Long-Term Prognosis Value of Paravalvular Leak and Patient–Prosthesis Mismatch following Transcatheter Aortic Valve Implantation: Insight from the France-TAVI Registry
- Type de publi. : Article dans une revue
- Date de publi. : 01/10/2022
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Auteurs :
Pierre DeharoLionel LerouxAlexis ThéronJérôme FerraraAntoine VaillierNicolas JaussaudAlizée PortoPierre MoreraVlad GariboldiBernard IungThierry LefevrePhilippe CommeauMargaux GouysseFlorence Du ChaylaNicolas GlattGuillaume CaylaHervé Le BretonHakim BenamerSylvain BeurtheretJean-Philippe VerhoyeHélène EltchaninoffMartine GilardJean-Philippe ColletNicolas DumonteilFrédéric CollartThomas ModineThomas Cuisset
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Organismes :
Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Hôpital de la Timone [CHU - APHM]
Aix-Marseille Université - École de médecine
Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux]
Département de Cardiologie [Hôpital de la Timone - APHM]
Département de Cardiologie [Hôpital de la Timone - APHM]
Département de Cardiologie [Hôpital de la Timone - APHM]
Département de Cardiologie [Hôpital de la Timone - APHM]
Département de Cardiologie [Hôpital de la Timone - APHM]
Département de Cardiologie [Hôpital de la Timone - APHM]
Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Aix-Marseille Université - École de médecine
Département de Cardiologie [Hôpital de la Timone - APHM]
Service de cardiologie [CHU Bichat]
Laboratoire de Recherche Vasculaire Translationnelle
Hôpital Privé Jacques Cartier [Massy]
Polyclinique Les Fleurs - ELSAN
Clinityx
Clinityx
Clinityx
Centre Hospitalier Universitaire de Nîmes
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Hôpital Privé Jacques Cartier [Massy]
Hôpital Saint-Joseph [Marseille]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Service de Cardiologie [CHU Rouen]
Hôpital de la Cavale Blanche - CHRU Brest
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases
Clinique Pasteur [Toulouse]
Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Aix-Marseille Université - École de médecine
Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux]
Médico-Chirurgical de Valvulopathies et Cardiomyopathies, Chirurgie Cardiaque Adulte, Cardiologie Interventionnelle Structurelle Adulte [CHU Bordeaux]
Département de Cardiologie [Hôpital de la Timone - APHM]
Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
Aix-Marseille Université - École de médecine
- Publié dans Journal of Clinical Medicine le 29/10/2020
Résumé : Background: Transcatheter aortic valve implantation (TAVI) is the preferred treatment for symptomatic severe aortic stenosis (AS) in a majority of patients across all surgical risks. Patients and methods: Paravalvular leak (PVL) and patient–prosthesis mismatch (PPM) are two frequent complications of TAVI. Therefore, based on the large France-TAVI registry, we planned to report the incidence of both complications following TAVI, evaluate their respective risk factors, and study their respective impacts on long-term clinical outcomes, including mortality. Results: We identified 47,494 patients in the database who underwent a TAVI in France between 1 January 2010 and 31 December 2019. Within this population, 17,742 patients had information regarding PPM status (5138 with moderate-to-severe PPM, 29.0%) and 20,878 had information regarding PVL (4056 with PVL ≥ 2, 19.4%). After adjustment, the risk factors for PVL ≥ 2 were a lower body mass index (BMI), a high baseline mean aortic gradient, a higher body surface area, a lower ejection fraction, a smaller diameter of TAVI, and a self-expandable TAVI device, while for moderate-to-severe PPM we identified a younger age, a lower BMI, a larger body surface area, a low aortic annulus area, a low ejection fraction, and a smaller diameter TAVI device (OR 0.85; 95% CI, 0.83–0.86) as predictors. At 6.5 years, PVL ≥ 2 was an independent predictor of mortality and was associated with higher mortality risk. PPM was not associated with increased risk of mortality. Conclusions: Our analysis from the France-TAVI registry showed that both moderate-to-severe PPM and PVL ≥ 2 continue to be frequently observed after the TAVI procedure. Different risk factors, mostly related to the patient’s anatomy and TAVI device selection, for both complications have been identified. Only PVL ≥ 2 was associated with higher mortality during follow-up.
Fichiers liés :
jcm-11-06117-v2.pdf
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