Echocardiographic outcomes of self-expandable CoreValve versus balloon-expandable Edwards SAPIEN XT valves: the comparison of two bioprosthesis implanted in a single centre


KAYA D., Tanriverdi Z., DURSUN H., Colluoglu T.

INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, vol.32, no.9, pp.1371-1378, 2016 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 9
  • Publication Date: 2016
  • Doi Number: 10.1007/s10554-016-0924-y
  • Journal Name: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.1371-1378
  • Keywords: Transcatheter aortic valve implantation, Echocardiography, Hemodynamic performance, Self-expandable valve, Balloon-expandable valve, HIGH-RISK PATIENTS, SEVERE AORTIC-STENOSIS, LONG-TERM OUTCOMES, MEDTRONIC-COREVALVE, EUROPEAN ASSOCIATION, AMERICAN SOCIETY, TRANSCATHETER, REPLACEMENT, REGURGITATION, RECOMMENDATIONS
  • Dokuz Eylül University Affiliated: Yes

Abstract

Transcatheter aortic valve implantation (TAVI) with self-expandable Medtronic CoreValve (MCV; Medtronic, Minneapolis, MN) or balloon-expandable Edwards SAPIEN XT valve (ESV; Edwards Lifesciences, Irvine, CA) has been widely used for treatment of high-risk patients with severe aortic stenosis (AS). There is limited data comparing the long-term hemodynamic performance of these two valves. Therefore, this study aimed to compare the short and long-term hemodynamic performance of TAVI with either MCV or ESV. A total of 78 patients who underwent TAVI in our center between June 01, 2012 and January 01, 2014 were enrolled in this retrospective study. For each of the patients we recorded the preprocedural echocardiographic data as well as the post-TAVI echocardiographic outcomes at day one, 6 months and 1 year. The MCV group had lower transaortic gradients than the ESV group, with respect to both maximum (13.4 +/- 5.8 vs 18.7 +/- 8.1 mmHg, p = 0.001) and mean values (6.5 +/- 3.2 vs 9.4 +/- 4.3 mmHg, p < 0.001) at post-TAVI day one. These values continued to be significantly lower in the MCV group during post-TAVI 6 months (p < 0.001) and post-TAVI 1 year follow-up (p < 0.05). A paravalvular leak (PVL, grade aeyen2) was observed in 6.4 % of patients after TAVI; however, this value decreased over time, and there was no significant difference between the MVC and ESV groups (8.2 vs 3.4 %, p = 0.646). The MCV bioprosthesis was associated with lower transaortic gradients than those of the ESV throughout 1 year of follow-up. The incidence of PVL grade aeyen2 in MCV and ESV was comparable.