient population eligible for transcatheter aortic valve implantation (TAVI) expands to include lower-risk and younger individuals who are expected to live many years after the procedure.</p><p><strong>Aims: </strong>This registry aimed to assess the incidence of long-term structural valve deterioration (SVD) beyond 5 years post-TAVI.</p><p><strong>Methods: </strong>Consecutive living patients who underwent TAVI up until 2014 using any commercially available transcatheter heart valve (THV) at 22 participant centres were enrolled in the European Valve Durability TAVI Registry. All patients underwent comprehensive echocardiographic assessments (61% were evaluated independently by a central core laboratory) within 6 months of enrolment and at least 5 years post-TAVI; SVD was defined according to Valve Academic Research Consortium 3 definitions.</p><p><strong>Results: </strong>A total of 597 patients (aged 79.6±7.1 years at the time of TAVI; 47.2% male, mean Society of Thoracic Surgeons score 5.0%) were included. At a median of 6.1 years of follow-up (interquartile range 5.2-7.3 years), the crude incidence of moderate/severe SVD was 9.5% (n=57; moderate: 6.2%, n=37; severe: 3.4%, n=20). Predictors of SVD identified by Cox regression analysis were use of an intra-annular THV (hazard ratio [HR] 38.44, 95% confidence interval [CI]: 10.8-136.3; p<0.001), a small THV size (HR 4.82, 95% CI: 2.42-9.60; p<0.001) and moderate/severe postprocedural paravalvular leak (HR 3.64, 95% CI: 1.59-8.32; p=0.002).</p><p><strong>Conclusions: </strong>The incidence of moderate/severe SVD during long-term follow-up after TAVI is low, with severe SVD being even rarer than moderate SVD. SVD occurs more frequently in patients treated with older-generation intra-annular valves and in those with small-sized THVs.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 10","pages":"537-549"},"PeriodicalIF":7.6000,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063547/pdf/","citationCount":"0","resultStr":"{\"title\":\"Long-term structural valve deterioration after TAVI: insights from the EORP ESC Valve Durability TAVI Registry.\",\"authors\":\"Cristina Giannini, Davide Capodanno, Gabor G Toth, Stephan Windecker, Stefanie Schüpke, Daniel J Blackman, Stéphane Noble, Hélène Eltchaninoff, Claudia Fiorina, Alaide Chieffo, Antonio L Bartorelli, Albrecht Schmidt, Ole De Backer, Martine Gilard, Elizabeth Curtis, Guillaume L'Official, Erwan Donal, Cécile Laroche, Bernard Prendergast, Anna Sonia Petronio, On Behalf The European Valve Durability Tavi Registry Investigators\",\"doi\":\"10.4244/EIJ-D-24-00662\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Valve durability is a key consideration as the patient population eligible for transcatheter aortic valve implantation (TAVI) expands to include lower-risk and younger individuals who are expected to live many years after the procedure.</p><p><strong>Aims: </strong>This registry aimed to assess the incidence of long-term structural valve deterioration (SVD) beyond 5 years post-TAVI.</p><p><strong>Methods: </strong>Consecutive living patients who underwent TAVI up until 2014 using any commercially available transcatheter heart valve (THV) at 22 participant centres were enrolled in the European Valve Durability TAVI Registry. All patients underwent comprehensive echocardiographic assessments (61% were evaluated independently by a central core laboratory) within 6 months of enrolment and at least 5 years post-TAVI; SVD was defined according to Valve Academic Research Consortium 3 definitions.</p><p><strong>Results: </strong>A total of 597 patients (aged 79.6±7.1 years at the time of TAVI; 47.2% male, mean Society of Thoracic Surgeons score 5.0%) were included. At a median of 6.1 years of follow-up (interquartile range 5.2-7.3 years), the crude incidence of moderate/severe SVD was 9.5% (n=57; moderate: 6.2%, n=37; severe: 3.4%, n=20). Predictors of SVD identified by Cox regression analysis were use of an intra-annular THV (hazard ratio [HR] 38.44, 95% confidence interval [CI]: 10.8-136.3; p<0.001), a small THV size (HR 4.82, 95% CI: 2.42-9.60; p<0.001) and moderate/severe postprocedural paravalvular leak (HR 3.64, 95% CI: 1.59-8.32; p=0.002).</p><p><strong>Conclusions: </strong>The incidence of moderate/severe SVD during long-term follow-up after TAVI is low, with severe SVD being even rarer than moderate SVD. SVD occurs more frequently in patients treated with older-generation intra-annular valves and in those with small-sized THVs.</p>\",\"PeriodicalId\":54378,\"journal\":{\"name\":\"Eurointervention\",\"volume\":\"21 10\",\"pages\":\"537-549\"},\"PeriodicalIF\":7.6000,\"publicationDate\":\"2025-05-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063547/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Eurointervention\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4244/EIJ-D-24-00662\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Eurointervention","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4244/EIJ-D-24-00662","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Long-term structural valve deterioration after TAVI: insights from the EORP ESC Valve Durability TAVI Registry.
Background: Valve durability is a key consideration as the patient population eligible for transcatheter aortic valve implantation (TAVI) expands to include lower-risk and younger individuals who are expected to live many years after the procedure.
Aims: This registry aimed to assess the incidence of long-term structural valve deterioration (SVD) beyond 5 years post-TAVI.
Methods: Consecutive living patients who underwent TAVI up until 2014 using any commercially available transcatheter heart valve (THV) at 22 participant centres were enrolled in the European Valve Durability TAVI Registry. All patients underwent comprehensive echocardiographic assessments (61% were evaluated independently by a central core laboratory) within 6 months of enrolment and at least 5 years post-TAVI; SVD was defined according to Valve Academic Research Consortium 3 definitions.
Results: A total of 597 patients (aged 79.6±7.1 years at the time of TAVI; 47.2% male, mean Society of Thoracic Surgeons score 5.0%) were included. At a median of 6.1 years of follow-up (interquartile range 5.2-7.3 years), the crude incidence of moderate/severe SVD was 9.5% (n=57; moderate: 6.2%, n=37; severe: 3.4%, n=20). Predictors of SVD identified by Cox regression analysis were use of an intra-annular THV (hazard ratio [HR] 38.44, 95% confidence interval [CI]: 10.8-136.3; p<0.001), a small THV size (HR 4.82, 95% CI: 2.42-9.60; p<0.001) and moderate/severe postprocedural paravalvular leak (HR 3.64, 95% CI: 1.59-8.32; p=0.002).
Conclusions: The incidence of moderate/severe SVD during long-term follow-up after TAVI is low, with severe SVD being even rarer than moderate SVD. SVD occurs more frequently in patients treated with older-generation intra-annular valves and in those with small-sized THVs.
期刊介绍：
EuroIntervention Journal is an international, English language, peer-reviewed journal whose aim is to create a community of high quality research and education in the field of percutaneous and surgical cardiovascular interventions.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
