TY - JOUR
T1 - Transcatheter heart valve failure
T2 - A systematic review
AU - Mylotte, Darren
AU - Andalib, Ali
AU - Thériault-Lauzier, Pascal
AU - Dorfmeister, Magdalena
AU - Girgis, Mina
AU - Alharbi, Waleed
AU - Chetrit, Michael
AU - Galatas, Christos
AU - Mamane, Samuel
AU - Sebag, Igal
AU - Buithieu, Jean
AU - Bilodeau, Luc
AU - De Varennes, Benoit
AU - Lachapelle, Kevin
AU - Lange, Ruediger
AU - Martucci, Giuseppe
AU - Virmani, Renu
AU - Piazza, Nicolo
N1 - Publisher Copyright:
© The Author 2014.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Aims A comprehensive description of transcatheter heart valve (THV) failure has not been performed. We undertook a systematic review to investigate the aetiology, diagnosis, management, and outcomes of THV failure. Methods and results The systematic review was performed in accordance with the PRISMA guidelines using EMBASE, MEDLINE, and Scopus. Between December 2002 and March 2014, 70 publications reported 87 individual cases of transcatheter aortic valve implantation (TAVI) failure. Similar to surgical bioprosthetic heart valve failure, we observed cases of prosthetic valve endocarditis (PVE) (n = 34), structural valve failure (n = 13), and THV thrombosis (n = 15). The microbiological profile of THV PVE was similar to surgical PVE, though one-quarter had satellite mitral valve endocarditis, and surgical intervention was required in 40% (75% survival). Structural valve failure occurred most frequently due to leaflet calcification and was predominantly treated by redo-THV (60%). Transcatheter heart valve thrombosis occurred at a mean 9+7 months post-implantation and was successfully treated by prolonged anticoagulation in three-quarters of cases. Twonovel causes of THV failurewere identified: lateTHVembolization (n = 18); and THV compression (n = 7) following cardiopulmonary resuscitation (CPR). These failure modes have not been reported in the surgical literature. Potential risk factors for late THV embolization include low prosthesis implantation, THV undersizing/underexpansion, bicuspid, and non-calcified anatomy. Transcatheter heart valve embolization mandated surgery in 80% of patients. Transcatheter heart valve compression was noted at post-mortem in most cases. Conclusion Transcatheter heart valves are susceptible to failure modes typical to those of surgical bioprostheses and unique to their specific design. Transcatheter heart valve compression and late embolization represent complications previously unreported in the surgical literature.
AB - Aims A comprehensive description of transcatheter heart valve (THV) failure has not been performed. We undertook a systematic review to investigate the aetiology, diagnosis, management, and outcomes of THV failure. Methods and results The systematic review was performed in accordance with the PRISMA guidelines using EMBASE, MEDLINE, and Scopus. Between December 2002 and March 2014, 70 publications reported 87 individual cases of transcatheter aortic valve implantation (TAVI) failure. Similar to surgical bioprosthetic heart valve failure, we observed cases of prosthetic valve endocarditis (PVE) (n = 34), structural valve failure (n = 13), and THV thrombosis (n = 15). The microbiological profile of THV PVE was similar to surgical PVE, though one-quarter had satellite mitral valve endocarditis, and surgical intervention was required in 40% (75% survival). Structural valve failure occurred most frequently due to leaflet calcification and was predominantly treated by redo-THV (60%). Transcatheter heart valve thrombosis occurred at a mean 9+7 months post-implantation and was successfully treated by prolonged anticoagulation in three-quarters of cases. Twonovel causes of THV failurewere identified: lateTHVembolization (n = 18); and THV compression (n = 7) following cardiopulmonary resuscitation (CPR). These failure modes have not been reported in the surgical literature. Potential risk factors for late THV embolization include low prosthesis implantation, THV undersizing/underexpansion, bicuspid, and non-calcified anatomy. Transcatheter heart valve embolization mandated surgery in 80% of patients. Transcatheter heart valve compression was noted at post-mortem in most cases. Conclusion Transcatheter heart valves are susceptible to failure modes typical to those of surgical bioprostheses and unique to their specific design. Transcatheter heart valve compression and late embolization represent complications previously unreported in the surgical literature.
KW - Aortic stenosis
KW - Heart valve failure
KW - Prosthetic valve endocarditis
KW - Transcatheter aortic valve implantation
KW - Transcatheter heart valve failure
UR - http://www.scopus.com/inward/record.url?scp=84937722424&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehu388
DO - 10.1093/eurheartj/ehu388
M3 - Article
C2 - 25265974
AN - SCOPUS:84937722424
SN - 0195-668X
VL - 36
SP - 1306
EP - 1327
JO - European Heart Journal
JF - European Heart Journal
IS - 21
ER -