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BIVALVE: procedural and mid-term results in patients with aortic stenosis treated with Implantation of 2 (in-series) prostheses in a single procedure
Session:
Posters (Sessão 6 - Écran 8) - Intervenção Coronária e Estrutural 5 - Intervenção Valvular
Speaker:
Francisco Albuquerque
Congress:
CPC 2022
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.4 Interventional Cardiology - Other
Session Type:
Pósters Electrónicos
FP Number:
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Authors:
Francisco Albuquerque; Pedro Lopes; Pedro de Araújo Gonçalves; Daniel Gomes; Mariana Gonçalves; Afonso Félix Oliveira; João Brito; Luis Raposo; Henrique Mesquita Gabriel; Rui Campante Teles; Silvio Leal; Manuel de Sousa Almeida; Miguel Mendes
Abstract
<p> </p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">[BACKGROUND]:</span></strong></span></span></p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Despite the increasing experience in transcatheter aortic valve implantation (TAVI), valve mispositioning still occurs. This study sought to report the incidence, management as well as post-procedural and mid-term outcomes of patients in which a second “in-series” prosthesis was implanted during the same intervention. </span></span></span></p> <p> </p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">[METHODS]:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">Single-center retrospective analysis on prospectively collected data of all consecutive patients who underwent a second “in-series” prosthesis implantation during a single TAVI procedure, between january 2015 and november 2021. Clinical and echocardiographic characteristics were recorded at baseline and after successful TAVI. Procedural, immediate post-procedural as well as mid-term follow-up data were collected for analysis. </span></span></span></p> <p style="text-align:justify"> </p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">[RESULTS]:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="font-family:"Times New Roman",serif">A total of 887 TAVI procedures were performed during the study period. A second “in-series” prosthesis implantation was necessary in 9 cases (1,0%) due to valve malpositioning <strong><span style="color:#4472c4">(table 1)</span></strong>: 7 - valve embolization; 1 - left main occlusion; 1 - low implantation with severe aortic regurgitation. All implantations of the second device were successful. Overall, 6 patients had peri-procedural events: 1 patient died the day after procedure due to intestinal ischemia; 2 patients implanted permanent pacemaker; 2 patients had a minor vascular complication of the main access - pseudoaneurysm; 1 patient had type 5 myocardial infarction. During a median follow-up of 31 months, all survivors (n=8) remained clinically stable and the extra-anatomically placed prosthesis (ascending aorta, n= 6; aortic arch, n=2, descending aorta=1) was not associated with clinical events.</span></span></span></p> <p> </p> <p><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-family:"Times New Roman",serif">[CONCLUSIONS]:</span></strong></span></span></p> <p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif"><span style="background-color:white"><span style="font-family:"Times New Roman",serif"><span style="color:black">The need for a second “in-series” prosthesis implantation during a single procedure is an extremely rare event. Mid-term clinical outcomes were favorable, even though periprocedural complications are common in this bailout scenario.</span></span></span></span></span></p>
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