TAVI Explored To Treat Aortic Bioprosthesis Failure — Physician’s First Watch
TAVI Explored To Treat Aortic Bioprosthesis Failure
By Larry Husten
With the increasing use of bioprosthetic aortic valves in aortic valve replacement surgery, more physicians will be faced with the dilemma of how best to treat degenerated valves. Although surgical reoperation is considered the best solution, many patients are too old and frail for surgery. Transcatheter aortic valve implantation (TAVI) has been proposed for use in this situation, though the risks and benefits have not as yet been well defined.
Now, a new study in JAMA provides information on 460 patients with failed bioprosthetic valves who underwent TAVI. The investigators in the VIVID (Valve-in-Valve International Data) Registry report that the death rate was 7.6% at 1 month and 16.8% at 1 year. Nearly 40% of valve failures were due to stenosis, 30% were due to regurgitation, and 30% were due to a combination of the two.
Survival was lowest in the stenosis group as well as in patients with small valves compared with patients with intermediate or large valves.
Adapted from CardioExchange