Universität zu Köln

Haverich, Axel, Wahlers, Thorsten C., Borger, Michael A., Shrestha, Malakh, Kocher, Alfred A., Walther, Thomas, Roth, Matthias, Misfeld, Martin, Mohr, Friedrich W., Kempfert, Joerg, Dohmen, Pascal M., Schmitz, Christoph, Rahmanian, Parwis, Wiedemann, Dominik ORCID: 0000-0002-2055-8293, Duhay, Francis G. and Laufer, Guenther (2014). Three-year hemodynamic performance, left ventricular mass regression, and prosthetic-patient mismatch after rapid deployment aortic valve replacement in 287 patients. J. Thorac. Cardiovasc. Surg., 148 (6). S. 2854 - 2861. NEW YORK: MOSBY-ELSEVIER. ISSN 1097-685X

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Abstract

Objective: Superior aortic valve hemodynamic performance can accelerate left ventricular mass regression and enhance survival and functional status after surgical aortic valve replacement. This can be achieved by rapid deployment aortic valve replacement using a subannular balloon-expandable stent frame, which functionally widens and reshapes the left ventricular outflow tract, to ensure a larger effective orifice area compared with conventional surgical valves. We report the intermediate-term follow-up data from a large series of patients enrolled in the Surgical Treatment of Aortic Stenosis With a Next Generation Surgical Aortic Valve (TRITON) trial. Methods: In a prospective, multicenter (6 European hospitals), single-arm study, 287 patients with aortic stenosis underwent rapid deployment aortic valve replacement using a stented trileaflet bovine pericardial bioprosthesis. Core laboratory echocardiography was performed at baseline, discharge, and 3 months, 1 year, and 3 years after rapid deployment aortic valve replacement. Results: The mean patient age was 75.7 +/- 6.7 years (range, 45-93; 49.1% women). The mean aortic valve gradient significantly decreased from discharge to 3 years of follow-up. The mean effective orifice area remained stable from discharge to 3 years. At 1 year, the left ventricular mass index had decreased by 14% (P < .0001) and at 3 years by 16% (P < .0001) compared with at discharge. The prevalence of severe patient-prosthesis mismatch was 3% at discharge and remained stable during the follow-up period. Conclusions: In a large series of elderly patients with symptomatic severe aortic stenosis, rapid deployment aortic valve replacement using a subannular balloon-expandable stent frame demonstrated excellent hemodynamic performance and significant left ventricular mass regression. With continued follow-up, future studies will establish whether these favorable structural changes correlate with improvement in long-term survival and functional status.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Haverich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Borger, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Shrestha, Malakh UNSPECIFIED UNSPECIFIED UNSPECIFIED Kocher, Alfred A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Roth, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Misfeld, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Mohr, Friedrich W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kempfert, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Dohmen, Pascal M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmitz, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiedemann, Dominik UNSPECIFIED orcid.org/0000-0002-2055-8293 UNSPECIFIED Duhay, Francis G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Laufer, Guenther UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-422680
DOI:	10.1016/j.jtcvs.2014.07.049
Journal or Publication Title:	J. Thorac. Cardiovasc. Surg.
Volume:	148
Number:	6
Page Range:	S. 2854 - 2861
Date:	2014
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1097-685X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LONG-TERM SURVIVAL; IMPACT; OUTCOMES; TRANSCATHETER; POSITION; STENOSIS Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/42268