{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:10:17Z","timestamp":1771233017767,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the risk for brain lesions in valve in valve (VIV)\u2010transcatheter aortic valve replacement (TAVR) compared to native valve procedures (NV\u2010TAVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>TAVR is associated with the risk of stroke and a high incidence of brain lesions in diffusion\u2010weighted magnetic resonance imaging (DW\u2010MRI). The risk in VIV procedures is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients were included, if they received a Sapien\u20103 or an Evolut\u2010R valve for an NV\u2010TAVR or VIV\u2010TAVR and a DW\u2010MRI within 3\u20135 days after the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred nine patients had NV\u2010TAVR and 41 patients had VIV\u2010TAVR.<\/jats:p><jats:p>The VIV group was significantly younger (mean 82.3 vs. 74.7\u2009years old, <jats:italic>p<\/jats:italic> &lt;\u2009.001) but had higher mean EuroSCORE II (4.8 vs. 7.8, <jats:italic>p<\/jats:italic> &lt;\u2009.001).<\/jats:p><jats:p>Predilatation was significantly more common with native valve (39% vs. 2%, <jats:italic>p<\/jats:italic> &lt;\u2009.01), postdilatation rate was lower in VIV but without statistical significance (17% vs. 7%, <jats:italic>p<\/jats:italic> =\u2009.110).<\/jats:p><jats:p>Combined in\u2010hospital safety outcome was comparable [13(6.6%) vs. 5(12.2%), <jats:italic>p<\/jats:italic> =\u2009.205]. Any stroke was documented in four (0.5%) patients after native valve and in one (2.4%) after VIV\u2010TAVR.<\/jats:p><jats:p>New DW\u2010MRI brain lesions were significantly more often found in patients with native valves [153(73.2%) vs. 21(51.2%), <jats:italic>p<\/jats:italic> =\u2009.005], mean number of new lesions was also higher with native valve (2.8 \u00b1 3.2 vs. 1.0 \u00b1 1.4, <jats:italic>p<\/jats:italic> &lt;\u2009.001).<\/jats:p><jats:p>Forward stepwise of logistic regression found age and post dilatation significant predictors of new MRI lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Compared to native valves, VIV procedures were associated with lower incidence and number of brain lesions according to DW\u2010MRI; these were explained by lower patients' age and lower rate of postdilatation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28391","type":"journal-article","created":{"date-parts":[[2019,7,10]],"date-time":"2019-07-10T06:03:38Z","timestamp":1562738618000},"page":"1017-1021","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Does valve in valve TAVR carry a higher risk for thromboembolic events compared to native valve TAVR?"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6710-9057","authenticated-orcid":false,"given":"Amnon","family":"Eitan","sequence":"first","affiliation":[{"name":"Medical Care Center Prof. Mathey, Prof. Schofer  Hamburg Germany"},{"name":"Carmel Medical Center  Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christina","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Medical Care Center Prof. Mathey, Prof. Schofer  Hamburg 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