Survival Over 80% After Valve-in-Valve Implantation
(HealthDay News) — For patients with failed surgical bioprosthetic valves, one-year survival after transcatheter valve-in-valve implantation is 83.2%, according to a study published in the July 9 issue of the Journal of the American Medical Association.
Danny Dvir, MD, from St. Paul's Hospital in Vancouver, Canada, and colleagues examined the survival of patients after transcatheter valve-in-valve implantation inside failed surgical bioprosthetic valves. Data were obtained from a multinational valve-in-valve registry that included 459 patients (mean age, 77.6 years) with degenerated bioprosthetic valves undergoing valve-in-valve implantation at 55 centers.
The models of bioprosthesis failure included stenosis (39.4%), regurgitation (30.3%), and combined (30.3%). The researchers found that 7.6% of patients died within one month following valve-in-valve implantation; 1.7% had major stroke; and 92.6% of surviving patients had good functional status (New York Heart Association class I/II). There was an 83.2% overall one-year Kaplan-Meier survival rate. One-year survival was worse for patients in the stenosis group (76.6%) vs. the regurgitation group (91.2%) and the combined group (83.9%) (P=0.01). One-year survival was worse for patients with small valves (74.8%) vs. intermediate-sized valves (81.8%) and large valves (93.3%) (P=0.001). Having small surgical bioprosthesis (≤21mm) and baseline stenosis (vs. regurgitation) were associated with mortality within one year (hazard ratios, 2.04 and 3.07, respectively).
"In this registry of patients who underwent transcatheter valve-in-valve implantation for degenerated bioprosthetic aortic valves, overall one-year survival was 83.2%," the authors write.
Several authors disclosed financial ties to the medical device and biotechnology industries.