Hemodynamic performance of two current-generation transcatheter heart valve prostheses in severely calcified aortic valve stenosis
- Background: Treatment of severely calcified aortic valve stenosis is associated with a higher rate of paravalvular leakage (PVL) and permanent pacemaker implantation (PPI). We hypothesized that the self-expanding transcatheter heart valve (THV) prostheses Evolut Pro (EPro) is comparable to the balloon-expandable Sapien 3 (S3) regarding hemodynamics, PPI, and clinical outcome in these patients. Methods: From 2014 to 2019, all patients with very severe calcification of the aortic valve who received an EPro or an S3 THV were included. Propensity score matching was utilized to create two groups of 170 patients. Results: At discharge, there was significant difference in transvalvular gradients (EPro vs. S3) (dPmean 8.1 vs. 11.1 mmHg, \(\it p\) \(\leq\) 0.001) and indexed effective orifice area (EOAi) (1.1 vs. 0.9, \(\it p\) \(\leq\) 0.001), as well as predicted EOAi (1 vs. 0.9, \(\it p\) \(\leq\) 0.001). Moderate patient prosthesis mismatch (PPM) was significantly lower in the EPro group (17.7% vs. 38%, \(\it p\) \(\leq\) 0.001), as well as severe PPM (2.9% vs. 8.8%, \(\it p\) = 0.03). PPI and the PVL rate as well as stroke, bleeding, vascular complication, and 30-day mortality were comparable. Conclusions: In patients with severely calcified aortic valves, both THVs performed similarly in terms of 30-day mortality, PPI rate, and PVL occurrence. However, patient prothesis mismatch was observed more often in the S3 group, which might be due to the intra-annular design.
Author: | Max PotratzORCiDGND, Kawa MohemedGND, Hazem OmranORCiDGND, Lasha GortamashviliGND, Kai FriedrichsORCiDGND, Werner ScholtzGND, Smita ScholtzGND, Volker RudolphORCiDGND, Cornelia PiperGND, Tomasz Gilis-JanuszewskiGND, René SchrammORCiDGND, Nobuyuki FurukawaGND, Jan GummertORCiDGND, Sabine BleizifferORCiDGND, Tanja RudolphORCiDGND |
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URN: | urn:nbn:de:hbz:294-102522 |
DOI: | https://doi.org/10.3390/jcm11154570 |
Parent Title (English): | Journal of clinical medicine |
Publisher: | MDPI |
Place of publication: | Basel, Schweiz |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2023/10/20 |
Date of first Publication: | 2022/08/05 |
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
Tag: | Open Access Fonds TAVI; balloon-expandable; calcification; self-expandable |
Volume: | 11 |
Issue: | 15, Article 4570 |
First Page: | 4570-1 |
Last Page: | 4570-11 |
Note: | Article Processing Charge funded by the Deutsche Forschungsgemeinschaft (DFG) and the Open Access Publication Fund of Ruhr-Universität Bochum. |
Institutes/Facilities: | Herz- und Diabeteszentrum NRW |
Herz- und Diabeteszentrum NRW, Klinik für Allgemeine und Interventionelle Kardiologie | |
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
open_access (DINI-Set): | open_access |
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |