Survival >80 Percent After Valve-in-Valve Implantation

Posted on Wed, Jul 23, 2014
Survival >80 Percent After Valve-in-Valve Implantation

Finding among patients with degenerated aortic valves; worse survival for stenosis as mode of failureFRIDAY, July 11, 2014 (HealthDay News) -- For patients with failed surgical bioprosthetic valves, one-year survival after transcatheter valve-in-valve implantation is 83.2 percent, according to a study published in the July 9 issue of the Journal of the American Medical Association.

Danny Dvir, M.D., 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 percent), regurgitation (30.3 percent), and combined (30.3 percent). The researchers found that 7.6 percent of patients died within one month following valve-in-valve implantation; 1.7 percent had major stroke; and 92.6 percent of surviving patients had good functional status (New York Heart Association class I/II). There was an 83.2 percent overall one-year Kaplan-Meier survival rate. One-year survival was worse for patients in the stenosis group (76.6 percent) versus the regurgitation group (91.2 percent) and the combined group (83.9 percent) (P = 0.01). One-year survival was worse for patients with small valves (74.8 percent) versus intermediate-sized valves (81.8 percent) and large valves (93.3 percent) (P = 0.001). Having small surgical bioprosthesis (≤21 mm) and baseline stenosis (versus 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 percent," the authors write.

Several authors disclosed financial ties to the medical device and biotechnology industries.

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