Title :

Impact of Direct TAVR Without Balloon Aortic Valvuloplasty on Procedural and Clinical Outcomes Insights From the FRANCE TAVI Registry

Author(s) :

Deharo, Pierre [Auteur]
CHU Marseille
Jaussaud, Nicolas [Auteur]
CHU Marseille
Grisoli, Dominique [Auteur]
CHU Marseille
Camus, Olivier [Auteur]
Resseguier, Noémie [Auteur]
Centre d'études et de recherche sur les services de santé et la qualité de vie [CEReSS]
Le Breton, Hervé [Auteur]
Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Auffret, Vincent [Auteur]
Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Verhoye, Jean Philippe [Auteur]
Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
Laboratoire Traitement du Signal et de l'Image [LTSI]
Koning, René [Auteur]
Clinique Saint-Hilaire [Rouen]
Lefevre, Thierry [Auteur]
van Belle, Eric [Auteur]
Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD]
Eltchaninoff, Helene [Auteur]
Endothélium, valvulopathies et insuffisance cardiaque [EnVI]
Service de cardiologie [CHU Rouen]
Gilard, Martine [Auteur]
Leprince, Pascal [Auteur]
Iung, Bernard [Auteur]
Lambert, Marc [Auteur]
CHU Marseille
Collart, Frédéric [Auteur]
CHU Marseille
Cuisset, Thomas [Auteur correspondant]
CHU Marseille

Journal title :

JACC: Cardiovascular Interventions

Pages :

1956-1965

Publisher :

Elsevier/American College of Cardiology

Publication date :

2018-10

ISSN :

1936-8798

English keyword(s) :

transcatheter aortic valve replacement
aortic regurgitation
balloon aortic valvuloplasty

HAL domain(s) :

Sciences du Vivant [q-bio]/Ingénierie biomédicale

English abstract : [en]

Objectives - This study sought to describe the current practices and compare outcomes according to the use of balloon aortic valvuloplasty (BAV) or not during transcatheter aortic valve replacement (TAVR). Background - ...
Show more >Objectives - This study sought to describe the current practices and compare outcomes according to the use of balloon aortic valvuloplasty (BAV) or not during transcatheter aortic valve replacement (TAVR). Background - Since its development, aortic valve pre-dilatation has been an essential step of TAVR procedures. However, the feasibility of TAVR without systematic BAV has been described. Methods - TAVR performed in 48 centers across France between January 2013 and December 2015 were prospectively included in the FRANCE TAVI (Registry of Aortic Valve Bioprostheses Established by Catheter) registry. We compared outcomes according to BAV during the TAVR procedure. Results - A total of 5,784 patients have been included in our analysis, corresponding to 2,579 (44.6%) with BAV avoidance and 3,205 (55.4%) patients with BAV performed. We observed a progressive decline in the use of BAV over time (78% of procedures in 2013 and 49% in the last trimester of 2015). Avoidance of BAV was associated with similar device implantation success (97.3% vs. 97.6%; p = 0.40). TAVR procedures without BAV were quicker (fluoroscopy 17.2 ± 9.1 vs. 18.5 ± 8.8 min; p < 0.01) and used lower amounts of contrast (131.5 ± 61.6 vs. 141.6 ± 61.5; p < 0.01) and radiation (608.9 ± 576.3 vs. 667.0 ± 631.3; p < 0.01). The rates of moderate to severe aortic regurgitation were lower with avoidance of BAV (8.3% vs. 12.2%; p < 0.01) and tamponade rates (1.5% vs. 2.3%; p = 0.04). Conclusions - We confirmed that TAVR without BAV is frequently performed in France with good procedural results. This procedure is associated with procedural simplification and lower rates of residual aortic regurgitation.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011

Source :

Harvested from HAL