Comparison of balloon-expandable versus self-expandable valves for transcatheter aortic valve implantation in patients with low-gradient severe aortic stenosis and preserved left ventricular ejection fraction

Elisa Covolo, Francesco Saia, Massimo Napodano, Anna Chiara Frigo, Pierfrancesco Agostoni, Marco Mojoli, Chiara Fraccaro, Cristina Ciuca, Patrizia Presbitero, Claudio Moretti, Fabrizio D'Ascenzo, Giuseppe Tarantini

Research output: Contribution to journalArticlepeer-review

Abstract

A relevant proportion of patients, classified as severe aortic stenosis on the basis of valve area, have a mean transvalvular gradient ≥;40 mm Hg, despite a preserved left ventricular ejection fraction (LGSAS). We assessed the clinical and hemodynamic impact of transcatheter aortic valve implantation in patients with symptomatic LGSAS at high risk for surgery or inoperable, according to the type of percutaneous valve implanted. Ninety-five patients received an Edwards SAPIEN valve (Edwards Lifesciences, Irvine, California) and 51 received a Medtronic CoreValve (Medtronic, Inc., Minneapolis, Minnesota). The hemodynamic performance of the 2 valves was similar in term of final transvalvular gradients (10 mm Hg, p = 0.069). Early mortality rate was 7% and was not different between the 2 valves (p = 0.73). During follow-up, cardiovascular mortality rate was similar between groups, and valve type was not a predictor of outcome (p = 0.72). Estimated survival by Kaplan-Meier at 2 years was 70%. At multivariate analysis, life-threatening or major bleeding, postprocedural aortic insufficiency, and acute kidney injury were the major predictors of an adverse outcome. In patients with LGSAS treated by transcatheter aortic valve implantation, the use of balloon-expandable versus self-expandable valves resulted in similar hemodynamic, early, and long-term clinical outcomes.

Original languageEnglish
Pages (from-to)810-815
Number of pages6
JournalThe American Journal of Cardiology
Volume115
Issue number6
DOIs
Publication statusPublished - Mar 15 2015

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

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