Evidence map›Paper›PMID 36217736›Full record

ArticleInnovations (Philadelphia, Pa.)2022

Midterm Durability and Structural Valve Degeneration of Transcatheter Aortic Valve Replacement in a Federal Facility.

Rachel Yang, Aaron F Grober, Ramon Riojas, Vimala Ponna, Kendrick A Shunk, Jeffrey M Zimmet, Joshua Gustafson, Liang Ge, Elaine E Tseng

Abstract read
In one paragraph

Article in Innovations (Philadelphia, Pa.), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Rachel YangDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.ORCID 0000-0002-8606-2565
Aaron F GroberDivision of Cardiology, University of California San Francisco and San Francisco VA Medical Center, CA, USA.ORCID 0000-0002-3330-3353
Ramon RiojasDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.ORCID 0000-0002-5486-6243
Vimala PonnaDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.
Kendrick A ShunkDivision of Cardiology, University of California San Francisco and San Francisco VA Medical Center, CA, USA.
Jeffrey M ZimmetDivision of Cardiology, University of California San Francisco and San Francisco VA Medical Center, CA, USA.
Joshua GustafsonDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.
Liang GeDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.
Elaine E TsengDivision of Cardiothoracic Surgery, University of California San Francisco and San Francisco VA Medical Center, CA, USA.ORCID 0000-0002-5519-6747

Funding

Biomechanical Understanding of Ascending Thoracic Aortic AneurysmsR01HL119857 · NHLBI · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI GE, LIANG, TSENG, ELAINE EVELINA · 2015 to 2018
$1.5M
Developing Biomechanical Predictors of Ascending Thoracic Aortic Aneurysm Growth and DissectionI01CX002465 · VA · VETERANS AFFAIRS MED CTR SAN FRANCISCO · PI TSENG, ELAINE EVELINA · 2022 to 2025
–
CSRD VA I01 CX002465NHLBI NIH HHS R01 HL119857
6 · The paper itself

Abstract

objectiveTranscatheter aortic valve replacement (TAVR), previously reserved for patients of intermediate to prohibitive surgical risk, has now been expanded to patients of any surgical risk with severe aortic stenosis. Bioprostheses are prone to structural valve degeneration (SVD), a progressive and multifactorial process that limits valve durability. As the population undergoing TAVR shifts toward a lower-risk and younger profile, long-term durability is a crucial determinant for patient outcomes. Our objective was to determine the incidence and risk factors of SVD at midterm follow-up in a veteran TAVR population.

methodsPatients undergoing TAVR at our federal facility were retrospectively evaluated for SVD and other endpoints with standardized consensus criteria. Multivariable Cox proportional hazards analysis was performed to evaluate risk factors for mortality and SVD.

resultsFrom 2013 to 2020, 344 patients (median age, 78 years) underwent TAVR. Survival from all-cause mortality was 91.3% at 1 year, 75.1% at 3 years, and 61.7% at 5 years. Cumulative freedom from SVD was 98.2% at 1 year, 96.5% at 3 years, and 93.7% at 5 years. All 13 patients with SVD met hemodynamic criteria, and 1 required intervention. Median time to hemodynamic SVD was 1.04 years. Independent risk factors for SVD included age (hazard ratio [HR] = 0.92, 95% confidence interval [CI]: 0.86 to 0.99) and valve size (HR = 0.19, 95% CI: 0.04 to 0.89).

conclusionsSVD was evident at a low but detectable rate at 5-year follow-up. Further understanding of TAVR biomechanics as well as continued longer-term follow-up will be essential for informing patient-specific risk of SVD.

Indexed as

Aortic Valve StenosisHeart Valve ProsthesisHeart Valve Prosthesis ImplantationTranscatheter Aortic Valve ReplacementAgedAortic ValveHumansRetrospective StudiesRisk FactorsTreatment Outcomemidterm durabilitystructural valve degenerationtranscatheter aortic valve replacement

Identifiers

PMID36217736
PMCPMC9761483

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.