Echocardiographic outcomes of self-expandable CoreValve versus balloon-expandable Edwards SAPIEN XT valves: the comparison of two bioprosthesis implanted in a single centre

Abstract

Transcatheter aortic valve implantation (TAVI) with self-expandable Medtronic CoreValve (MCV; Medtronic, Minneapolis, MN) or balloon-expandable Edwards SAPIEN XT valve (ESV; Edwards Lifesciences, Irvine, CA) has been widely used for treatment of high-risk patients with severe aortic stenosis (AS). There is limited data comparing the long-term hemodynamic performance of these two valves. Therefore, this study aimed to compare the short and long-term hemodynamic performance of TAVI with either MCV or ESV. A total of 78 patients who underwent TAVI in our center between June 01, 2012 and January 01, 2014 were enrolled in this retrospective study. For each of the patients we recorded the preprocedural echocardiographic data as well as the post-TAVI echocardiographic outcomes at day one, 6 months and 1 year. The MCV group had lower transaortic gradients than the ESV group, with respect to both maximum (13.4 ± 5.8 vs 18.7 ± 8.1 mmHg, p = 0.001) and mean values (6.5 ± 3.2 vs 9.4 ± 4.3 mmHg, p < 0.001) at post-TAVI day one. These values continued to be significantly lower in the MCV group during post-TAVI 6 months (p < 0.001) and post-TAVI 1 year follow-up (p < 0.05). A paravalvular leak (PVL, grade ≥2) was observed in 6.4 % of patients after TAVI; however, this value decreased over time, and there was no significant difference between the MVC and ESV groups (8.2 vs 3.4 %, p = 0.646). The MCV bioprosthesis was associated with lower transaortic gradients than those of the ESV throughout 1 year of follow-up. The incidence of PVL grade ≥2 in MCV and ESV was comparable.

Evaluation of structural valve deterioration and bioprosthetic valve failure utilizing the new European consensus definition in patients undergoing TAVI with first-generation devices: Outcomes beyond 5 years from a single center in Turkey

“…Previous studies demonstrated that MCV implantation was related to better hemodynamic performance than ESV implantation. It was observed that maximum and MG were significantly lower and the effective orifice area was significantly larger with an MCV compared with an ESV (34)(35)(36)(37). In this study, both valves demonstrated significant decreases in MG following TAVI, and MG remained low and stable over time.…”

“…The incidence of PVL after TAVI has been reported to be between 7% and 24%. However, it has been demonstrated that its frequency decreases over time (36). In the new standardized definition, PVL has not been regarded as SVD, and it was defined as nonstructional deterioration.…”

Long‐term outcomes of self‐expanding versus balloon‐expandable transcatheter aortic valves: Insights from the OBSERVANT study

“…A number of studies have shown favorable clinical outcomes of both early‐ and new‐generation, intra‐annular balloon‐expandable (BE) and supra‐annular self‐expanding (SE) transcatheter aortic valves (TAVs) at long term. However, head‐to‐head comparisons between these two device technologies are limited and most of them do not extend beyond 1 year follow‐up 3‐8 . Considering such a paucity of evidence, it is crucial to assess whether any difference may emerge at longer‐term period between BE and SE TAVs.…”

“…However, head-to-head comparisons between these two device technologies are limited and most of them do not extend beyond 1 year follow-up. [3][4][5][6][7][8] Considering such a paucity of evidence, it is crucial to assess whether any difference may emerge at longer-term period between BE and SE TAVs. The aim of this analysis from the OBservational Study of Effectiveness of SAVR-TAVI procedures for severe Aortic steNosis Treatment (OBSERVANT) Study is to compare long-term clinical outcomes of patients treated with TAVI using either supra-annular SE and intra-annular BE TAVs.…”

Validation of methods for effective orifice area measurement of prosthetic valves by two-dimensional and Doppler echocardiography following transcatheter self-expanding aortic valve implantation

“…Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to standard surgical aortic valve replacement (SAVR) in high-risk patients with severe aortic stenosis. Five-year results in real-world, elderly, high-risk patients undergoing TAVI with a self-expanding bio-prosthesis provided evidence for continued valve durability with low rates of reinterventions and hemodynamic valve dysfunction [1][2][3].…”