Changes in the Pacemaker Rate After Transition From Edwards SAPIEN XT to SAPIEN 3 Transcatheter Aortic Valve Implantation

Abstract

The PMIR after TAVR is higher with the S3 than with the XT and is independently associated with the implantation height. This increase in the PMIR may be avoided by intending an aortic stent extension >70%.

Variations in rotation of the aortic root and membranous septum with implications for transcatheter valve implantation

“…For the newer Edwards SAPIEN 3 prosthesis, for example, a suggested final depth of implantation of no deeper than 8 mm has been proposed 23. Others have suggested maintaining an aortic percentage of greater than 70%,24 which corresponds to an implantation depth of approximately 5–7 mm, depending on the size of the chosen valve 25. These suggestions are in keeping with the CT findings in our adult cohort, showing the mean height of the membranous septum to be approximately 7 mm.…”

Incidence and Predictors of Pacemaker Implant Post Commercial Approval of the CoreValve System for TAVR

“…This mechanism is also supported by the increased rate of pacemaker implantation with the ESV S3 valve compared with the ESV XT valve, in which the stent and increase in mesh fabric extends further into the LVOT. 30 It is somewhat controversial whether PPI adversely affects long-term outcome and mortality after TAVR. 31 Data from the PARTNER study and registry demonstrate that PPI is associated with a longer hospital stay and risk of subsequent hospitalization.…”

Permanent pacemaker insertion in patients with conduction abnormalities post transcatheter aortic valve replacement: a review and proposed guidelines

“…Several studies with early experience in the use of Edwards Sapien 3 was responsible for this discovery. De Torres-Alba et al (22) showed that a deeper position of the S3 in the LVOT is independently associated with a higher PPM implantation after TAVR.…”

“…This initially led to a significant increase in PPM implant rates with a single center study showing increase in PPM implantation from 12% in Sapien XT to 19% in Sapien S3 (21).…”