Predictors of Paravalvular Regurgitation After Implantation of the Fully Repositionable and Retrievable Lotus Transcatheter Aortic Valve (from the REPRISE II Trial Extended Cohort).
Identifieur interne : 000899 ( PubMed/Curation ); précédent : 000898; suivant : 000900Predictors of Paravalvular Regurgitation After Implantation of the Fully Repositionable and Retrievable Lotus Transcatheter Aortic Valve (from the REPRISE II Trial Extended Cohort).
Auteurs : Daniel J. Blackman [Royaume-Uni] ; Ian T. Meredith [États-Unis] ; Nicolas Dumonteil [France] ; Didier Tchétché [France] ; David Hildick-Smith [Royaume-Uni] ; Mark S. Spence [Royaume-Uni] ; Darren L. Walters [Australie] ; Jan Harnek [Suède] ; Stephen G. Worthley [Australie] ; Gilles Rioufol [France] ; Thierry Lefèvre [France] ; Vicki M. Houle [États-Unis] ; Dominic J. Allocco [États-Unis] ; Keith D. Dawkins [États-Unis]Source :
- The American journal of cardiology [ 1879-1913 ] ; 2017.
Descripteurs français
- KwdFr :
- Complications postopératoires, Conception de prothèse, Défaillance de prothèse, Femelle, Humains, Indice de gravité médicale, Insuffisance aortique (diagnostic), Insuffisance aortique (étiologie), Mâle, Pronostic, Prothèse valvulaire cardiaque (effets indésirables), Remplacement valvulaire aortique par cathéter (effets indésirables), Sténose aortique (), Sujet âgé de 80 ans ou plus, Tomodensitométrie multidétecteurs (), Valve aortique (), Échocardiographie, Études de suivi.
- MESH :
- diagnostic : Insuffisance aortique.
- effets indésirables : Prothèse valvulaire cardiaque, Remplacement valvulaire aortique par cathéter.
- étiologie : Insuffisance aortique.
- Complications postopératoires, Conception de prothèse, Défaillance de prothèse, Femelle, Humains, Indice de gravité médicale, Mâle, Pronostic, Sténose aortique, Sujet âgé de 80 ans ou plus, Tomodensitométrie multidétecteurs, Valve aortique, Échocardiographie, Études de suivi.
English descriptors
- KwdEn :
- Aged, 80 and over, Aortic Valve (surgery), Aortic Valve Insufficiency (diagnosis), Aortic Valve Insufficiency (etiology), Aortic Valve Stenosis (surgery), Echocardiography, Female, Follow-Up Studies, Heart Valve Prosthesis (adverse effects), Humans, Male, Multidetector Computed Tomography (methods), Postoperative Complications, Prognosis, Prosthesis Design, Prosthesis Failure, Severity of Illness Index, Transcatheter Aortic Valve Replacement (adverse effects).
- MESH :
- adverse effects : Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement.
- diagnosis : Aortic Valve Insufficiency.
- etiology : Aortic Valve Insufficiency.
- methods : Multidetector Computed Tomography.
- surgery : Aortic Valve, Aortic Valve Stenosis.
- Aged, 80 and over, Echocardiography, Female, Follow-Up Studies, Humans, Male, Postoperative Complications, Prognosis, Prosthesis Design, Prosthesis Failure, Severity of Illness Index.
Abstract
Paravalvular leak (PVL) after transcatheter aortic valve replacement is associated with worse long-term outcomes. The Lotus Valve incorporates an innovative Adaptive Seal designed to minimize PVL. This analysis evaluated the incidence and predictors of PVL after implantation of the Lotus transcatheter aortic valve. The REPRISE II (REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Evaluation of Safety and Performance) Study With Extended Cohort enrolled 250 high-surgical risk patients with severe symptomatic aortic stenosis. Aortic regurgitation was assessed by echocardiography pre-procedure, at discharge and 30 days, by an independent core laboratory. Baseline and procedural predictors of mild or greater PVL at 30 days (or at discharge if 30-day data were not available) were determined using a multivariate regression model (n = 229). Of the 229 patients, 197 (86%) had no/trace PVL, 30 had mild, and 2 had moderate PVL; no patient had severe PVL. Significant predictors of mild/moderate PVL included device:annulus area ratio (odds ratio [OR] 0.87; 95% CI 0.83 to 0.92; p <0.001), left ventricular outflow tract calcium volume (OR 2.85; 95% CI 1.44 to 5.63; p = 0.003), and annulus area (OR 0.89; 95% CI 0.82 to 0.96; p = 0.002). When the device:annulus area ratio was <1, the rate of mild/moderate PVL was 53.1% (17 of 32). The rates of mild/moderate PVL with 0% to 5%, 5% to 10%, and >10% annular oversizing by area were 17.5% (11 of 63), 2.9% (2 of 70), and 3.2% (2 of 63), respectively. Significant independent predictors of PVL included device:annulus area ratio and left ventricular outflow tract calcium volume. When the prosthetic valve was oversized by ≥5%, the rate of mild or greater PVL was only 3%. In conclusion, the overall rates of PVL with the Lotus Valve are low and predominantly related to device/annulus areas and calcium; these findings have implications for optimal device sizing.
DOI: 10.1016/j.amjcard.2017.04.026
PubMed: 28535962
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Walters, Darren L" sort="Walters, Darren L" uniqKey="Walters D" first="Darren L" last="Walters">Darren L. Walters</name>
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<author><name sortKey="Worthley, Stephen G" sort="Worthley, Stephen G" uniqKey="Worthley S" first="Stephen G" last="Worthley">Stephen G. Worthley</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.</nlm:affiliation>
<country xml:lang="fr">Australie</country>
<wicri:regionArea>Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Rioufol, Gilles" sort="Rioufol, Gilles" uniqKey="Rioufol G" first="Gilles" last="Rioufol">Gilles Rioufol</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Hôpital Cardiologique de Lyon and INSERM 1060, CARMEN, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Cardiology, Hôpital Cardiologique de Lyon and INSERM 1060, CARMEN</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Lefevre, Thierry" sort="Lefevre, Thierry" uniqKey="Lefevre T" first="Thierry" last="Lefèvre">Thierry Lefèvre</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Cardiology, Institut Cardiovasculaire-Paris Sud, Massy, France.</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Department of Cardiology, Institut Cardiovasculaire-Paris Sud, Massy</wicri:regionArea>
</affiliation>
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<author><name sortKey="Houle, Vicki M" sort="Houle, Vicki M" uniqKey="Houle V" first="Vicki M" last="Houle">Vicki M. Houle</name>
<affiliation wicri:level="2"><nlm:affiliation>Boston Scientific Corporation, Marlborough, Massachusetts.</nlm:affiliation>
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<placeName><region type="state">Massachusetts</region>
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<author><name sortKey="Allocco, Dominic J" sort="Allocco, Dominic J" uniqKey="Allocco D" first="Dominic J" last="Allocco">Dominic J. Allocco</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Boston Scientific Corporation, Marlborough</wicri:cityArea>
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<author><name sortKey="Dawkins, Keith D" sort="Dawkins, Keith D" uniqKey="Dawkins K" first="Keith D" last="Dawkins">Keith D. Dawkins</name>
<affiliation wicri:level="2"><nlm:affiliation>Boston Scientific Corporation, Marlborough, Massachusetts.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Massachusetts</region>
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<term>Aortic Valve (surgery)</term>
<term>Aortic Valve Insufficiency (diagnosis)</term>
<term>Aortic Valve Insufficiency (etiology)</term>
<term>Aortic Valve Stenosis (surgery)</term>
<term>Echocardiography</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Heart Valve Prosthesis (adverse effects)</term>
<term>Humans</term>
<term>Male</term>
<term>Multidetector Computed Tomography (methods)</term>
<term>Postoperative Complications</term>
<term>Prognosis</term>
<term>Prosthesis Design</term>
<term>Prosthesis Failure</term>
<term>Severity of Illness Index</term>
<term>Transcatheter Aortic Valve Replacement (adverse effects)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Complications postopératoires</term>
<term>Conception de prothèse</term>
<term>Défaillance de prothèse</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Insuffisance aortique (diagnostic)</term>
<term>Insuffisance aortique (étiologie)</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Prothèse valvulaire cardiaque (effets indésirables)</term>
<term>Remplacement valvulaire aortique par cathéter (effets indésirables)</term>
<term>Sténose aortique ()</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tomodensitométrie multidétecteurs ()</term>
<term>Valve aortique ()</term>
<term>Échocardiographie</term>
<term>Études de suivi</term>
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</keywords>
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</keywords>
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<term>Remplacement valvulaire aortique par cathéter</term>
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</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Aortic Valve</term>
<term>Aortic Valve Stenosis</term>
</keywords>
<keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Insuffisance aortique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged, 80 and over</term>
<term>Echocardiography</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Postoperative Complications</term>
<term>Prognosis</term>
<term>Prosthesis Design</term>
<term>Prosthesis Failure</term>
<term>Severity of Illness Index</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Complications postopératoires</term>
<term>Conception de prothèse</term>
<term>Défaillance de prothèse</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de gravité médicale</term>
<term>Mâle</term>
<term>Pronostic</term>
<term>Sténose aortique</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tomodensitométrie multidétecteurs</term>
<term>Valve aortique</term>
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<front><div type="abstract" xml:lang="en">Paravalvular leak (PVL) after transcatheter aortic valve replacement is associated with worse long-term outcomes. The Lotus Valve incorporates an innovative Adaptive Seal designed to minimize PVL. This analysis evaluated the incidence and predictors of PVL after implantation of the Lotus transcatheter aortic valve. The REPRISE II (REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Evaluation of Safety and Performance) Study With Extended Cohort enrolled 250 high-surgical risk patients with severe symptomatic aortic stenosis. Aortic regurgitation was assessed by echocardiography pre-procedure, at discharge and 30 days, by an independent core laboratory. Baseline and procedural predictors of mild or greater PVL at 30 days (or at discharge if 30-day data were not available) were determined using a multivariate regression model (n = 229). Of the 229 patients, 197 (86%) had no/trace PVL, 30 had mild, and 2 had moderate PVL; no patient had severe PVL. Significant predictors of mild/moderate PVL included device:annulus area ratio (odds ratio [OR] 0.87; 95% CI 0.83 to 0.92; p <0.001), left ventricular outflow tract calcium volume (OR 2.85; 95% CI 1.44 to 5.63; p = 0.003), and annulus area (OR 0.89; 95% CI 0.82 to 0.96; p = 0.002). When the device:annulus area ratio was <1, the rate of mild/moderate PVL was 53.1% (17 of 32). The rates of mild/moderate PVL with 0% to 5%, 5% to 10%, and >10% annular oversizing by area were 17.5% (11 of 63), 2.9% (2 of 70), and 3.2% (2 of 63), respectively. Significant independent predictors of PVL included device:annulus area ratio and left ventricular outflow tract calcium volume. When the prosthetic valve was oversized by ≥5%, the rate of mild or greater PVL was only 3%. In conclusion, the overall rates of PVL with the Lotus Valve are low and predominantly related to device/annulus areas and calcium; these findings have implications for optimal device sizing.</div>
</front>
</TEI>
<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28535962</PMID>
<DateCreated><Year>2017</Year>
<Month>05</Month>
<Day>24</Day>
</DateCreated>
<DateCompleted><Year>2017</Year>
<Month>08</Month>
<Day>10</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>08</Month>
<Day>10</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-1913</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>120</Volume>
<Issue>2</Issue>
<PubDate><Year>2017</Year>
<Month>Jul</Month>
<Day>15</Day>
</PubDate>
</JournalIssue>
<Title>The American journal of cardiology</Title>
<ISOAbbreviation>Am. J. Cardiol.</ISOAbbreviation>
</Journal>
<ArticleTitle>Predictors of Paravalvular Regurgitation After Implantation of the Fully Repositionable and Retrievable Lotus Transcatheter Aortic Valve (from the REPRISE II Trial Extended Cohort).</ArticleTitle>
<Pagination><MedlinePgn>292-299</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S0002-9149(17)30714-2</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/j.amjcard.2017.04.026</ELocationID>
<Abstract><AbstractText>Paravalvular leak (PVL) after transcatheter aortic valve replacement is associated with worse long-term outcomes. The Lotus Valve incorporates an innovative Adaptive Seal designed to minimize PVL. This analysis evaluated the incidence and predictors of PVL after implantation of the Lotus transcatheter aortic valve. The REPRISE II (REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Evaluation of Safety and Performance) Study With Extended Cohort enrolled 250 high-surgical risk patients with severe symptomatic aortic stenosis. Aortic regurgitation was assessed by echocardiography pre-procedure, at discharge and 30 days, by an independent core laboratory. Baseline and procedural predictors of mild or greater PVL at 30 days (or at discharge if 30-day data were not available) were determined using a multivariate regression model (n = 229). Of the 229 patients, 197 (86%) had no/trace PVL, 30 had mild, and 2 had moderate PVL; no patient had severe PVL. Significant predictors of mild/moderate PVL included device:annulus area ratio (odds ratio [OR] 0.87; 95% CI 0.83 to 0.92; p <0.001), left ventricular outflow tract calcium volume (OR 2.85; 95% CI 1.44 to 5.63; p = 0.003), and annulus area (OR 0.89; 95% CI 0.82 to 0.96; p = 0.002). When the device:annulus area ratio was <1, the rate of mild/moderate PVL was 53.1% (17 of 32). The rates of mild/moderate PVL with 0% to 5%, 5% to 10%, and >10% annular oversizing by area were 17.5% (11 of 63), 2.9% (2 of 70), and 3.2% (2 of 63), respectively. Significant independent predictors of PVL included device:annulus area ratio and left ventricular outflow tract calcium volume. When the prosthetic valve was oversized by ≥5%, the rate of mild or greater PVL was only 3%. In conclusion, the overall rates of PVL with the Lotus Valve are low and predominantly related to device/annulus areas and calcium; these findings have implications for optimal device sizing.</AbstractText>
<CopyrightInformation>Copyright © 2017 Elsevier Inc. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Blackman</LastName>
<ForeName>Daniel J</ForeName>
<Initials>DJ</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Leeds Teaching Hospitals, Leeds, United Kingdom. Electronic address: daniel.blackman1@nhs.net.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Meredith</LastName>
<ForeName>Ian T</ForeName>
<Initials>IT</Initials>
<AffiliationInfo><Affiliation>Division of Cardiology, MonashHeart, Monash Medical Centre and Monash University, Melbourne, Australia; Boston Scientific Corporation, Marlborough, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dumonteil</LastName>
<ForeName>Nicolas</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Clinique Pasteur, Toulouse, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tchétché</LastName>
<ForeName>Didier</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Clinique Pasteur, Toulouse, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hildick-Smith</LastName>
<ForeName>David</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Spence</LastName>
<ForeName>Mark S</ForeName>
<Initials>MS</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Royal Victoria Hospital, Belfast, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Walters</LastName>
<ForeName>Darren L</ForeName>
<Initials>DL</Initials>
<AffiliationInfo><Affiliation>Division of Cardiology, The Prince Charles Hospital, Brisbane, Queensland, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Harnek</LastName>
<ForeName>Jan</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, University Hospital of Lund, Lund, Sweden.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Worthley</LastName>
<ForeName>Stephen G</ForeName>
<Initials>SG</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rioufol</LastName>
<ForeName>Gilles</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Hôpital Cardiologique de Lyon and INSERM 1060, CARMEN, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lefèvre</LastName>
<ForeName>Thierry</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Cardiology, Institut Cardiovasculaire-Paris Sud, Massy, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Houle</LastName>
<ForeName>Vicki M</ForeName>
<Initials>VM</Initials>
<AffiliationInfo><Affiliation>Boston Scientific Corporation, Marlborough, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Allocco</LastName>
<ForeName>Dominic J</ForeName>
<Initials>DJ</Initials>
<AffiliationInfo><Affiliation>Boston Scientific Corporation, Marlborough, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dawkins</LastName>
<ForeName>Keith D</ForeName>
<Initials>KD</Initials>
<AffiliationInfo><Affiliation>Boston Scientific Corporation, Marlborough, Massachusetts.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType>
<PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2017</Year>
<Month>04</Month>
<Day>27</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Am J Cardiol</MedlineTA>
<NlmUniqueID>0207277</NlmUniqueID>
<ISSNLinking>0002-9149</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>AIM</CitationSubset>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001021" MajorTopicYN="N">Aortic Valve</DescriptorName>
<QualifierName UI="Q000601" MajorTopicYN="N">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001022" MajorTopicYN="N">Aortic Valve Insufficiency</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001024" MajorTopicYN="N">Aortic Valve Stenosis</DescriptorName>
<QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D004452" MajorTopicYN="N">Echocardiography</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006350" MajorTopicYN="N">Heart Valve Prosthesis</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D061330" MajorTopicYN="N">Multidetector Computed Tomography</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011183" MajorTopicYN="Y">Postoperative Complications</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011379" MajorTopicYN="N">Prognosis</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011474" MajorTopicYN="N">Prosthesis Design</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011475" MajorTopicYN="N">Prosthesis Failure</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D065467" MajorTopicYN="N">Transcatheter Aortic Valve Replacement</DescriptorName>
<QualifierName UI="Q000009" MajorTopicYN="Y">adverse effects</QualifierName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year>
<Month>12</Month>
<Day>02</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2017</Year>
<Month>04</Month>
<Day>05</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2017</Year>
<Month>04</Month>
<Day>05</Day>
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<Month>5</Month>
<Day>26</Day>
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