Improvements of procedural results with a new-generation self-expanding transfemoral aortic valve prosthesis in comparison to the old-generation device

• Verfasst von: Gomes Botelho Quintas, Bruna [VerfasserIn]
• Verfasst von: Geis, Nicolas [VerfasserIn]
• Verfasst von: Chorianopoulos, Emmanuel [VerfasserIn]
• Verfasst von: Meder, Benjamin [VerfasserIn]
• Verfasst von: Leuschner, Florian [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Bekeredjian, Raffi [VerfasserIn]
• Titel: Improvements of procedural results with a new-generation self-expanding transfemoral aortic valve prosthesis in comparison to the old-generation device
• Verf.angabe: Bruna Gomes, M.D., Nicolas A. Geis, M.D., Emmanuel Chorianopoulos, M.D., Benjamin Meder, M.D., Florian Leuschner, M.D., Hugo A. Katus, M.D., and Raffi Bekeredjian, M.D.
• Jahr: 2017
• Umfang: 7 S.
• Teil: volume:30
• Teil: year:2017
• Teil: number:1
• Teil: pages:72-78
• Teil: extent:7
• Fussnoten: First published: 24 November 2016 ; Gesehen am 02.10.2018
• Titel Quelle: Enthalten in: Journal of interventional cardiology
• Ort Quelle: London : Hindawi, 1988
• Jahr Quelle: 2017
• Band/Heft Quelle: 30(2017), 1, Seite 72-78
• ISSN Quelle: 1540-8183
• DOI: doi:10.1111/joic.12356
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1581488173

Abstract

Objectives In this study, we compare procedural results of our first Evolut R (Medtronic, Minneapolis, MN, USA) implantations with the last CoreValve implantations. Main endpoints include paravalvular regurgitation, major vascular complications, stroke, and pacemaker implantation. Background The evolution of transcatheter aortic valve replacement (TAVR) was possible due to various technical improvements, leading to better periprocedural and long-term outcome. The newly designed Evolut R valve has the potential to further improve TAVR's performance. Methods We retrospectively analyzed our first 100 consecutive patients who received the Evolut R valve with the last 100 consecutive patients who received the CoreValve prosthesis between July 2013 and February 2016. Only patients treated with a 26 mm or 29 mm bioprosthesis were included. Results No significant differences in patient characteristics were noticed. Both angiography and echocardiography after TAVR showed significantly higher rates of “none or trace” regurgitation in the Evolut R group (angiography: 67% Evolut R vs. 29.3% CoreValve; P < 0.001; echocardiography: 68% Evolut R vs. 46.5% CoreValve; P < 0.05). No significant differences were seen in 30-day mortality (7% CoreValve vs. 1% Evolut R), stroke rates (3% CoreValve vs. 2% Evolut R), pacemaker implantation rates (24% CoreValve vs. 23% Evolut R), and major vascular complications (6% CoreValve vs. 1% Evolut R). Implantations were significantly higher with the Evolut R prosthesis. Conclusions TAVR with the new Evolut R resulted in significantly lower paravalvular regurgitation. This may be due to redesigned cell geometry and higher precision during implantations, as well as the ability to resheath a malpositioned valve.