Transcatheter aortic valve implantation (TAVI) is common in adults but rare in children
and adolescents. Since 2014, our institution has incorporated a transcatheter approach
as an option for aortic valve replacement in this population. The purpose of this
study was to compare short-term outcomes of TAVI with surgical aortic valve replacement
(SAVR). This single-center, retrospective study included patients aged 10 to 21 years
who had a native SAVR or TAVI between January 2010 to April 2020. Comparative analysis
of baseline characteristics and a composite outcome (stroke within 6 months, readmission
within 30 days, death) between SAVR and TAVI were made using chi-square test or Wilcoxon
rank sum test, as appropriate. Of the 77 patients who underwent native aortic valve
implantation during the study period (60 SAVR, 17 TAVI), 46 were aged 10 to 21 years
(30 SAVR, 16 TAVI). Median follow-up was 3.8 years (interquartile range 1.5 to 4.9)
for the SAVR group and 1.5 years (interquartile range 1.1 to 1.2) for the TAVI group.
There was no difference in the composite outcome between groups. Patients in the SAVR
group were more likely to have undergone concomitant surgical intervention and have
longer intensive care unit and hospital stays. In conclusion, our study suggests similar
short-term outcomes between SAVR and TAVI in children and young adults aged 10 to
21 years. Longer-term studies are essential to understand the utility of TAVI and
to better consider the option of a transcatheter approach as an alternative to SAVR
in the pediatric population.
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References
- National practice patterns and early outcomes of aortic valve replacement in children and teens.Ann Thorac Surg. 2019; 108: 544-551
- Outcomes after mechanical aortic valve replacement in children and young adults with congenital heart disease.J Thorac Cardiovasc Surg. 2019; 157: 329-340
- The Ross procedure: a systematic review, meta-analysis, and microsimulation.Circ Cardiovasc Qual Outcomes. 2018; 11e004748
- Ross versus non-Ross aortic valve replacement in children: a 22-year single institution comparison of outcomes.Ann Thorac Surg. 2016; 101: 1804-1810
- Near catastrophic accelerated structural degeneration of the Perimount Magna pericardial bioprosthesis in children.Ann Thorac Surg. 2016; 102: 308-311
- Aortic valve replacement with bovine pericardial tissue valve in children and young adults.Circulation. 2019; 139: 983-985
- Aortic valve replacement in children: options and outcomes.J Saudi Heart Assoc. 2014; 26: 33-41
- Aortic valve replacement in young and middle-aged adults: current and potential roles of TAVR.Ann Thorac Surg. 2021; 112: 132-138
- Transcatheter aortic valve replacement: a review.Surg Clin North Am. 2017; 97: 899-921
- One-year mortality in patients undergoing transcatheter aortic valve replacement for stenotic bicuspid versus tricuspid aortic valves: a meta-analysis and meta-regression.J Interv Cardiol. 2019; 20198947204
- Anatomical predictors of conduction damage after transcatheter implantation of the aortic valve.Open Heart. 2019; 6e000972
- Comparison of outcomes after transcatheter aortic valve replacement vs surgical aortic valve replacement among patients with aortic stenosis at low operative risk.JAMA Network Open. 2019; 2e195742
- Transcatheter/hybrid aortic valves in the young.Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2016; 19: 68-74
- PARTNER 3 Investigators. Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients.N Engl J Med. 2019; 380: 1695-1705
- Application of transcatheter aortic valves for aortic valve replacement in pediatric patients: a case series.Catheter Cardiovasc Interv. 2020; 95: 253-261
- Semilunar valve interventions for congenital heart disease: JACC State-of-the-Art Review.J Am Coll Cardiol. 2021; 77: 71-79
- PARTNER 2 Investigators. Structural deterioration of transcatheter versus surgical aortic valve bioprostheses in the PARTNER-2 trial.J Am Coll Cardiol. 2020; 76: 1830-1843
Article Info
Publication History
Published online: June 09, 2022
Received in revised form:
April 23,
2022
Received:
March 11,
2022
Footnotes
This investigation was supported by the University of Utah Population Health Research Foundation, with funding in part from the National Center for Advancing Translational Sciences of the National Institutes of Health, Bethesda, Maryland, under award number UL1TR002538.
Identification
Copyright
Published by Elsevier Inc.
