TY - JOUR
T1 - 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
AU - Covolo, Elisa
AU - Saia, Francesco
AU - Napodano, Massimo
AU - Frigo, Anna Chiara
AU - Agostoni, Pierfrancesco
AU - Mojoli, Marco
AU - Fraccaro, Chiara
AU - Ciuca, Cristina
AU - Presbitero, Patrizia
AU - Moretti, Claudio
AU - D'Ascenzo, Fabrizio
AU - Tarantini, Giuseppe
PY - 2015/3/15
Y1 - 2015/3/15
N2 - 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.
AB - 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.
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U2 - 10.1016/j.amjcard.2014.12.042
DO - 10.1016/j.amjcard.2014.12.042
M3 - Article
C2 - 25620039
AN - SCOPUS:84926151573
VL - 115
SP - 810
EP - 815
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 6
ER -