MedStar Authors catalog › Details for: Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (placement of aortic transcatheter valves).
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Comparison of transcatheter and surgical aortic valve replacement in severe aortic stenosis: a longitudinal study of echocardiography parameters in cohort A of the PARTNER trial (placement of aortic transcatheter valves).

by Weissman, Neil J.
Citation: Journal of the American College of Cardiology. 61(25):2514-21, 2013 Jun 25..Journal: Journal of the American College of Cardiology.ISSN: 0735-1097.Full author list: Akin JJ; Anderson WN; Anwaruddin S; Bilsker M; Douglas PS; Gopalakrishnan D; Hahn RT; Herrmann HC; Keane MG; Kodali SK; Leon MB; Lindman BR; Makkar R; Pibarot P; Stewart WJ; Svensson LG; Thourani VH; Wang Z; Weissman NJ.UI/PMID: 23623915.Subject(s): *Aortic Valve Stenosis/ep [Epidemiology] | *Aortic Valve Stenosis/su [Surgery] | *Cardiac Catheterization/td [Trends] | *Heart Valve Prosthesis Implantation/td [Trends] | *Severity of Illness Index | Aged | Aged, 80 and over | Aortic Valve Stenosis/di [Diagnosis] | Cohort Studies | Echocardiography/td [Trends] | Female | Follow-Up Studies | Humans | Longitudinal Studies | Male | Treatment OutcomeInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Comparative Study | Journal Article | Randomized Controlled Trial | Research Support, Non-U.S. Gov'tOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.jacc.2013.02.087 (Click here) Abbreviated citation: J Am Coll Cardiol. 61(25):2514-21, 2013 Jun 25.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: The PARTNER (Placement of Aortic Transcatheter Valves) trial randomized patients 1:1 to SAVR or TAVR.Abstract: CONCLUSIONS: Patients randomized to either SAVR or TAVR experience enduring, significant reductions in transaortic gradients and increase in EOA. Compared with SAVR, TAVR patients had higher indexed EOA, lower prosthesis-patient mismatch, and more aortic regurgitation. Univariate predictors of death for the TAVR and SAVR groups differed and might allow future refinement in patient selection. (THE PARTNER TRIAL: Placement of AoRTic TraNscathetER Valve Trial; NCT00530894). Copyright 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.Abstract: METHODS: Echocardiograms were obtained at baseline, discharge, 30 days, 6 months, 1 year, and 2 years after the procedure and analyzed in a core laboratory. For the analysis of post-implantation variables, the first interpretable study (<=6 months) was used.Abstract: OBJECTIVES: This study sought to compare echocardiographic findings in patients with critical aortic stenosis following surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR).Abstract: RESULTS: Both groups showed a decrease in aortic valve gradients and increase in effective orifice area (EOA) (p < 0.0001), which remained stable over 2 years. Compared with SAVR, TAVR resulted in larger indexed EOA (p = 0.038), less prosthesis-patient mismatch (p = 0.019), and more total and paravalvular aortic regurgitation (p < 0.0001). Baseline echocardiographic univariate predictors of death were lower peak transaortic gradient in TAVR patients, and low left ventricular diastolic volume, low stroke volume, and greater severity of mitral regurgitation in SAVR patients. Post-implantation echocardiographic univariate predictors of death were: larger left ventricular diastolic volume, left ventricular systolic volume and EOA, decreased ejection fraction, and greater aortic regurgitation in TAVR patients; and smaller left ventricular systolic and diastolic volumes, low stroke volume, smaller EOA, and prosthesis-patient mismatch in SAVR patients.

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