CoreValve implantation for severe aortic regurgitation: A multicentre registry

Luca Testa, Azeem Latib, Marco Luciano Rossi, Federico De Marco, Marco De Carlo, Claudia Fiorina, Jacopo Oreglia, Anna Sonia Petronio, Federica Ettori, Stefano De Servi, Silvio Klugmann, Gian Paolo Ussia, Corrado Tamburino, Paolo Panisi, Nedy Brambilla, Antonio Colombo, Patrizia Presbitero, Francesco Bedogni

Research output: Contribution to journalArticlepeer-review

51 Scopus citations

Abstract

Aims: We sought to evaluate the outcome of transcatheter aortic valve replacement (TAVR) with the CoreValve Revalving System (CRS-TAVR) in inoperable patients presenting with severe aortic regurgitation (AR), compared to in patients treated for severe native aortic stenosis (AS).

Methods and results: From October 2008 to January 2013, 1,557 consecutive patients undergoing CRS-TAVR, of whom 26 (1.6-) presented with AR, were prospectively followed. Compared with patients with AS, patients with AR were significantly younger (mean age 73±10 vs. 82±6, p=0.02), more frequently in NYHA Class III/IV (95- vs. 73-, p=0.01) and had a higher incidence of severe pulmonary hypertension (sPAP >60 mmHg, 31- vs. 10-, p=0.007). Log EuroSCORE and STS score were similar. VARC-2-defined device success was lower in the AR group (79- vs. 96-, p=0.006). At one month, patients treated for AR had a higher overall mortality (23- vs. 5.9-; OR 4.22 [3.03-8.28], p<0.001) and cardiac mortality (15.3- vs. 4-, OR 4.01 [2.40-7.66], p<0.001). Results were consistent at 12 months: overall mortality (31- vs. 19-, HR 2.1 [1.5-4.41], p<0.001) and cardiac mortality (19.2- vs. 6-, HR 3.1 [2.09-8.22], p<0.001).

Conclusions: CRS-TAVR for AR is associated with a significantly higher mortality compared to CRS-TAVR for AS. Considering the ominous prognosis of these patients when treated medically, TAVR may be a reasonable choice in selected patients. In this regard, conventional risk scores have an inadequate predictive value.

Original languageEnglish (US)
JournalEuroIntervention
Volume10
Issue number6
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Keywords

  • Aortic regurgitation
  • Transcatheter aortic valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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