Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry

Matheus Simonato; Brian Whisenant; Henrique Barbosa Ribeiro; John G. Webb; Ran Kornowski; Mayra Guerrero; Harindra Wijeysundera; Lars Søndergaard; Ole de Backer; Pedro Villablanca; Charanjit Rihal; Mackram Eleid; Jörg Kempfert; Axel Unbehaun; Magdalena Erlebach; Filip Casselman; Matti Adam; Matteo Montorfano; Marco Ancona; Francesco Saia; Timm Ubben; Felix Meincke; Massimo Napodano; Pablo Codner; Joachim Schofer; Marc Pelletier; Anson Cheung; Mony Shuvy; José Honório Palma; Diego Felipe Gaia; Alison Duncan; David Hildick-Smith; Verena Veulemans; Jan Malte Sinning; Yaron Arbel; Luca Testa; Arend de Weger; Helene Eltchaninoff; Thibault Hemery; Uri Landes; Didier Tchetche; Nicolas Dumonteil; Josep Rodés-Cabau; Won Keun Kim; Konstantinos Spargias; Panagiota Kourkoveli; Ori Ben-Yehuda; Rui Campante Teles; Marco Barbanti; Claudia Fiorina; Arun Thukkani; G. Burkhard Mackensen; Noah Jones; Patrizia Presbitero; Anna Sonia Petronio; Abdelhakim Allali; Didier Champagnac; Sabine Bleiziffer; Tanja Rudolph; Alessandro Iadanza; Stefano Salizzoni; Marco Agrifoglio; Luis Nombela-Franco; Nikolaos Bonaros; Malek Kass; Giuseppe Bruschi; Nicolas Amabile; Adnan Chhatriwalla; Antonio Messina; Sameer A. Hirji; Martin Andreas; Robert Welsh; Wolfgang Schoels; Farrel Hellig; Stephan Windecker; Stefan Stortecky; Francesco Maisano; Gregg W. Stone; Danny Dvir

doi:10.1161/CIRCULATIONAHA.120.049088

Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry

Matheus Simonato, Brian Whisenant, Henrique Barbosa Ribeiro, John G. Webb, Ran Kornowski, Mayra Guerrero, Harindra Wijeysundera, Lars Søndergaard, Ole de Backer, Pedro Villablanca, Charanjit Rihal, Mackram Eleid, Jörg Kempfert, Axel Unbehaun, Magdalena Erlebach, Filip Casselman, Matti Adam, Matteo Montorfano, Marco Ancona, Francesco SaiaTimm Ubben, Felix Meincke, Massimo Napodano, Pablo Codner, Joachim Schofer, Marc Pelletier, Anson Cheung, Mony Shuvy, José Honório Palma, Diego Felipe Gaia, Alison Duncan, David Hildick-Smith, Verena Veulemans, Jan Malte Sinning, Yaron Arbel, Luca Testa, Arend de Weger, Helene Eltchaninoff, Thibault Hemery, Uri Landes, Didier Tchetche, Nicolas Dumonteil, Josep Rodés-Cabau, Won Keun Kim, Konstantinos Spargias, Panagiota Kourkoveli, Ori Ben-Yehuda, Rui Campante Teles, Marco Barbanti, Claudia Fiorina, Arun Thukkani, G. Burkhard Mackensen, Noah Jones, Patrizia Presbitero, Anna Sonia Petronio, Abdelhakim Allali, Didier Champagnac, Sabine Bleiziffer, Tanja Rudolph, Alessandro Iadanza, Stefano Salizzoni, Marco Agrifoglio, Luis Nombela-Franco, Nikolaos Bonaros, Malek Kass, Giuseppe Bruschi, Nicolas Amabile, Adnan Chhatriwalla, Antonio Messina, Sameer A. Hirji, Martin Andreas, Robert Welsh, Wolfgang Schoels, Farrel Hellig, Stephan Windecker, Stefan Stortecky, Francesco Maisano, Gregg W. Stone, Danny Dvir

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

BACKGROUND: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. METHODS: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient ≥10 mmHg and significant residual mitral regurgitation (MR) as ≥ moderate. RESULTS: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5±12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76–996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510–1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR (P<0.001). Mean gradient across the mitral valve postprocedure was 5.7±2.8 mmHg (≥5 mmHg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients (P=0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P<0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P=0.02). The rates of Mitral Valve Academic Research Consortium–defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P=0.01), mostly related to having postprocedural mean gradient ≥5 mmHg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74–12.56; P=0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88–21.53; P<0.001) were both independently associated with repeat mitral valve replacement. CONCLUSIONS: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.

Original language	English (US)
Pages (from-to)	104-116
Number of pages	13
Journal	Circulation
Volume	143
Issue number	2
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.120.049088
State	Published - Jan 12 2021

Keywords

heart valve disease
hemodynamics
mitral valve
mitral valve insufficiency
mitral valve stenosis

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

Access to Document

10.1161/CIRCULATIONAHA.120.049088

Cite this

Simonato, M., Whisenant, B., Ribeiro, H. B., Webb, J. G., Kornowski, R., Guerrero, M., Wijeysundera, H., Søndergaard, L., de Backer, O., Villablanca, P., Rihal, C., Eleid, M., Kempfert, J., Unbehaun, A., Erlebach, M., Casselman, F., Adam, M., Montorfano, M., Ancona, M., ... Dvir, D. (2021). Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry. Circulation, 143(2), 104-116. https://doi.org/10.1161/CIRCULATIONAHA.120.049088

Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry. / Simonato, Matheus; Whisenant, Brian; Ribeiro, Henrique Barbosa et al.
In: Circulation, Vol. 143, No. 2, 12.01.2021, p. 104-116.

Research output: Contribution to journal › Article › peer-review

Simonato, M, Whisenant, B, Ribeiro, HB, Webb, JG, Kornowski, R, Guerrero, M, Wijeysundera, H, Søndergaard, L, de Backer, O, Villablanca, P, Rihal, C, Eleid, M, Kempfert, J, Unbehaun, A, Erlebach, M, Casselman, F, Adam, M, Montorfano, M, Ancona, M, Saia, F, Ubben, T, Meincke, F, Napodano, M, Codner, P, Schofer, J, Pelletier, M, Cheung, A, Shuvy, M, Palma, JH, Gaia, DF, Duncan, A, Hildick-Smith, D, Veulemans, V, Sinning, JM, Arbel, Y, Testa, L, de Weger, A, Eltchaninoff, H, Hemery, T, Landes, U, Tchetche, D, Dumonteil, N, Rodés-Cabau, J, Kim, WK, Spargias, K, Kourkoveli, P, Ben-Yehuda, O, Teles, RC, Barbanti, M, Fiorina, C, Thukkani, A, Mackensen, GB, Jones, N, Presbitero, P, Petronio, AS, Allali, A, Champagnac, D, Bleiziffer, S, Rudolph, T, Iadanza, A, Salizzoni, S, Agrifoglio, M, Nombela-Franco, L, Bonaros, N, Kass, M, Bruschi, G, Amabile, N, Chhatriwalla, A, Messina, A, Hirji, SA, Andreas, M, Welsh, R, Schoels, W, Hellig, F, Windecker, S, Stortecky, S, Maisano, F, Stone, GW & Dvir, D 2021, 'Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry', Circulation, vol. 143, no. 2, pp. 104-116. https://doi.org/10.1161/CIRCULATIONAHA.120.049088

@article{301df5199fb74045ba070357b735ba2d,

title = "Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry",

abstract = "BACKGROUND: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. METHODS: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient ≥10 mmHg and significant residual mitral regurgitation (MR) as ≥ moderate. RESULTS: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5±12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76–996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510–1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR (P<0.001). Mean gradient across the mitral valve postprocedure was 5.7±2.8 mmHg (≥5 mmHg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients (P=0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P<0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P=0.02). The rates of Mitral Valve Academic Research Consortium–defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P=0.01), mostly related to having postprocedural mean gradient ≥5 mmHg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74–12.56; P=0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88–21.53; P<0.001) were both independently associated with repeat mitral valve replacement. CONCLUSIONS: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.",

keywords = "heart valve disease, hemodynamics, mitral valve, mitral valve insufficiency, mitral valve stenosis",

author = "Matheus Simonato and Brian Whisenant and Ribeiro, {Henrique Barbosa} and Webb, {John G.} and Ran Kornowski and Mayra Guerrero and Harindra Wijeysundera and Lars S{\o}ndergaard and {de Backer}, Ole and Pedro Villablanca and Charanjit Rihal and Mackram Eleid and J{\"o}rg Kempfert and Axel Unbehaun and Magdalena Erlebach and Filip Casselman and Matti Adam and Matteo Montorfano and Marco Ancona and Francesco Saia and Timm Ubben and Felix Meincke and Massimo Napodano and Pablo Codner and Joachim Schofer and Marc Pelletier and Anson Cheung and Mony Shuvy and Palma, {Jos{\'e} Hon{\'o}rio} and Gaia, {Diego Felipe} and Alison Duncan and David Hildick-Smith and Verena Veulemans and Sinning, {Jan Malte} and Yaron Arbel and Luca Testa and {de Weger}, Arend and Helene Eltchaninoff and Thibault Hemery and Uri Landes and Didier Tchetche and Nicolas Dumonteil and Josep Rod{\'e}s-Cabau and Kim, {Won Keun} and Konstantinos Spargias and Panagiota Kourkoveli and Ori Ben-Yehuda and Teles, {Rui Campante} and Marco Barbanti and Claudia Fiorina and Arun Thukkani and Mackensen, {G. Burkhard} and Noah Jones and Patrizia Presbitero and Petronio, {Anna Sonia} and Abdelhakim Allali and Didier Champagnac and Sabine Bleiziffer and Tanja Rudolph and Alessandro Iadanza and Stefano Salizzoni and Marco Agrifoglio and Luis Nombela-Franco and Nikolaos Bonaros and Malek Kass and Giuseppe Bruschi and Nicolas Amabile and Adnan Chhatriwalla and Antonio Messina and Hirji, {Sameer A.} and Martin Andreas and Robert Welsh and Wolfgang Schoels and Farrel Hellig and Stephan Windecker and Stefan Stortecky and Francesco Maisano and Stone, {Gregg W.} and Danny Dvir",

note = "Publisher Copyright: {\textcopyright} 2020 American Heart Association, Inc.",

year = "2021",

month = jan,

day = "12",

doi = "10.1161/CIRCULATIONAHA.120.049088",

language = "English (US)",

volume = "143",

pages = "104--116",

journal = "Circulation",

issn = "0009-7322",

publisher = "Lippincott Williams and Wilkins",

number = "2",

}

TY - JOUR

T1 - Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry

AU - Simonato, Matheus

AU - Whisenant, Brian

AU - Ribeiro, Henrique Barbosa

AU - Webb, John G.

AU - Kornowski, Ran

AU - Guerrero, Mayra

AU - Wijeysundera, Harindra

AU - Søndergaard, Lars

AU - de Backer, Ole

AU - Villablanca, Pedro

AU - Rihal, Charanjit

AU - Eleid, Mackram

AU - Kempfert, Jörg

AU - Unbehaun, Axel

AU - Erlebach, Magdalena

AU - Casselman, Filip

AU - Adam, Matti

AU - Montorfano, Matteo

AU - Ancona, Marco

AU - Saia, Francesco

AU - Ubben, Timm

AU - Meincke, Felix

AU - Napodano, Massimo

AU - Codner, Pablo

AU - Schofer, Joachim

AU - Pelletier, Marc

AU - Cheung, Anson

AU - Shuvy, Mony

AU - Palma, José Honório

AU - Gaia, Diego Felipe

AU - Duncan, Alison

AU - Hildick-Smith, David

AU - Veulemans, Verena

AU - Sinning, Jan Malte

AU - Arbel, Yaron

AU - Testa, Luca

AU - de Weger, Arend

AU - Eltchaninoff, Helene

AU - Hemery, Thibault

AU - Landes, Uri

AU - Tchetche, Didier

AU - Dumonteil, Nicolas

AU - Rodés-Cabau, Josep

AU - Kim, Won Keun

AU - Spargias, Konstantinos

AU - Kourkoveli, Panagiota

AU - Ben-Yehuda, Ori

AU - Teles, Rui Campante

AU - Barbanti, Marco

AU - Fiorina, Claudia

AU - Thukkani, Arun

AU - Mackensen, G. Burkhard

AU - Jones, Noah

AU - Presbitero, Patrizia

AU - Petronio, Anna Sonia

AU - Allali, Abdelhakim

AU - Champagnac, Didier

AU - Bleiziffer, Sabine

AU - Rudolph, Tanja

AU - Iadanza, Alessandro

AU - Salizzoni, Stefano

AU - Agrifoglio, Marco

AU - Nombela-Franco, Luis

AU - Bonaros, Nikolaos

AU - Kass, Malek

AU - Bruschi, Giuseppe

AU - Amabile, Nicolas

AU - Chhatriwalla, Adnan

AU - Messina, Antonio

AU - Hirji, Sameer A.

AU - Andreas, Martin

AU - Welsh, Robert

AU - Schoels, Wolfgang

AU - Hellig, Farrel

AU - Windecker, Stephan

AU - Stortecky, Stefan

AU - Maisano, Francesco

AU - Stone, Gregg W.

AU - Dvir, Danny

PY - 2021/1/12

Y1 - 2021/1/12

N2 - BACKGROUND: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. METHODS: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient ≥10 mmHg and significant residual mitral regurgitation (MR) as ≥ moderate. RESULTS: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5±12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76–996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510–1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR (P<0.001). Mean gradient across the mitral valve postprocedure was 5.7±2.8 mmHg (≥5 mmHg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients (P=0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P<0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P=0.02). The rates of Mitral Valve Academic Research Consortium–defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P=0.01), mostly related to having postprocedural mean gradient ≥5 mmHg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74–12.56; P=0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88–21.53; P<0.001) were both independently associated with repeat mitral valve replacement. CONCLUSIONS: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.

AB - BACKGROUND: Mitral valve-in-valve (ViV) and valve-in-ring (ViR) are alternatives to surgical reoperation in patients with recurrent mitral valve failure after previous surgical valve repair or replacement. Our aim was to perform a large-scale analysis examining midterm outcomes after mitral ViV and ViR. METHODS: Patients undergoing mitral ViV and ViR were enrolled in the Valve-in-Valve International Data Registry. Cases were performed between March 2006 and March 2020. Clinical endpoints are reported according to the Mitral Valve Academic Research Consortium (MVARC) definitions. Significant residual mitral stenosis (MS) was defined as mean gradient ≥10 mmHg and significant residual mitral regurgitation (MR) as ≥ moderate. RESULTS: A total of 1079 patients (857 ViV, 222 ViR; mean age 73.5±12.5 years; 40.8% male) from 90 centers were included. Median STS-PROM score 8.6%; median clinical follow-up 492 days (interquartile range, 76–996); median echocardiographic follow-up for patients that survived 1 year was 772.5 days (interquartile range, 510–1211.75). Four-year Kaplan-Meier survival rate was 62.5% in ViV versus 49.5% for ViR (P<0.001). Mean gradient across the mitral valve postprocedure was 5.7±2.8 mmHg (≥5 mmHg; 61.4% of patients). Significant residual MS occurred in 8.2% of the ViV and 12.0% of the ViR patients (P=0.09). Significant residual MR was more common in ViR patients (16.6% versus 3.1%; P<0.001) and was associated with lower survival at 4 years (35.1% versus 61.6%; P=0.02). The rates of Mitral Valve Academic Research Consortium–defined device success were low for both procedures (39.4% total; 32.0% ViR versus 41.3% ViV; P=0.01), mostly related to having postprocedural mean gradient ≥5 mmHg. Correlates for residual MS were smaller true internal diameter, younger age, and larger body mass index. The only correlate for residual MR was ViR. Significant residual MS (subhazard ratio, 4.67; 95% CI, 1.74–12.56; P=0.002) and significant residual MR (subhazard ratio, 7.88; 95% CI, 2.88–21.53; P<0.001) were both independently associated with repeat mitral valve replacement. CONCLUSIONS: Significant residual MS and/or MR were not infrequent after mitral ViV and ViR procedures and were both associated with a need for repeat valve replacement. Strategies to improve postprocedural hemodynamics in mitral ViV and ViR should be further explored.

KW - heart valve disease

KW - hemodynamics

KW - mitral valve

KW - mitral valve insufficiency

KW - mitral valve stenosis

UR - http://www.scopus.com/inward/record.url?scp=85100069320&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85100069320&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.120.049088

DO - 10.1161/CIRCULATIONAHA.120.049088

M3 - Article

C2 - 32975133

AN - SCOPUS:85100069320

SN - 0009-7322

VL - 143

SP - 104

EP - 116

JO - Circulation

JF - Circulation

IS - 2

ER -

Transcatheter Mitral Valve Replacement After Surgical Repair or Replacement Comprehensive Midterm Evaluation of Valve-in-Valve and Valve-in-Ring Implantation From the VIVID Registry

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this