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Dvir D, Leipsic J, Blanke P, Ribeiro HB, Kornowski R, Pichard A, Rodés-Cabau J, Wood DA, Stub D, Ben-Dor I, Maluenda G, Makkar RR, Webb JG. Coronary Obstruction in Transcatheter Aortic Valve-in-Valve Implantation. Circ Cardiovasc Interv 2015; 8:CIRCINTERVENTIONS.114.002079. [DOI: 10.1161/circinterventions.114.002079] [Citation(s) in RCA: 161] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Danny Dvir
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Jonathon Leipsic
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Philipp Blanke
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Henrique B. Ribeiro
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Ran Kornowski
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Augusto Pichard
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Joseph Rodés-Cabau
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - David A. Wood
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Dion Stub
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Itsik Ben-Dor
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Gabriel Maluenda
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - Raj R. Makkar
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
| | - John G. Webb
- From the Department of Cardiology, St. Paul’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada (D.D., J.L., P.B., D.A.W., D.S., J.G.W.); Department of Cardiology, Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada (H.B.R., J.R.-C.); Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel (R.K.); Department of Cardiology, Medstar Washington Hospital Center, DC (A.P., I.B.-D.); Department of Cardiology, Cardiovascular Center,
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Dvir D, Webb J, Brecker S, Bleiziffer S, Hildick-Smith D, Colombo A, Descoutures F, Hengstenberg C, Moat NE, Bekeredjian R, Napodano M, Testa L, Lefevre T, Guetta V, Nissen H, Hernández JM, Roy D, Teles RC, Segev A, Dumonteil N, Fiorina C, Gotzmann M, Tchetche D, Abdel-Wahab M, De Marco F, Baumbach A, Laborde JC, Kornowski R. Transcatheter Aortic Valve Replacement for Degenerative Bioprosthetic Surgical Valves. Circulation 2012; 126:2335-44. [PMID: 23052028 DOI: 10.1161/circulationaha.112.104505] [Citation(s) in RCA: 453] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background—
Transcatheter aortic valve-in-valve implantation is an emerging therapeutic alternative for patients with a failed surgical bioprosthesis and may obviate the need for reoperation. We evaluated the clinical results of this technique using a large, worldwide registry.
Methods and Results—
The Global Valve-in-Valve Registry included 202 patients with degenerated bioprosthetic valves (aged 77.7±10.4 years; 52.5% men) from 38 cardiac centers. Bioprosthesis mode of failure was stenosis (n=85; 42%), regurgitation (n=68; 34%), or combined stenosis and regurgitation (n=49; 24%). Implanted devices included CoreValve (n=124) and Edwards SAPIEN (n=78). Procedural success was achieved in 93.1% of cases. Adverse procedural outcomes included initial device malposition in 15.3% of cases and ostial coronary obstruction in 3.5%. After the procedure, valve maximum/mean gradients were 28.4±14.1/15.9±8.6 mm Hg, and 95% of patients had ≤+1 degree of aortic regurgitation. At 30-day follow-up, all-cause mortality was 8.4%, and 84.1% of patients were at New York Heart Association functional class I/II. One-year follow-up was obtained in 87 patients, with 85.8% survival of treated patients.
Conclusions—
The valve-in-valve procedure is clinically effective in the vast majority of patients with degenerated bioprosthetic valves. Safety and efficacy concerns include device malposition, ostial coronary obstruction, and high gradients after the procedure.
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Affiliation(s)
- Danny Dvir
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - John Webb
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Stephen Brecker
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Sabine Bleiziffer
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - David Hildick-Smith
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Antonio Colombo
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Fleur Descoutures
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Christian Hengstenberg
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Neil E. Moat
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Raffi Bekeredjian
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Massimo Napodano
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Luca Testa
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Thierry Lefevre
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Victor Guetta
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Henrik Nissen
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - José-María Hernández
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - David Roy
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Rui C. Teles
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Amit Segev
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Nicolas Dumonteil
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Claudia Fiorina
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Michael Gotzmann
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Didier Tchetche
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Mohamed Abdel-Wahab
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Federico De Marco
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Andreas Baumbach
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Jean-Claude Laborde
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
| | - Ran Kornowski
- From Washington Hospital Center, Washington, DC (D.D.); Rabin Medical Center and Tel-Aviv University, Tel-Aviv, Israel (D.D., R.K.); St. Paul's Hospital, Vancouver, British Columbia, Canada (J.W.); St. George's Hospital, London, United Kingdom (S. Brecker, D.R., J.L.); German Heart Center, Munich, Germany (S. Bleiziffer); Sussex Cardiac Centre, Brighton, UK (D.H.-S.); San Raffaele Scientific Institute, Milan, Italy (A.C.); Hospital Bichat, Paris, France (F.D.); Universitaetsklinikum Regensburg,
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