COMPARISON OF PROPENSITY SCORES FOR SURGICAL TREATMENT OF BIOPROSTHETIC MITRAL VALVE DYSFUNCTION USING TRADITIONAL AND “VALVE-IN-VALVE” METHODS

Highlights

The article describes the first conducted pseudorandomized comparative study of mitral valve replacement using either traditional or “valve-in-valve” techniques.

Abstract

Aim. To compare short-term (perioperative) and medium-term (6 months) outcomes of surgical treatment of bioprosthetic mitral valve dysfunction using traditional and “valve-in-valve” methods.

Methods. The study included 18 patients undergoing “valve-in-valve” replacement and 18 patients undergoing traditional mitral valve replacement (open mitral valve replacement) chosen according to the following criteria: heart disease type, predominant type of defect, age, gender, severity of the disease and the presence of concomitant pathology and using 1:1 matching on the propensity score.

Results. No perioperative mortality was noted in both groups. The cardiopulmonary bypass and cross-clamping of the aorta time was significantly lower in the “valve-in-valve” group. Comparison of echocardiographic parameters revealed a decrease in the mean pulmonary arterial pressure gradient, and a decrease in the size of the heart chambers in both groups. The peak and mean transvalvular gradient were lower in the “traditional” group. There were no cases of patient-prosthesis mismatch. In the mid-term period, patients in both groups presented with a lower functional class of heart failure.

Conclusion. Bioprosthetic mitral valve replacement using the “valve-in-valve” technique provides comparable clinical and hemodynamic results compared to the “traditional” technique in short-term and mid-term periods, and significantly reduces cardiopulmonary bypass and aortic cross clamping time.

1. Chen J., Li W., Xiang M. Burden of valvular heart disease, 1990-2017: Results from the Global Burden of Disease Study 2017. J Glob Health. 2020;10(2):020404. doi: 10.7189/jogh.10.020404

2. Рабочая группа по ведению пациентов с клапанной болезнью сердца европейского общества кардиологов (ЕОК, ESC) и европейской ассоциации кардио-торакальной хирургии (EACTS) рекомендации ESC/EACTS 2017 по лечению клапанной болезни сердца (текст доступен в электронной версии). Российский кардиологический журнал. 2018; (7): 103-155. doi. 10.15829/1560-4071-2018-7-103-155

3. Бокерия Л.А., Милиевская Е.Б., Кудзоева З.Ф., Прянишников В.В. Сердечно-сосудистая хирургия–2017. Болезни и врожденные аномалии системы кровообращения.М.: Издательство НМЦССХ им. А.Н.Бакулева МЗ РФ; 2018.

4. Kaneko T., Aranki S., Javed Q., McGurk S., Shekar P., Davidson M., Cohn L.. Mechanical versus bioprosthetic mitral valve replacement in patients <65 years old. J Thorac Cardiovasc Surg. 2014;147(1):117-26. doi: 10.1016/j.jtcvs.2013.08.028

5. Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J., Capodanno D., Conradi L., De Bonis M., De Paulis R., Delgado V., Freemantle N., Gilard M., Haugaa K.H., Jeppsson A., Jüni P., Pierard L., Prendergast B.D., Sádaba J.R., Tribouilloy C., Wojakowski W.; ESC/EACTS Scientific Document Group. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022;43(7):561-632. doi: 10.1093/eurheartj/ehab395

6. Барбараш Л.С. Биопротезы в сердечно-сосудистой хирургии. 20-летний опыт Кемеровского кардиологического центра. Патология кровообращения и кардиохирургия. 1999; 1: 69-73.

7. Bourguignon T., Bouquiaux-Stablo A.L., Loardi C., Mirza A., Candolfi P., Marchand M., Aupart M.R. Very late outcomes for mitral valve replacement with the Carpentier-Edwards pericardial bioprosthesis: 25-year follow-up of 450 implantations. J Thorac Cardiovasc Surg. 2014; 148 (5): 2004-2011.doi: 10.1016/j.jtcvs.2014.02.050

8. Paradis J.M., Del Trigo M., Puri R., Rodés-Cabau J. Transcatheter Valve-in-Valve and Valve-in-Ring for Treating Aortic and Mitral Surgical Prosthetic Dysfunction. J Am Coll Cardiol. 2015; 66(18): 2019-2037. doi: 10.1016/j.jacc.2015.09.015

9. Vohra H.A., Whistance R.N., Roubelakis A., Burton A., Barlow C.W., Tsang G.M., Livesey S.A., Ohri S.K. Outcome after redo-mitral valve replacement in adult patients: a 10-year single-centre experience. Interact Cardiovasc Thorac Surg. 2012; 14(5): 575-579. doi: 10.1093/icvts/ivs0059

10. Akins C.W., Miller D.C. Turina M.I., Kouchoukos N.T., Blackstone E.H., Grunkemeier G.L., Takkenberg J.J., David T.E., Butchart E.G., Adams D.H., Shahian D.M., Hagl S., Mayer J.E., Lytle B.W; STS; AATS; EACTS. Guidelines for reporting mortality and morbidity after cardiac valve interventions. Ann Thorac Surg. 2008; 85(4): 1490-1495. doi: 10.1016/j.athoracsur.2007.12.082

11. Papadopoulos N., Dietrich M., Christodoulou T., Moritz A., Doss M. Midterm survival after decalcification of the mitral annulus. Ann Thorac Surg. 2009; 87(4): 1143-1147. doi: 10.1016/j.athoracsur.2008.12.041

12. Протопопов А.В, Ганюков В.И., Тарасов Р.С. Транскатетерные вмешательства при патологии клапанов сердца. Красноярск: ООО «Версо»; 2021.

13. Overtchouk P., Piazza N., Granada J., Soliman O., Prendergast B., Modine T. Advances in transcatheter mitral and tricuspid therapies. BMC Cardiovasc Disord. 2020; 20 (1) :1. doi: 10.1186/s12872-019-01312-3

14. Baumgartner H., Falk V., Bax J.J., De Bonis M., Hamm C., Holm P.J., Iung B., Lancellotti P., Lansac E., Rodriguez Muñoz D., Rosenhek R., Sjögren J., Tornos Mas P., Vahanian A., Walther T., Wendler O., Windecker S., Zamorano J.L; ESC Scientific Document Group. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2017; 38 (36): 2739-2791. doi: 10.1093/eurheartj/ehx391

15. Yoon S.H., Whisenant B.K., Bleiziffer S., Delgado V., Dhoble A., Schofer N., Eschenbach L., Bansal E., Murdoch D.J., Ancona M., Schmidt T., Yzeiraj E., Vincent F., Niikura H., Kim W.K., Asami M., Unbehaun A., Hirji S., Fujita B., Silaschi M., Tang GHL, Kuwata S., Wong S.C., Frangieh A.H., Barker C.M., Davies J.E., Lauten A., Deuschl F., Nombela-Franco L., Rampat R., Nicz PFG, Masson J.B., Wijeysundera H.C., Sievert H., Blackman D.J., Gutierrez-Ibanes E., Sugiyama D., Chakravarty T., Hildick-Smith D., de Brito FS Jr., Jensen C., Jung C., Smalling R.W., Arnold M., Redwood S., Kasel A.M., Maisano F., Treede H., Ensminger S.M., Kar S., Kaneko T., Pilgrim T., Sorajja P., Van Belle E., Prendergast B.D., Bapat V., Modine T., Schofer J., Frerker C., Kempfert J., Attizzani G.F., Latib A., Schaefer U., Webb J.G., Bax J.J., Makkar R.R. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J. 2019; 40 (5): 441-451. doi: 10.1093/eurheartj/ehy590

16. Geha A.S., Lee J.H. New approach for replacement of degenerated mitral bioprostheses. Eur J Cardiothorac Surg. 1996; 10(12): 1090-1096. doi: 10.1016/s1010-7940(96)80356-3

17. Geha A.S., Massad M.G., Snow N.J. Replacement of degenerated mitral and aortic bioprostheses without explantation. Ann Thorac Surg. 2001; 72 (5): 1509-1514. doi: 10.1016/s0003-4975(01)02973-3

18. Клышников К.Ю., Овчаренко Е.А., Стасев А.Н., Глушкова Т.В., Кудрявцева Ю.А., Барбараш Л.С. Экспериментальное обоснование конструкции протеза клапана сердца для имплантации по типу «протез-в-протез». Вестник трансплантологии и искусственных органов. 2017; 19 (2): 69-77. doi: 10.15825/1995-1191-2017-2-69-77

19. Chang J.P., Kao C.L, Tsai K.T., Hsieh M.J., Fu M. Conduit-on-valve replacement of a degenerated mitral bioprosthesis with a bioprosthesis. Ann Thorac Surg. 2003; 75 (6): 1987-1989. doi: 10.1016/s0003-4975(02)04658-1

20. Eleid M.F., Whisenant B.K., Cabalka A.K., Williams M.R., Nejjari M., Attias D., Fam N., Amoroso N., Foley T.A., Pollak P.M., Alli O.O., Pislaru S.V., Said S.M., Dearani J.A., Rihal C.S. Early Outcomes of Percutaneous Transvenous Transseptal Transcatheter Valve Implantation in Failed Bioprosthetic Mitral Valves, Ring Annuloplasty, and Severe Mitral Annular Calcification. JACC Cardiovasc Interv. 2017; 10 (19): 1932-1942. doi: 10.1016/j.jcin.2017.08.014

21. Hammermeister K., Sethi G.K., Henderson W.G., Grover F.L., Oprian C., Rahimtoola S.H. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. J Am Coll Cardiol. 2000t; 36 (4): 1152-1158. doi: 10.1016/s0735-1097(00)00834-2

22. Kamioka N., Babaliaros V., Morse M.A., Frisoli T., Lerakis S., Iturbe J.M., Binongo J., Corrigan F., Yousef A., Gleason P., Wells J.A, Caughron H., Dong A., Rodriguez E., Leshnower B., O'Neill W., Paone G., Eng M., Guyton R., Block P.C., Greenbaum A. Comparison of Clinical and Echocardiographic Outcomes After Surgical Redo Mitral Valve Replacement and Transcatheter Mitral Valve-in-Valve Therapy. JACC Cardiovasc Interv. 2018; 11 (12): 1131-1138. doi: 10.1016/j.jcin.2018.03.011

23. Барбараш, Л., Стасев А., Кокорин С., Рутковская Н., Сизова И. Непосредственные результаты имплантации «клапан-в-клапан» при дисфункциях биопротезов в митральной позиции. Патология кровообращения и кардиохирургия, 2015; 19 (2): 36–41. doi. 10.21688/1681-3472-2015-2-36-41

24. Барбараш О.Л., Левадин Ю.В., Кутихин А.Г., Казанцев А.Н., Кокорин С.Г., Иванов С.В., Стасев А.Н., Евтушенко А.В., Барбараш Л.С. Разработка модели шкалы прогнозирования риска неблагоприятного исхода у пациентов, оперированных по поводу дисфункции диэпоксиобработанных биопротезов в митральной позиции. Кардиология и сердечно-сосудистая хирургия. 2020; 13(4): 286‑293. doi: 10.17116/kardio202013041286

25. Mitchell C., Rahko P.S., Blauwet L.A., Canaday B., Finstuen J.A., Foster M.C., Horton K., Ogunyankin K.O., Palma R.A., Velazquez E.J. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019; 32 (1): 1-64. doi: 10.1016/j.echo.2018.06.004

26. Baumgartner H., Hung J., Bermejo J., Chambers J.B., Evangelista A., Griffin B.P., Iung B., Otto C.M., Pellikka P.A., Quiñones M. American Society of Echocardiography; European Association of Echocardiography. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr. 2009; 22 (1): 1-23. doi: 10.1016/j.echo.2008.11.029

27. Campanella C, Hider CF, Duncan AJ, Bloomfield P. Must the mitral valve always be removed during prosthetic replacement ? Ann Thorac Surg. 1990; 49(1):167-168. doi: 10.1016/0003-4975(90)90389-n

28. Egbe A.C., Poterucha J.T., Rihal C.S., Taggart N.W., Cetta F., Cabalka A.K., Pollak P.M., Reeder G.S., Hagler D.J. Transcatheter closure of postmyocardial infarction, iatrogenic, and postoperative ventricular septal defects: The Mayo Clinic experience. Catheter Cardiovasc Interv. 2015; 86(7): 1264-1270. doi: 10.1002/ccd.25989

29. Grande A.M., Fiore A., Massetti M., Viganò M. Iatrogenic circumflex coronary lesion in mitral valve surgery: case report and review of the literature. Tex Heart Inst J. 2008; 35(2): 179-183.

30. Virmani R., Chun P.K., Parker J., McAllister H.A Jr. Suture obliteration of the circumflex coronary artery in three patients undergoing mitral valve operation. Role of left dominant or codominant coronary artery. J Thorac Cardiovasc Surg. 1982; 84(5): 773-778.

31. Абдуллаев Ф.3., Аббасов Ф.Э., Гейбатов И.Д., и др. Предикторы риска и современные принципы коррекции разрывов задней стенки левого желудочка после протезирования митрального клапана (обзор литературы и собственное наблюдение). Грудная и сердечно-сосудистая хирургия. 2011;2:23–29

32. Назаров В.М., Желтовский Ю.В., Железнев С.И., Богачев-Прокопьев А.В., Демин И.И., Афанасьев А.В., Лавинюков С.О. Профилактика разрывов задней стенки левого желудочка// Сибирский медицинский журнал. 2013;6:25–40

33. Yamaguchi A. [Left Ventricular Rupture following Mitral Valve Replacement]. Kyobu Geka. 2015; 68 (8): 596-602. Japanese.

34. Шнайдер Ю.А., Цой М.Д., Антипов Г.Н., Исаян М.В., Михеев А.А., Созинова Е.С., Худеньких Е.Е., Белов В.А., Астапов Д.А. Опыт лечения спонтанного разрыва задней стенки левого желудочка после замены митрального клапана. Кардиология. 2017; 57(5): 85–90 doi: 10.18565/cardio.2017.5.85-90

35. Cullen M.W., Cabalka A.K, Alli O.O., Pislaru S.V., Sorajja P., Nkomo V.T., Malouf J.F., Cetta F., Hagler D.J., Rihal C.S. Transvenous, antegrade Melody valve-in-valve implantation for bioprosthetic mitral and tricuspid valve dysfunction: a case series in children and adults. JACC Cardiovasc Interv. 2013; 6(6): 598-605. doi: 10.1016/j.jcin.2013.02.010

36. Yoon S.H., Whisenant B.K., Bleiziffer S., Delgado V., Dhoble A., Schofer N., Eschenbach L., Bansal E., Murdoch D.J., Ancona M, Schmidt T, Yzeiraj E, Vincent F, Niikura H, Kim WK, Asami M, Unbehaun A, Hirji S, Fujita B, Silaschi M, Tang GHL, Kuwata S, Wong SC, Frangieh AH, Barker CM, Davies JE, Lauten A, Deuschl F, Nombela-Franco L, Rampat R, Nicz PFG, Masson JB, Wijeysundera HC, Sievert H, Blackman DJ, Gutierrez-Ibanes E, Sugiyama D, Chakravarty T, Hildick-Smith D, de Brito FS Jr, Jensen C, Jung C, Smalling RW, Arnold M, Redwood S, Kasel AM, Maisano F, Treede H, Ensminger SM, Kar S, Kaneko T, Pilgrim T, Sorajja P, Van Belle E, Prendergast BD, Bapat V, Modine T, Schofer J, Frerker C, Kempfert J, Attizzani GF, Latib A, Schaefer U, Webb JG, Bax JJ, Makkar RR. Outcomes of transcatheter mitral valve replacement for degenerated bioprostheses, failed annuloplasty rings, and mitral annular calcification. Eur Heart J. 2019;40(5):441-451. doi: 10.1093/eurheartj/ehy590

37. Рогулина Н.В., Халивопуло И.К. “Valve-On-Valve” — альтернативная методика хирургического лечения дисфункций биологических протезов клапанов сердца. Российский кардиологический журнал. 2019; (8): 140-149. doi:10.15829/1560-4071-2019-8-140-149