Predictors of Outcomes of Reintervention After Transcatheter Aortic Valve Replacement
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Durand, Eric | Eltchaninoff, Hélène | Tchetche, Didier | Levesque, Thomas | Garmendia, Christian | Iung, Bernard | Benamer, Hakim | Cayla, Guillaume | Van Belle, Eric | Commeau, Philippe | Le Breton, Herve | Cuisset, Thomas | Akodad, Mariama | Verhoye, Jean-Philippe | Beurtheret, Sylvain | Du Chayla, Florence | Leclere, Manon | Gilard, Martine | Dumonteil, Nicolas | Adjedj, Julien | Albat, Bernard | Aubert, Stéphane | Azmoun, Alexandre | Bach, Vincent | Bar, Olivier | Belle, Loïc | Bellien, Jérémy | Bertrand, Benjamin | Bertrand, Bernard | Bessou, Jean-Paul | Beygui, Farzin | Béziau-Gasnier, Delphine | Bischoff, Nicolas | Bonnet, Jean-Louis | Bonnet, Nicolas | Brakenhielm, Ebba | Berger, Eric Braun | Caligiuri, Giuseppina | Carrié, Didier | Caus, Thierry | Champagnac, Didier | Chatel, Didier | Chavanis, Nicolas | Chevreul, Karine | Chocron, Sidney | Choplain, Jean-Noël | Christiaens, Luc-Philippe | Christophe, Charles | Claudel, Jean-Philippe | Collart, Frédéric | Collet, Frédéric | Collet, Jean-Philippe | Corbi, Pierre | Curtil, Alain | Darodes, Nicole | Darremont, Olivier | Debroucker, Frédérique | Delepine, Stéphane | Delomez, Maxence | Derieux, Thierry | Diab, Camille | Dibie, Alain | Doisy, Vincent | Durrleman, Nicolas | Durand de Gevigney, Guy | Fabre, Olivier | Farge, Arnaud | Favereau, Xavier | Folliguet, Thierry | Fraschini, Christophe | Ghostine, Saïd | Gommeaux, Antoine | Grimaud, Jean-Philippe | Guyon, Philippe | Hepp, Alain | Himbert, Dominique | Houel, Rémi | Innorta, Andrea | Isaaz, Karl | Ivascau, Calin | Jacquemin, Laurent | Jazayeri, Saed | Jegaden, Olivier | Joly, Patrick | Juthier, Francis | Kamel, Said | Kindo, Michel | Labrousse, Louis | Laghzaoui, Amine | Laschet, Jamila | Le Breton, Hervé | Leclercq, Florence | Lefevre, Thierry | Lemoine, Simon | Leprince, Pascal | Leroux, Lionel | Levy, Gilles | Lorgis, Luc | Makowski, Serge | Manigold, Thibaut | Manrique, Alain | Marcheix, Bertrand | Maupas, Eric | Messas, Emmanuel | Messika-Zeitoun, David | Metz, Damien | Mirode, Anfani | Mirza, Alain | Mohsinaly, Franck | Monassier, François | Morelle, Jean-François | Munos, Emmanuel | Nataf, Patrick | Ohlmann, Patrick | Pinaud, Frédéric | Pinelli, Georges | Pinet, Florence | Portocarrero, Erik | Pouzet, Bruno | Quilliet, Laurent | Richard, Vincent | Robert, Gabriel | Roussel, Jean-Christian | Saade, Yves | Saloux, Eric | Schiele, François | Souteyrand, Géraud | Spaulding, Christian | Tchétché, Didier | Teboul, Jacques | Teiger, Emmanuel | Thoenes, Martin | Tribouilloy, Christophe | Vahdat, Olivier | Vézier, Claire | Vilat, Jacques | Yassine, Marwanne | Zannis, Konstantinos | Zegdi, Rachid
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CCSD ; Elsevier -
International audience.
Background: In a context of extending transcatheter aortic valve replacement (TAVR) to patients with a longer life expectancy, it is important to better document the incidence and outcomes of reintervention.Objectives: The authors sought to evaluate the incidence, predictive factors, and long-term outcomes of surgical (explant TAVR) or transcatheter (redo TAVR) reintervention after TAVR.Methods: Patients who had a TAVR between 2010 and 2022 recorded in the FRANCE 2 and FRANCE TAVI registries were included in the analysis. Cumulative incidence of early (≤1 year) and late (>1 year) reintervention was assessed using the Kalbfleisch and Prentice method to account for all-cause death as a competing risk. Patients who had reintervention for infective endocarditis were excluded. Long-term mortality was evaluated using Kaplan-Meier analysis.Results: Among 72,850 patients included, the cumulative incidence of overall reintervention at 8 years was 1.7% including 591 patients who had redo TAVR and 111 patients who required explant TAVR with a low incidence of Bentall intervention. Reintervention occurred mostly early in 62.1% of cases and was more frequent in patients who had a mean aortic gradient >20 mm Hg immediately after index TAVR. Age and mean aortic gradient before TAVR and mean aortic gradient >20 mm Hg, aortic regurgitation ≥ grade 2, and percutaneous coronary intervention after TAVR were predictive of reintervention. Six-year mortality was high but was similar in patients who had early and late reintervention (76.2% vs 64.0%; P = 0.77).Conclusions: Reintervention after TAVR remains rare and was mostly performed early after the procedure and by redo TAVR. Further studies are warranted, particularly in younger patients with longer life expectancy.
