Long-Term Outcome with New Generation Prostheses in Patients Undergoing Transcatheter Aortic Valve Replacement

Tamm, Alexander; Geyer, Martin; Kreidel, Felix; Dausmann, Lea; Jablonski, Caroline; Hahad, Omar; Schulz, Eberhard; Münzel, Thomas; Bardeleben, Ralph Stephan von

doi:10.3390/jcm10143102

Cited by 4 publications

(1 citation statement)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In light of the current lack of long-term real-world data on Portico, the present results thus provide further evidence that Portico can be considered a promising TAVI device for patients with severe aortic stenosis who are not ideal candidate for cardiac surgery. The high event rates accrued during follow-up in our study should be viewed in light of the all-comer patient sample, as compare in a reasonably favorable fashion to other long-term reports from observational real-world registries on other TAVI devices [ 29 ]. Notably, while not-negligible, rates of permanent pacemaker implantation were reasonably low, especially in light of the patient risk profile (mean age of > 82 years, and features of frailty in almost 40% of patients).…”

Section: Discussionmentioning

confidence: 57%

Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

et al. 2023

View full text Add to dashboard Cite

Aim Transcatheter aortic valve implantation (TAVI) is a mainstay in the management of severe aortic valve stenosis in elderly patients, but there is uncertainty on their long-term effectiveness. We aimed to assess the long-term outcome of patients undergoing TAVI with the Portico valve. Methods We retrospectively collected the data on patients in whom TAVI with Portico was attempted from 7 high-volume centres. Only patients theoretically eligible for 3 or more years of follow-up were included. Clinical outcomes, including death, stroke, myocardial infarction, reintervention for valve degeneration and hemodynamic valve performance were systematically assessed. Results A total of 803 patients were included, with 504 (62.8%) women, mean age of 82 years, median EuroSCORE II of 3.1%, and 386 (48.1%) subjects at low/moderate risk. The median follow-up was 3.0 years (3.0; 4.0). The composite of death, stroke, myocardial infarction, and reintervention for valve degeneration occurred in 37.5% (95% confidence interval: 34.1–40.9%), with all-cause death in 35.1% (31.8–38.4%), stroke in 3.4% (1.3–3.4%), myocardial infarction in 1.0% (0.3–1.5%), and reintervention for valve degeneration in 1.1% (0.6–2.1%). The mean aortic valve gradient at follow-up was 8.1 ± 4.6 mmHg, and at least moderate aortic regurgitation was present in 9.1% (6.7–12.3%). Independent predictors of major adverse events or death were: peripheral artery disease, chronic obstructive pulmonary disease, estimated glomerular filtration rate, atrial fibrillation, prior pacemaker implantation, EuroSCORE II, and reduced left ventricular ejection fraction (all p < 0.05). Conclusions Portico use is associated with favorable long-term clinical outcomes. Clinical outcomes were largely impacted by baseline risk factors and surgical risk.

show abstract

Section: Discussionmentioning

confidence: 57%

Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

et al. 2023

View full text Add to dashboard Cite

show abstract

Meta-analysis of short- and long-term clinical outcomes of the self-expanding Evolut R/pro valve versus the balloon-expandable Sapien 3 valve for transcatheter aortic valve implantation

Lerman¹,

Levi²,

Kornowski³

2023

International Journal of Cardiology

View full text Add to dashboard Cite

Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis

Yang

Liu

et al. 2023

International Journal of Surgery

View full text Add to dashboard Cite

Background: Whether there are differences among the new-generation transcatheter aortic valve implantation (TAVI) devices for patients with aortic stenosis remains unclear. The aim of the study was to compare the efficiency and safety of different new-generation TAVI devices for patients with aortic stenosis. Materials and methods: A comprehensive search of PubMed, Embase and Web of Science from their inception to 1 February 2022. Randomized clinical trials and observational studies that compared two or more different TAVI devices were enroled. Pairwise meta-analysis and frequentist network meta-analysis were conducted to pool the outcome estimates of interest. Results: A total of 79 studies were finally included. According to the surface under the cumulative ranking, the top two ranked valves for lower rates of events were as follows: direct flow medical (DFM) (4.6%) and Lotus (48.8%) for lower rate of device success; Sapien 3 (16.8%) and DFM (19.7%) for lower mortality; DFM (8.6%) and Sapien 3 (25.5%) for lower rates of stroke; Evolut (27.6%) and DFM (35.8%) for lower rates of major and life-threatening bleeding; Portico (22.6%) and Sapien 3 (41.9%) for lower rates of acute kidney injury; Acurate (8.6%) and DFM (13.2%) for lower rates of permanent pacemaker implantation; Lotus (0.3%) and Sapien 3 (22.7%) for lower rates of paravalvular leak; Evolut (1.4%) and Portico (29.1%) for lower rates of mean aortic valve gradients. Conclusions: The findings of the present study suggested that the device success rates were comparable among these new-generation valves except for DFM. After excluding DFM, Sapien 3 might be the best effective for decreased mortality and stroke; Lotus might be the best effective for decreased paravalvular leak; Evolut might be the best effective for decreased major and life-threatening bleeding and mean aortic valve gradients; Acurate and Portico might be the best effective for decreased permanent pacemaker implantation and acute kidney injury, respectively.

show abstract

Long-Term Outcome with New Generation Prostheses in Patients Undergoing Transcatheter Aortic Valve Replacement

Cited by 4 publications

References 22 publications

Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

Long-term outcomes following transcatheter aortic valve implantation with the Portico self-expanding valve

Meta-analysis of short- and long-term clinical outcomes of the self-expanding Evolut R/pro valve versus the balloon-expandable Sapien 3 valve for transcatheter aortic valve implantation

Comparisons of different new-generation transcatheter aortic valve implantation devices for patients with severe aortic stenosis: a systematic review and network meta-analysis

Contact Info

Product

Resources

About