Kiramijyan, Starkis Magalhaes, Marco A Koifman, Edward Didier, Romain Escarcega, Ricardo O Baker, Nevin C Negi, Smita I Minha, Sa'ar Torguson, Rebecca Jiaxiang, Gai Asch, Federico M Wang, Zuyue Okubagzi, Petros Gaglia, Michael AJ Ben-Dor, Itsik Satler, Lowell F Pichard, Augusto D Waksman, Ron

Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement With the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve. - 2016

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR.Copyright © 2016 Elsevier Inc. All rights reserved.


English

0002-9149


Aged
Aged, 80 and over
*Aortic Valve Insufficiency/th [Therapy]
Female
*Heart Valve Prosthesis/ae [Adverse Effects]
Hospitalization
Humans
Incidence
Logistic Models
Male
Prosthesis Design
Retrospective Studies
Severity of Illness Index
*Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
Treatment Outcome


MedStar Heart & Vascular Institute
MedStar Health Research Institute


Journal Article

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