Author + information
- Charles Choi1,
- Vivian Cheng2,
- Waqas Qureshi3,
- Daniel Green2,
- Neal Kon2,
- Ted Kincaid2,
- Sanjay Gandhi2,
- Robert Applegate2 and
- David Zhao1
The literature is limited on ViV TAVR in stentless vs. stented bioprosthetic surgical aortic valve.
We retrospectively analyzed 36 patients who underwent ViV TAVR in prior surgical bioprosthetic valves at Wake Forest Baptist Medical Center from October 2014 to December 2016. 28/36 (77.8%) ViV TAVR were with prior stentless while 8/36 (22.2%) were with stented bioprosthetic valves. The initial stentless surgical valves were implanted using a root replacement technique. A p-value less than 0.05 was considered statistically significant in this study.
ViV TAVR procedure success was 100% in both groups. The most commonly used TAVR was the Medtronic CoreValve Evolute: 5/8 (62.5%) and 17/28 (60.7%) in the stented and stentless group, respectively. The average prior surgical aortic valve size in the stented and stentless group was 23.9±2.3mm and 26.0±1.8mm, respectively, and the average TAVR size was 24.5±1.6mm and 28.1±2.6mm, respectively. 6/28 (21%) in the stentless group required a second TAVR compared 0/8 (0%, p=0.07) in the stented group. Moderate/severe paravalvular leak (PVL) was more common in stentless than stented group, however was not statistically significant. Longitudinal comparison of clinical outcomes and hemodynamics are listed in Table 1.
Procedure success, mortality, complication and hospitalization rates were similar in both groups. A second TAVR was more frequently required in stentless group. Moderate/severe PVL was more prevalent in stentless group up to 12-month follow up. The mean and peak aortic gradients were significantly higher in the stented group.
STRUCTURAL: Valvular Disease: Aortic