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Valve-in-valve procedure for bioprosthesis dysfunction in rheumatic patients: a new procedure for an old disease

Lopes, M P ; Emer Egypto Rosa, V ; Palma, J H ; Fernandes, J R C ; De Santis, A S A L ; Spina, G S ; Abizaid, A C ; De Brito Jr, F S ; Tarasoutchi, F ; Sampaio, R O ; Ribeiro, H B

European heart journal, 2021-10, Vol.42 (Supplement_1) [Periódico revisado por pares]

Oxford University Press

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  • Título:
    Valve-in-valve procedure for bioprosthesis dysfunction in rheumatic patients: a new procedure for an old disease
  • Autor: Lopes, M P ; Emer Egypto Rosa, V ; Palma, J H ; Fernandes, J R C ; De Santis, A S A L ; Spina, G S ; Abizaid, A C ; De Brito Jr, F S ; Tarasoutchi, F ; Sampaio, R O ; Ribeiro, H B
  • É parte de: European heart journal, 2021-10, Vol.42 (Supplement_1)
  • Descrição: Abstract Background Bioprosthetic heart valve has a limited durability and lower long-term performance especially in rheumatic patients. The standard treatment for degenerated bioprosthesis involves redo open-heart surgery, which is associated with significant morbidity and mortality, particularly in high-risk patients. Minimally invasive procedures, as valve-in-valve (ViV) implantation, may offer an attractive therapy alternative. Methods The aim of this study was to evaluate the characteristics and short-term post-procedure data of rheumatic and non-rheumatic patients undergoing aortic, mitral or tricuspid ViV procedure. Results Single centre data-base analysis study, with prospective data collection, during the period of May 2015 to September 2020. Among 106 patients included, 69 had rheumatic etiology and 37 were non-rheumatic. Rheumatic patients had higher incidence of female sex (73.9% vs 43.2%, respectively; p=0.004) and atrial fibrillation (82.6% vs 45.9%, respectively; p<0.001). There were no statistical difference regarding number of previous surgeries (2 [3–1] vs 1 [2–1], respectively; p=0.103). There was a tendency towards higher 30-day mortality in rheumatic patients (21.7% vs 5.4%, respectively; p=0.057) and device success rate was low, but similar between groups (78.3% vs 72.0%, respectively; p=0.710). Transapical access rate was also higher in rheumatic group (92.6% vs 70.3%, respectively; p=0.008); Conclusion Rheumatic patients tend to have a higher mortality when undergoing ViV procedures, although not statistically significant. Rheumatic patients underwent a greater number of previous valve surgeries than reported in literature, and also had high rate of transapical ViV procedure, which may have contributed to higher 30-day mortality and a lower device success rate. FUNDunding Acknowledgement Type of funding sources: None.
  • Editor: Oxford University Press
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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