Kim, Won-Keun ORCID: 0000-0002-0799-7478, Schaefer, Ulrich, Tchetche, Didier, Nef, Holger, Arnold, Martin, Avanzas, Pablo ORCID: 0000-0002-4958-6108, Rudolph, Tanja, Scholtz, Smita, Barbanti, Marco ORCID: 0000-0002-4903-5437, Kempfert, Joerg, Mangieri, Antonio, Lauten, Alexander, Frerker, Christian, Yoon, Sung-Han, Holzamer, Andreas, Praz, Fabien, De Backer, Ole ORCID: 0000-0002-9674-0278, Toggweiler, Stefan, Blumenstein, Johannes, Purita, Paola, Tarantini, Giuseppe, Thilo, Christian, Wolf, Alexander, Husser, Oliver, Pellegrini, Costanza, Burgdorf, Christof, Antolin, Rosa Ana Hernandez, Diaz, Victor A. Jimenez, Liebetrau, Christoph, Schofer, Niklas, Moellmann, Helge, Eggebrecht, Holger, Sondergaard, Lars, Walther, Thomas, Pilgrim, Thomas, Hilker, Michael, Makkar, Raj, Unbehaun, Axel, Boergermann, Jochen, Moris, Cesar ORCID: 0000-0002-2871-190X, Achenbach, Stephan, Doerr, Oliver, Brochado, Bruno, Conradi, Lenard and Hamm, Christian W. (2019). Incidence and outcome of peri-procedural transcatheter heart valve embolization and migration: the TRAVEL registry (TranscatheteR HeArt Valve EmboLization and Migration). Eur. Heart J., 40 (38). S. 3156 - 3166. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims Peri-procedural transcatheter valve embolization and migration (TVEM) is a rare but potentially devastating complication of transcatheter aortic valve implantation (TAVI). We sought to assess the incidence, causes, and outcome of TVEM in a large multicentre cohort. Methods and results We recorded cases of peri-procedural TVEM in patients undergoing TAVI between January 2010 and December 2017 from 26 international sites. Peri-procedural TVEM occurred in 273/29 636 (0.92%) TAVI cases (age 80.8 +/- 7.3 years; 53.8% female), of which 217 were to the ascending aorta and 56 to the left ventricle. The use of self-expanding or first-generation prostheses and presence of a bicuspid aortic valve were independent predictors of TVEM. Bail-out measures included repositioning attempts using snares or miscellaneous tools (41.0%), multiple valve implantations (83.2%), and conversion to surgery (19.0%). Using 1:4-propensity matching, we identified a cohort of 235 patients with TVEM (TVEMPS) and 932 patients without TVEM (non-TVEMPS). In the matched cohort, all-cause mortality was higher in TVEMPS than in non-TVEMPS at 30 days (18.6% vs. 4.9%; P < 0.001) and after 1 year (30.5% vs. 16.6%; P < 0.001). Major stroke was more frequent in TVEMPS at 30 days (10.6% vs. 2.8%; P < 0.001), but not at 1 year (4.6% vs. 1.9%; P = 0.17). The need for emergent cardiopulmonary support, major stroke at 30 days, and acute kidney injury Stages 2 and 3 increased the risk of 1-year mortality, whereas a better renal function at baseline was protective. Conclusion Transcatheter valve embolization and migration occurred in approximately 1% and was associated with increased morbidity and mortality.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Kim, Won-KeunUNSPECIFIEDorcid.org/0000-0002-0799-7478UNSPECIFIED
Schaefer, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tchetche, DidierUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nef, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Arnold, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Avanzas, PabloUNSPECIFIEDorcid.org/0000-0002-4958-6108UNSPECIFIED
Rudolph, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholtz, SmitaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbanti, MarcoUNSPECIFIEDorcid.org/0000-0002-4903-5437UNSPECIFIED
Kempfert, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mangieri, AntonioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lauten, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Frerker, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yoon, Sung-HanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Holzamer, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Praz, FabienUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Backer, OleUNSPECIFIEDorcid.org/0000-0002-9674-0278UNSPECIFIED
Toggweiler, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blumenstein, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Purita, PaolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tarantini, GiuseppeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thilo, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wolf, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Husser, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pellegrini, CostanzaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burgdorf, ChristofUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antolin, Rosa Ana HernandezUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diaz, Victor A. JimenezUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liebetrau, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schofer, NiklasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moellmann, HelgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eggebrecht, HolgerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sondergaard, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Walther, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pilgrim, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hilker, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Makkar, RajUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Unbehaun, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Boergermann, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moris, CesarUNSPECIFIEDorcid.org/0000-0002-2871-190XUNSPECIFIED
Achenbach, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerr, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brochado, BrunoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Conradi, LenardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hamm, Christian W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-131281
DOI: 10.1093/eurheartj/ehz429
Journal or Publication Title: Eur. Heart J.
Volume: 40
Number: 38
Page Range: S. 3156 - 3166
Date: 2019
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1522-9645
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
WEIGHTED METAANALYSIS; CLINICAL-OUTCOMES; IMPLANTATION; DEFINITIONS; THERAPYMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13128

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