Dataset Information

The "Cooing Pigeon": TAVI for Acute Aortic Regurgitation Secondary to Homograft Degeneration.

ABSTRACT: We present a case of acute aortic homograft regurgitation manifesting as a new-onset "cooing" murmur in a patient with congenital heart disease who did not have signs of clinical decompensation or evidence of infective endocarditis. He underwent successful transcatheter aortic valve implantation following a diagnosis of sterile acute valvular degeneration. (Level of Difficulty: Intermediate.).

SUBMITTER: Shouls G

PROVIDER: S-EPMC8299863 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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The "Cooing Pigeon": TAVI for Acute Aortic Regurgitation Secondary to Homograft Degeneration.

Shouls Genevieve G Bagnall Timothy J TJ Pandya Bejal B

JACC. Case reports 20201111 14

We present a case of acute aortic homograft regurgitation manifesting as a new-onset "cooing" murmur in a patient with congenital heart disease who did not have signs of clinical decompensation or evidence of infective endocarditis. He underwent successful transcatheter aortic valve implantation following a diagnosis of sterile acute valvular degeneration. (<b>Level of Difficulty: Intermediate.</b>). ...[more]

PMID: 34317129

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Project description:AimTranscatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic stenosis in patients with intermediate to prohibitive surgical risk. When a single TAVI device fails and cannot be retrieved, TAVI-in-TAVI must be performed acutely, but outcomes of bailout TAVI-in-TAVI have been incompletely appraised. We aimed at analyzing patient, procedural and outcome features of patients undergoing bailout TAVI-in-TAVI in a multicenter registry.MethodsDetails of patients undergoing bailout TAVI-in-TAVI, performed acutely or within 24 h of index TAVI, in 6 international high-volume institutions, were collected. For every case provided, 2 same-week consecutive controls (prior TAVI, and subsequent TAVI) were provided. Outcomes of interest were procedural and long-term events, including death, myocardial infarction, stroke, access site complication, major bleeding, and reintervention, and their composite (i.e. major adverse events [MAE]).ResultsA total of 106 patients undergoing bailout TAVI-in-TAVI were included, as well as 212 controls, for a total of 318 individuals. Bailout TAVI-in-TAVI was less common in younger patients, those with higher body mass index, or treated with Portico/Navitor or Sapien devices (all p < 0.05). Bailout TAVI-in-TAVI was associated with higher in-hospital rates of death, emergency surgery, MAE, and permanent pacemaker implantation (all p < 0.05). Long-term follow-up showed that bailout TAVI-in-TAVI was associated with higher rates of death and MAE (both < 0.05). Similar findings were obtained at adjusted analyses (all p < 0.05). However, censoring early events, outlook was not significantly different when comparing the two groups (p = 0.897 for death, and p = 0.645 for MAE).ConclusionsBail-out TAVI-in-TAVI is associated with significant early and long-term mortality and morbidity. Thus, meticulous preprocedural planning and sophisticated intraprocedural techniques are of paramount importance to avoid these emergency procedures.

Dataset Information

The "Cooing Pigeon": TAVI for Acute Aortic Regurgitation Secondary to Homograft Degeneration.

Publications

The "Cooing Pigeon": TAVI for Acute Aortic Regurgitation Secondary to Homograft Degeneration.

Similar Datasets

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