title: Comparison of outcomes after one-versus-two transcatheter aortic valve implantation during a same procedure (from the FRANCE2 Registry).
abstract: Analysis of the causes, outcomes, and mortality of patients with severe symptomatic aortic stenosis requiring the implantation of 2 valves during transcatheter aortic valve implantation was conducted from the French Aortic National CoreValve and Edwards 2 (FRANCE2) registry. Pre- and postprocedural data from 3,919 patients from January 2010 to December 2011 (CoreValve or Edwards) were collated and analyzed. Characteristics of patients requiring immediate second valve procedures were compared with those of the other patients. The 72 patients (1.8%) who underwent implantation of a second valve were studied. Indications were device malpositioning (72%) and embolization (28%). Clinical and echocardiographic characteristics of patients receiving 2 valves were comparable with those of the other patients. The 2-year survival rate was 51.7% for patients with 2 valves as opposed to 62.3% for those with 1 valve (p<0.001). The need for a second valve was an independent predictor of all-cause (hazard ratio 2.32, 95% confidence interval 1.50 to 3.60, p<0.001) and cardiovascular (hazard ratio 2.64, 95% confidence interval 1.35 to 5.15, p<0.001) mortality at 2 years. During follow-up, clinical and echocardiographic data remained similar between the 2 groups. In conclusion, in the FRANCE2 study, the main causes for second valve implantation during the same procedure were malpositioning and embolization. Although the procedure was feasible, it was accompanied by excess mortality. Valve hemodynamic status was preserved during the course of follow-up.
authors: Cardiology Department, University Hospital Clermont, Ferrand, France. Electronic address: gclerfond@chu-clermontferrand.fr.
authors: Guillaume
authors: G
authors: Clerfond
authors: Cardiology Department, University Hospital Clermont, Ferrand, France.
authors: Bruno
authors: B
authors: Pereira
authors: Cardiology Department, University Hospital Clermont, Ferrand, France.
authors: Andrea
authors: A
authors: Innorta
authors: Cardiology Department, University Hospital Clermont, Ferrand, France.
authors: Pascal
authors: P
authors: Motreff
authors: Cardiology Department, University Hospital, Brest, France.
authors: Martine
authors: M
authors: Gilard
authors: Cardiovascular and Thoracic Surgery Department, University Hospital, Limoges, France.
authors: Marc
authors: M
authors: Laskar
authors: Cardiology Department, University Hospital, Rouen, France.
authors: Helene
authors: H
authors: Eltchaninoff
authors: Cardiology Department, University Hospital Bichat, Paris, France.
authors: Bernard
authors: B
authors: Iung
authors: Cardiovascular and Thoracic Surgery Department, University Hospital Pitié-Salpêtrière, Paris, France.
authors: Pascal
authors: P
authors: Leprince
authors: Cardiology Department, University Hospital Henri-Mondor, Paris, France.
authors: Emmanuel
authors: E
authors: Teiger
authors: URC-ECO, Paris, France.
authors: Karine
authors: K
authors: Chevreul
authors: Cardiovascular and Thoracic Surgery Department, University Hospital, Lille, France.
authors: Alain
authors: A
authors: Prat
authors: Pharmacology Department, University Hospital, Lyon, France.
authors: Michel
authors: M
authors: Lievre
authors: Cardiovascular and Thoracic Surgery Department, University Hospital, Rennes, France.
authors: Alain
authors: A
authors: Leguerrier
authors: Cardiovascular and Thoracic Surgery Department, Hospital Jacques Cartier, Massy, France.
authors: Patrick
authors: P
authors: Donzeau-Gouge
authors: Cardiology Department, Clinique Pasteur, Toulouse, France.
authors: Jean
authors: J
authors: Fajadet
authors: Cardiology Department, University Hospital Clermont, Ferrand, France.
authors: Géraud
authors: G
authors: Souteyrand
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000401:mortality* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate; D065467:Transcatheter Aortic Valve Replacement; D016896:Treatment Outcome