TY  - BOOK
AU  - Asch, Federico M
AU  - Weissman, Neil J
TI  - Structural Deterioration of Transcatheter Versus Surgical Aortic Valve Bioprostheses in the PARTNER-2 Trial
SN  - 0735-1097
PY  - 2020///
KW  - *Aortic Valve Insufficiency/di [Diagnosis]
KW  - *Aortic Valve Insufficiency/su [Surgery]
KW  - *Bioprosthesis
KW  - *Heart Valve Prosthesis
KW  - *Prosthesis Failure
KW  - *Transcatheter Aortic Valve Replacement/mt [Methods]
KW  - Aged
KW  - Aged, 80 and over
KW  - Aortic Valve Insufficiency/pp [Physiopathology]
KW  - Bioprosthesis/td [Trends]
KW  - Female
KW  - Heart Valve Prosthesis/td [Trends]
KW  - Humans
KW  - Male
KW  - Prosthesis Failure/td [Trends]
KW  - Transcatheter Aortic Valve Replacement/is [Instrumentation]
KW  - Transcatheter Aortic Valve Replacement/td [Trends]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: It is unknown whether transcatheter valves will have similar durability as surgical bioprosthetic valves. Definitions of structural valve deterioration (SVD), based on valve related reintervention or death, underestimate the incidence of SVD; CONCLUSIONS: Compared with SAVR, the second-generation SAPIEN XT balloon-expandable valve has a higher 5-year rate of SVD, whereas the third-generation SAPIEN 3 has a rate of SVD that was not different from SAVR. (The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves - PII A [PARTNERII A]; NCT01314313; The PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - PARTNER II - PARTNERII - S3 Intermediate [PARTNERII S3i]; NCT03222128). Copyright (c) 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved; METHODS: In the PARTNER 2A trial, patients were randomly assigned to receive either TAVR with the SAPIEN XT or SAVR, whereas in the SAPIEN 3 registry, patients were assigned to TAVR with the SAPIEN 3. The primary endpoint was the incidence of SVD, that is, the composite of SVD-related hemodynamic valve deterioration during echocardiographic follow-up and/or SVD-related bioprosthetic valve failure (BVF) at 5 years; OBJECTIVES: This study sought to determine and compare the 5-year incidence of SVD, using new standardized definitions based on echocardiographic follow-up of valve function, in intermediate-risk patients with severe aortic stenosis given transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) in the PARTNER (Placement of Aortic Transcatheter Valves) 2A trial and registry; RESULTS: Compared with SAVR, the SAPIEN-XT TAVR cohort had a significantly higher 5-year exposure adjusted incidence rates (per 100 patient-years) of SVD (1.61 +/- 0.24% vs. 0.63 +/- 0.16%), SVD-related BVF (0.58 +/- 0.14% vs. 0.12 +/- 0.07%), and all-cause (structural or nonstructural) BVF (0.81 +/- 0.16% vs. 0.27 +/- 0.10%) (p <= 0.01 for all). The 5-year rates of SVD (0.68 +/- 0.18% vs. 0.60 +/- 0.17%; p = 0.71), SVD-related BVF (0.29 +/- 0.12% vs. 0.14 +/- 0.08%; p = 0.25), and all-cause BVF (0.60 +/- 0.15% vs. 0.32 +/- 0.11%; p = 0.32) in SAPIEN 3 TAVR were not significantly different to a propensity score matched SAVR cohort. The 5-year rates of SVD and SVD-related BVF were significantly lower in SAPIEN 3 versus SAPIEN XT TAVR matched cohorts
UR  - https://dx.doi.org/10.1016/j.jacc.2020.08.049
ER  -