POD after TAVR has an incidence of around 13% and occurs early in the post-operative course. Nontransfemoral access is strongly associated with the occurrence of POD. Patients who develop POD show prolonged in-hospital stay and impaired long-term survival.

T ranscatheter aortic valve implantation (TAVI) has become a firmly established treatment option for symptomatic severe aortic stenosis (AS) in inoperable patients 1 and patients at high operative risk. 2,3 Although proven noninferior to surgical aortic valve replacement in terms of all-cause mortality, TAVI is associated with a higher incidence of postoperative aortic regurgitation (AR) and vascular complications. 2,3 Other non-negligible TAVI-related complications are cerebral embolic events and advanced conduction disturbances. 4 The extension of TAVI to lower risk populations requires minimization of these adverse events, partly depending on technological developments in transcatheter heart valves (THVs) and delivery systems.Recently, the new balloon-expandable Sapien 3 THV (S3-THV; Edwards Lifesciences, Irvine, CA) has become commercially available. 5 The S3-THV embodies the next generation balloon-expandable valve of the Sapien valve family, building on the clinical experiences gained with the previous Sapien XT-THV (SXT-THV; Edwards Lifesciences). With its new features, including an outer annular sealing cuff, improved delivery system, and low crimped profile, the S3-THV is thought to achieve better results than the preceding SXT-THV. 5 Initial data from a multicenter registry prospectively evaluating the S3-THV looked promising, reporting low rates of AR, vascular complications, and stroke. 6 Comparative studies on the clinical outcomes of TAVI with the S3-THV and SXT-THV are currently scarce.Aim of this study was to retrospectively compare the hemodynamic and clinical outcomes of TAVI with the S3-THV versus the SXT-THV in patients with symptomatic severe native AS.Background-The new balloon-expandable Sapien 3 transcatheter heart valve (S3-THV) incorporates new features to reduce aortic regurgitation (AR) and vascular complications in transcatheter aortic valve implantation. Aim of this study is to compare the outcomes of the S3-THV with the preceding Sapien XT THV (SXT-THV) in patients who underwent transcatheter aortic valve implantation for symptomatic severe native aortic stenosis. Methods and Results-Eligible patients were retrospectively identified in our institutional database and periprocedural clinical and imaging data were collected. Non-parsimonious one-to-many propensity score matching was performed to account for differences in baseline characteristics. Between November 2011 and December 2014, 167 patients underwent balloon-expandable transcatheter aortic valve implantation with either the S3-THV (n=49) or SXT-THV (n=118 MethodsThis is a retrospective single-center study. All patients who underwent TAVI for severe native AS at the University Medical Center Utrecht by means of S3-THV or SXT-THV implantation were identified in our institutional database and included in the study. Implantation of the SXT-THV had to be state-of-the-art, meaning performed with the Novaflex+ delivery system through an expandable sheath. Patients with bicuspid aortic valve anatomy or a degenerated surgical aortic...

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PPCI by DEB-only in selected patients yielded an angiographic outcome comparable to BMS alone and DEB followed by BMS. PES proved angiographic superiority to DEB-only. DEB-only is therefore a potential treatment alternative during PPCI in patients with contra-indications to drug-eluting stents.

This is an author version of the contribution published on:Questa è la versione dell'autore dell'opera: Am J Cardiol.