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

Sung Han Yoon, Sabine Bleiziffer, Ole De Backer, Victoria Delgado, Takahide Arai, Johannes Ziegelmueller, Marco Barbanti, Rahul Sharma, Gidon Y. Perlman, Omar K. Khalique, Erik W. Holy, Smriti Saraf, Florian Deuschl, Buntaro Fujita, Philipp Ruile, Franz Josef Neumann, Gregor Pache, Masao Takahashi, Hidehiro Kaneko, Tobias Schmidt & 42 others Yohei Ohno, Niklas Schofer, William K.F. Kong, Edgar Tay, Daisuke Sugiyama, Hiroyuki Kawamori, Yoshio Maeno, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Shingo Kuwata, Gerald Yong, Hsien Li Kao, Michael Lee, Hyo Soo Kim, Thomas Modine, S. Chiu Wong, Francesco Bedgoni, Luca Testa, Emmanuel Teiger, Christian Butter, Stephan M. Ensminger, Ulrich Schaefer, Danny Dvir, Philipp Blanke, Jonathon Leipsic, Fabian Nietlispach, Mohamed Abdel-Wahab, Bernard Chevalier, Corrado Tamburino, David Hildick-Smith, Brian K. Whisenant, Seung Jung Park, Antonio Colombo, Azeem Latib, Susheel K. Kodali, Jeroen J. Bax, Lars Søndergaard, John G. Webb, Thierry Lefèvre, Martin B. Leon, Raj Makkar

Research output: Contribution to journalArticle

92 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)2579-2589
Number of pages11
JournalJournal of the American College of Cardiology
Volume69
Issue number21
DOIs
Publication statusPublished - 2017 May 30

Fingerprint

Bicuspid
Aortic Valve Stenosis
Tricuspid Valve Stenosis
Pathologic Constriction
Equipment and Supplies
Transcatheter Aortic Valve Replacement
Propensity Score
Bicuspid Aortic Valve
Prostheses and Implants
Registries

Keywords

  • aortic stenosis
  • bicuspid aortic valve
  • transcatheter aortic valve implantation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yoon, S. H., Bleiziffer, S., De Backer, O., Delgado, V., Arai, T., Ziegelmueller, J., ... 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

Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis. / Yoon, Sung Han; Bleiziffer, Sabine; De Backer, Ole; Delgado, Victoria; Arai, Takahide; Ziegelmueller, Johannes; Barbanti, Marco; Sharma, Rahul; Perlman, Gidon Y.; Khalique, Omar K.; Holy, Erik W.; Saraf, Smriti; Deuschl, Florian; Fujita, Buntaro; Ruile, Philipp; Neumann, Franz Josef; Pache, Gregor; Takahashi, Masao; Kaneko, Hidehiro; Schmidt, Tobias; Ohno, Yohei; Schofer, Niklas; Kong, William K.F.; Tay, Edgar; Sugiyama, Daisuke; Kawamori, Hiroyuki; Maeno, Yoshio; Abramowitz, Yigal; Chakravarty, Tarun; Nakamura, Mamoo; Kuwata, Shingo; Yong, Gerald; Kao, Hsien Li; Lee, Michael; Kim, Hyo Soo; Modine, Thomas; Wong, S. Chiu; Bedgoni, Francesco; Testa, Luca; Teiger, Emmanuel; Butter, Christian; Ensminger, Stephan M.; Schaefer, Ulrich; Dvir, Danny; Blanke, Philipp; Leipsic, Jonathon; Nietlispach, Fabian; Abdel-Wahab, Mohamed; Chevalier, Bernard; Tamburino, Corrado; Hildick-Smith, David; Whisenant, Brian K.; Park, Seung Jung; Colombo, Antonio; Latib, Azeem; Kodali, Susheel K.; Bax, Jeroen J.; Søndergaard, Lars; Webb, John G.; Lefèvre, Thierry; Leon, Martin B.; Makkar, Raj.

In: Journal of the American College of Cardiology, Vol. 69, No. 21, 30.05.2017, p. 2579-2589.

Research output: Contribution to journalArticle

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
Yoon, Sung Han ; Bleiziffer, Sabine ; De Backer, Ole ; Delgado, Victoria ; Arai, Takahide ; Ziegelmueller, Johannes ; Barbanti, Marco ; Sharma, Rahul ; Perlman, Gidon Y. ; Khalique, Omar K. ; Holy, Erik W. ; Saraf, Smriti ; Deuschl, Florian ; Fujita, Buntaro ; Ruile, Philipp ; Neumann, Franz Josef ; Pache, Gregor ; Takahashi, Masao ; Kaneko, Hidehiro ; Schmidt, Tobias ; Ohno, Yohei ; Schofer, Niklas ; Kong, William K.F. ; Tay, Edgar ; Sugiyama, Daisuke ; Kawamori, Hiroyuki ; Maeno, Yoshio ; Abramowitz, Yigal ; Chakravarty, Tarun ; Nakamura, Mamoo ; Kuwata, Shingo ; Yong, Gerald ; Kao, Hsien Li ; Lee, Michael ; Kim, Hyo Soo ; Modine, Thomas ; Wong, S. Chiu ; Bedgoni, Francesco ; Testa, Luca ; Teiger, Emmanuel ; Butter, Christian ; Ensminger, Stephan M. ; Schaefer, Ulrich ; Dvir, Danny ; Blanke, Philipp ; Leipsic, Jonathon ; Nietlispach, Fabian ; Abdel-Wahab, Mohamed ; Chevalier, Bernard ; Tamburino, Corrado ; Hildick-Smith, David ; Whisenant, Brian K. ; Park, Seung Jung ; Colombo, Antonio ; Latib, Azeem ; Kodali, Susheel K. ; Bax, Jeroen J. ; Søndergaard, Lars ; Webb, John G. ; Lefèvre, Thierry ; Leon, Martin B. ; Makkar, Raj. / Outcomes in Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Valve Stenosis. In: Journal of the American College of Cardiology. 2017 ; Vol. 69, No. 21. pp. 2579-2589.
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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.",
keywords = "aortic stenosis, bicuspid aortic valve, transcatheter aortic valve implantation",
author = "Yoon, {Sung Han} and Sabine Bleiziffer and {De Backer}, Ole and Victoria Delgado and Takahide Arai and Johannes Ziegelmueller and Marco Barbanti and Rahul Sharma and Perlman, {Gidon Y.} and Khalique, {Omar K.} and Holy, {Erik W.} and Smriti Saraf and Florian Deuschl and Buntaro Fujita and Philipp Ruile and Neumann, {Franz Josef} and Gregor Pache and Masao Takahashi and Hidehiro Kaneko and Tobias Schmidt and Yohei Ohno and Niklas Schofer and Kong, {William K.F.} and Edgar Tay and Daisuke Sugiyama and Hiroyuki Kawamori and Yoshio Maeno and Yigal Abramowitz and Tarun Chakravarty and Mamoo Nakamura and Shingo Kuwata and Gerald Yong and Kao, {Hsien Li} and Michael Lee and Kim, {Hyo Soo} and Thomas Modine and Wong, {S. Chiu} and Francesco Bedgoni and Luca Testa and Emmanuel Teiger and Christian Butter and Ensminger, {Stephan M.} and Ulrich Schaefer and Danny Dvir and Philipp Blanke and Jonathon Leipsic and Fabian Nietlispach and Mohamed Abdel-Wahab and Bernard Chevalier and Corrado Tamburino and David Hildick-Smith and Whisenant, {Brian K.} and Park, {Seung Jung} and Antonio Colombo and Azeem Latib and Kodali, {Susheel K.} and Bax, {Jeroen J.} and Lars S{\o}ndergaard and Webb, {John G.} and Thierry Lef{\`e}vre and Leon, {Martin B.} and Raj Makkar",
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month = "5",
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TY - JOUR

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

AU - Yoon, Sung Han

AU - Bleiziffer, Sabine

AU - De Backer, Ole

AU - Delgado, Victoria

AU - Arai, Takahide

AU - Ziegelmueller, Johannes

AU - Barbanti, Marco

AU - Sharma, Rahul

AU - Perlman, Gidon Y.

AU - Khalique, Omar K.

AU - Holy, Erik W.

AU - Saraf, Smriti

AU - Deuschl, Florian

AU - Fujita, Buntaro

AU - Ruile, Philipp

AU - Neumann, Franz Josef

AU - Pache, Gregor

AU - Takahashi, Masao

AU - Kaneko, Hidehiro

AU - Schmidt, Tobias

AU - Ohno, Yohei

AU - Schofer, Niklas

AU - Kong, William K.F.

AU - Tay, Edgar

AU - Sugiyama, Daisuke

AU - Kawamori, Hiroyuki

AU - Maeno, Yoshio

AU - Abramowitz, Yigal

AU - Chakravarty, Tarun

AU - Nakamura, Mamoo

AU - Kuwata, Shingo

AU - Yong, Gerald

AU - Kao, Hsien Li

AU - Lee, Michael

AU - Kim, Hyo Soo

AU - Modine, Thomas

AU - Wong, S. Chiu

AU - Bedgoni, Francesco

AU - Testa, Luca

AU - Teiger, Emmanuel

AU - Butter, Christian

AU - Ensminger, Stephan M.

AU - Schaefer, Ulrich

AU - Dvir, Danny

AU - Blanke, Philipp

AU - Leipsic, Jonathon

AU - Nietlispach, Fabian

AU - Abdel-Wahab, Mohamed

AU - Chevalier, Bernard

AU - Tamburino, Corrado

AU - Hildick-Smith, David

AU - Whisenant, Brian K.

AU - Park, Seung Jung

AU - Colombo, Antonio

AU - Latib, Azeem

AU - Kodali, Susheel K.

AU - Bax, Jeroen J.

AU - Søndergaard, Lars

AU - Webb, John G.

AU - Lefèvre, Thierry

AU - Leon, Martin B.

AU - Makkar, Raj

PY - 2017/5/30

Y1 - 2017/5/30

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.

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.

KW - aortic stenosis

KW - bicuspid aortic valve

KW - transcatheter aortic valve implantation

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