Balloon-expandable valve geometry after transcatheter aortic valve replacement in low-risk patients with bicuspid versus tricuspid aortic stenosis
Asch, Federico M
Ben-Dor, Itsik
Case, Brian
Chezar-Azerrad, Chava
Craig, Paige E
Forrestal, Brian
Garcia-Garcia, Hector M
Medranda, Giorgio
Rogers, Toby
Satler, Lowell F
Shea, Corey
Shults, Christian
Waksman, Ron
Weigold, William Guy
Weissman, Gaby
Yerasi, Charan
Zhang, Cheng
text
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2021
monographic
en
BACKGROUND: Prospective bicuspid low-risk transcatheter aortic valve replacement (TAVR) registries' data demonstrated encouraging short-term results. Detailed data on transcatheter heart valve (THV) geometry after deployment using contemporary devices are lacking. This study sought to examine valve geometry after TAVR in patients with bicuspid aortic stenosis (AS).
CONCLUSION: Despite challenging bicuspid anatomy of the aortic valve, our comprehensive CT analysis supports similar THV geometry between patients with bicuspid and tricuspid AS undergoing TAVR using the SAPIEN 3 THV in low-risk patients. This translated to excellent short-term clinical outcomes and THV hemodynamics in both aortic valve morphologies.
METHODS: The study population was patients from the LRT (Low Risk TAVR) trial who underwent TAVR using the SAPIEN 3 THV for bicuspid and tricuspid AS. THV geometry measured on 30-day computed tomography (CT) included valve height, angle, depth, and eccentricity. Additionally, THV hemodynamics and outcomes post-TAVR were compared among patients with bicuspid and tricuspid AS.
RESULTS: A total of 107 patients from the LRT trial using the SAPIEN 3 THV were included in our analysis. On 30-day CT, the valve height ratio (1.07 vs. 1.07; p = 0.348), depths (right [5.6 mm vs. 6.2 mm; p = 0.223], left [5.3 mm vs. 4.4 mm; p = 0.082] and non [4.8 mm vs. 4.5 mm; p = 0.589] coronary cusps), eccentricities (1.08 vs. 1.07; p = 0.9550), and angles (except the right [3.9 degrees vs. 6.3 degrees; p = 0.003] and left [3.6 degrees vs. 6.0 degrees; p = 0.007]) were similar between bicuspid and tricuspid patients. Hemodynamics, stroke, and mortality were similar at 1 year.
TRIAL REGISTRY: NCT02628899, https://clinicaltrials.gov/ct2/show/NCT02628899. Copyright (c) 2021. Published by Elsevier Inc.
Available in print through MWHC library: 2002 - present
English
IN PROCESS -- NOT YET INDEXED
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Advanced Cardiac Catheterization Research Fellowship
Interventional Cardiology Fellowship
1878-0938
https://dx.doi.org/10.1016/j.carrev.2021.03.027
https://dx.doi.org/10.1016/j.carrev.2021.03.027
Ovid MEDLINE(R)
210628