TY  - BOOK
AU  - Ali, Syed
AU  - Asch, Federico M
AU  - Ben-Dor, Itsik
AU  - Bhogal, Sukhdeep
AU  - Garcia-Garcia, Hector M
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shea, Corey
AU  - Shults, Christian
AU  - Waksman, Ron
AU  - Weissman, Gaby
AU  - Zhang, Cheng
TI  - Self-expanding and balloon-expandable valves in low risk TAVR patients
SN  - 0167-5273
PY  - 2024///
KW  - *Aortic Valve Stenosis
KW  - *Heart Valve Prosthesis
KW  - *Stroke
KW  - *Thrombosis
KW  - *Transcatheter Aortic Valve Replacement
KW  - Aortic Valve Stenosis/di [Diagnosis]
KW  - Aortic Valve Stenosis/et [Etiology]
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Aortic Valve/dg [Diagnostic Imaging]
KW  - Aortic Valve/su [Surgery]
KW  - Humans
KW  - Prosthesis Design
KW  - Risk Factors
KW  - Stroke/et [Etiology]
KW  - Thrombosis/et [Etiology]
KW  - Transcatheter Aortic Valve Replacement/ae [Adverse Effects]
KW  - Treatment Outcome
KW  - MedStar Health Research Institute
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Interventional Cardiology Fellowship
KW  - Journal Article
N2  - BACKGROUND: Recent randomized studies have broadened the indication of transcatheter aortic valve replacement (TAVR) to also include low-surgical-risk patients. However, the data on self-expanding (SE) and balloon-expandable (BE) valves in low-risk patients remain sparse; CLINICAL TRIAL REGISTRY: LRT 1.0: NCT02628899 LRT 2.0: NCT03557242. Copyright © 2023 Elsevier B.V. All rights reserved; CONCLUSION: In this non-randomized study assessing SE and BE valves in low-risk TAVR patients, SE valves are associated with better hemodynamics and lesser leaflet thrombosis, with increased rates of stroke and permanent pacemaker implantation at 30 days; however, this could be due to certain patient-dependent factors not fully evaluated in this study. The long-term implications of these outcomes on structural valve durability remain to be further investigated; METHODS: The current study is a post hoc analysis of combined data from both LRT 1.0 and 2.0 trials comparing BE and SE transcatheter heart valves; RESULTS: A total of 294 patients received a BE valve, and 102 patients received an SE valve. The 30-day clinical outcomes were similar across both groups except for stroke (4.9% vs. 0.7%, p = 0.014) and permanent pacemaker implantation (17.8% vs. 5.8%, p < 0.001), which were higher in the SE cohort than the BE cohort. No difference was observed in terms of paravalvular leak (>=moderate) between the groups (0% vs. 1.5%, p = 0.577). SE patients had higher aortic valve area (1.92 +/- 0.43 mm2 vs. 1.69 +/- 0.45 mm2, p < 0.001) and lower mean gradient (8.93 +/- 3.53 mmHg vs. 13.41 +/- 4.73 mmHg, p < 0.001) than BE patients. In addition, the rate of subclinical leaflet thrombosis was significantly lower in SE patients (5.6% vs. 13.8%, p = 0.038)
UR  - https://dx.doi.org/10.1016/j.ijcard.2023.131431
ER  -