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Alvarado T, Rivero F, Diego G, García-Guimaraes M, Salamanca J, Díez-Villanueva P, Cuesta J, Antuña P, Jiménez-Borreguero J, Alfonso F. Transcatheter aortic valve replacement using the new Evolut-Pro system: a prospective comparison with the Evolut-R device. J Thorac Dis 2021; 13:4023-4032. [PMID: 34422332 PMCID: PMC8339791 DOI: 10.21037/jtd-20-2409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 05/12/2021] [Indexed: 11/25/2022]
Abstract
Background Evolut Pro (EVP) is a novel self-expandable aortic valve. This prosthesis consists of an external porcine pericardial wrap designed to reduce paravalvular leak (PVL), maintaining the benefits of its predecessor, the Evolut R (EVR). The aim was to compare the functional and clinical results in the short and medium term of the new EVP with the EVR system. Methods Consecutive patients receiving either the EVR (n=50) or the EVP (n=33) from June 2015 to October 2018 were compared. Baseline characteristics, cardiovascular imaging, procedural outcomes, short and mid-term follow-up outcomes were prospectively collected and assessed. Results Residual mild PVL was common and comparable in the two groups (EVR 79% vs. EVP 70%; P=0.4). In the EVR group, the presence of PVL was directly related to prosthesis size, but this correlation was not observed in the EVP group. Conduction abnormalities were more prevalent with the EVP, but these did not translate into a higher need of permanent pacemaker implantation. Vascular and bleeding complications were infrequent in both groups. At mid-term clinical follow-up (median survival time: EVR 11±0.3 months, EVP 12±0.2 months), the 1-year rate of adverse events was similar (EVR: 24%, EVP: 33%; P=0.3). Conclusions Both protheses are effective for the treatment of severe aortic stenosis with excellent results at mid-term clinical follow up. The EVP remains associated with a significant rate of residual mild PVL that appears to be similar to that observed with EVR.
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Affiliation(s)
- Teresa Alvarado
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Fernando Rivero
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Guillermo Diego
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Jorge Salamanca
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Javier Cuesta
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Paula Antuña
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
| | | | - Fernando Alfonso
- Department of Cardiology, Hospital Universitario de La Princesa, Madrid, Spain
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2
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Modolo R, Chang CC, Onuma Y, Schultz C, Tateishi H, Abdelghani M, Miyazaki Y, Aben JP, Rutten MC, Pighi M, El Bouziani A, van Mourik M, Lemos PA, Wykrzykowska JJ, Brito FS, Sahyoun C, Piazza N, Eltchaninoff H, Soliman O, Abdel-Wahab M, Van Mieghem NM, de Winter RJ, Serruys PW. Quantitative aortography assessment of aortic regurgitation. EUROINTERVENTION 2020; 16:e738-e756. [DOI: 10.4244/eij-d-19-00879] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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3
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Ovcharenko EA, Klyshnikov KU, Ganyukov VI, Shilov AA, Vereshchagin IE, Sizova IN, Tarasov RS, Barbarash LS. Prognostic Model of Typical Complications Caused by Transcatheter Aortic Valve Replacement. Sovrem Tekhnologii Med 2020; 12:27-32. [PMID: 34513050 PMCID: PMC8353678 DOI: 10.17691/stm2020.12.2.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Indexed: 11/14/2022] Open
Abstract
The aim of the study was to develop a prognostic model based on statistical discriminant analysis to assess the risk of postoperative disturbance of cardiac conduction and paraprosthetic regurgitation after transcatheter aortic valve replacement. Materials and Methods Clinical data of 10 patients implanted with CoreValveTM prostheses (Medtronic Inc., USA) were used to develop prognostic models. To that end, we analyzed changes in hemodynamic and functional parameters provided by echocardiography in the pre- and postoperative periods. Results We observed significant positive changes in the severity of left ventricular myocardial hypertrophy; on the contrary, volume indicators did not significantly change, which might be associated with the concentric type of left ventricular hypertrophy. The discriminant analysis made it possible to determine major (preoperative) morphological and functional indicators associated with the two most common complications of the procedure: left bundle branch block and paraprosthetic regurgitation. Left ventricular posterior wall thickness, interventricular septal thickness, left atrium dimension, and myocardial mass are the critical factors that determine the development of these complications. Conclusion In the prognostic model, the proposed weighting coefficients allow one to assess the risk of postoperative complications; however, the presence of false-positive results requires further refinement of these coefficients within the linear equation.
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Affiliation(s)
- E A Ovcharenko
- Head of Laboratory, Department of Experimental and Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - K U Klyshnikov
- Researcher, Department of Experimental and Clinical Cardiology, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - V I Ganyukov
- Head of Laboratory, Department of Multifocal Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - A A Shilov
- Senior Researcher, Department of Multifocal Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - I E Vereshchagin
- Junior Researcher, Department of Multifocal Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - I N Sizova
- Senior Researcher, Department of Cardiovascular Disease Diagnostics, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - R S Tarasov
- Head of Laboratory, Department of Multifocal Atherosclerosis, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
| | - L S Barbarash
- Professor, Member of the Russian Academy of Sciences, Chief Researcher, Research Institute for Complex Issues of Cardiovascular Diseases, 6 Sosnovy Blvd, Kemerovo, 650002, Russia
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4
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Li YM, Mei FY, Yao YJ, Tsauo JY, Peng Y, Chen M. Causes and predictors of readmission after transcatheter aortic valve implantation : A meta-analysis and systematic review. Herz 2019; 46:1-8. [PMID: 31807789 DOI: 10.1007/s00059-019-04870-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/13/2019] [Accepted: 11/11/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Since readmission rate is an important clinical index to determine the quality of inpatient care and hospital performance, the aim of this study was to explain the causes and predictors of readmission following transcatheter aortic valve implantation (TAVI) at short-term and mid-term follow-up. METHODS AND RESULTS A systematic review and meta-analysis of all published articles from Embase, Pubmed/MEDLINE, and Ovid was carried out. In all, 10 studies including 52,702 patients were identified. The pooled estimate for the overall event rate was 0.15, and cardiovascular causes were the main reason for 30-day readmission (0.42, 95% confidence interval [CI]: 0.39-0.45). In addition, the pooled incidence of 1‑year readmission was 0.31, and cardiovascular events were still the main cause (0.41, 95% CI: 0.33-0.48). Patients with major and life-threatening bleeding, new permanent pacemaker implantation, and clinical heart failure were associated with a high risk for early readmission after TAVI. Moreover, an advanced (≥3) New York Heart Association classification, acute kidney injury, paravalvular leak, mitral regurgitation (≥ moderate), and major bleeding predicted unfavorable outcome to 1‑year readmission. Female gender and transfemoral TAVI was associated with a lower risk for unplanned rehospitalization. CONCLUSIONS This meta-analysis found cardiovascular factors to be the main causes for both 30-day and 1‑year rehospitalization. Heart failure represented the most common cardiovascular event at both short-term and mid-term follow-up. Several baseline characteristics and procedure-related factors were deemed unfavorable predictors of readmission. Importantly, transfemoral access and female gender were associated with a lower risk of readmission.
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Affiliation(s)
- Yi-Ming Li
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, 610041, Chengdu, China
| | - Fu-Yang Mei
- Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Yi-Jun Yao
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Jia-Yu Tsauo
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, 610041, Chengdu, China
| | - Yong Peng
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, 610041, Chengdu, China
| | - Mao Chen
- Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, 610041, Chengdu, China.
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5
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He C, Xiao L, Liu J. Safety and efficacy of self-expandable Evolut R vs. balloon-expandable Sapien 3 valves for transcatheter aortic valve implantation: A systematic review and meta-analysis. Exp Ther Med 2019; 18:3893-3904. [PMID: 31602250 PMCID: PMC6777306 DOI: 10.3892/etm.2019.8000] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to systematically search literature and conduct a meta-analysis comparing the clinical efficacy and safety of Evolut R and Sapien 3 valves for transcatheter aortic valve implantation (TAVI). The PubMed, Biomed Central, Scopus, Cochrane library and Google scholar databases were searched for articles published up to June, 2019. A total of 5 studies were included. In total, 795 patients underwent TAVI with Evolut R, while 665 patients received the Sapien 3 valve in the included studies. Overall device success with Evolut R was 95.7% and with Sapien 3 was 94.2%. Pooled data indicated no significant differences between the 2 valves (OR, 1.12; 95% CI, 0.66–1.89; P=0.68; I2=0%). No significant differences were observed in the incidence of none to mild paravalvular leakage between the 2 groups (OR, 1.71; 95% CI, 0.83–3.54; P=0.14; I2=0%). Both mean [random; mean difference (MD) = −3.96; 95% CI, −4.61 to −3.31; P<0.00001, I2=0%] and peak (random; MD = −6.85; 95% CI, −8.22 to −5.48; P<0.00001, I2=0%) aortic valve gradients were significantly lower with Evolut R. No significant differences were observed in the 30-day mortality (OR, 1.32; 95% CI, 0.45–3.87; P=0.62; I2=0%) or 30-day stroke outcomes (OR, 0.76; 95% CI, 0.32–1.81; P=0.54; I2=0%) between the 2 devices. On the whole, the findings of this study indicate that Evolut R and Sapien 3 valves may be comparable in terms of device success and short-term complications. The differences between the 2 devices for post-operative moderate to severe paravalvular leak and permanent pacemaker implantation remain unclear. There is thus a need for a large multi-center randomized controlled trial to provide stronger evidence on this subject.
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Affiliation(s)
- Chenglin He
- Department of Cardiovascular Medicine, Hanchuan People's Hospital, Hanchuan, Hubei 431600, P.R. China
| | - Lang Xiao
- Department of Haematology, Hanchuan Hospital of Traditional Chinese Medicine, Hanchuan, Hubei 431600, P.R. China
| | - Junli Liu
- Department of Critical Care Medicine, Hanchuan People's Hospital, Hanchuan, Hubei 431600, P.R. China
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6
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Network meta-analysis of new-generation valves for transcatheter aortic valve implantation. Heart Vessels 2019; 34:1984-1992. [PMID: 31144096 DOI: 10.1007/s00380-019-01442-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/24/2019] [Indexed: 11/29/2022]
Abstract
To comprehensively compare and rank new-generation valves (NGVs) for transcatheter aortic valve implantation, we performed a network meta-analysis (NMA) of all eligible comparative studies. MEDLINE and EMBASE were searched through September 2018. We included all studies comparing 4 NGVs (ACURATE, Evolut R, Lotus, and SAPIEN 3) and an early generation valve (CoreValve) as the reference transcatheter heart valve (THV) each other and reporting at least one of postprocedural incidence of all-cause death, ≥ moderate aortic regurgitation (AR), and new permanent pacemaker implantation (PMI). To compare different THVs, a random-effects restricted-maximum-likelihood NMA based on a frequentist framework for indirect and mixed comparisons was used. Using surface under the cumulative ranking curve (SUCRA), the relative ranking probability of each THV was estimated and the hierarchy of competing THVs was obtained. We identified 29 eligible studies enrolling a total of 17,817 patients. In accordance with the estimated SUCRA probability, SAPIEN 3 was the best effective for a reduction in death (80.6%) and the second best for decreased ≥ moderate AR (74.4%) and PMI (74.1%) compared with the other THVs. Lotus was ranked the best for a reduction in ≥ moderate AR (94.5%;), whereas the worst for decreased PMI (1.2%) and the second worst for a reduction in mortality (38.6%). ACURATE was the best for decreased PMI (99.2%) and the second best for a reduction in mortality (77.9%). As a whole, SAPIEN 3 may be the best effective NGV among the 4 examined NGVs (ACURATE, Evolut R, Lotus, and SAPIEN 3).
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Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611, Japan. .,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan.
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, 762-1 Nagasawa, Shimizu-cho, Sunto-gun, Shizuoka, 411-8611, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, New York, NY, USA
| | - Tomo Ando
- Department of Cardiology, Detroit Medical Center, Detroit, MI, USA
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7
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Miyazaki Y, Modolo R, Abdelghani M, Tateishi H, Cavalcante R, Collet C, Asano T, Katagiri Y, Tenekecioglu E, Sarmento-Leite R, Mangione JA, Abizaid A, Soliman OII, Onuma Y, Serruys PW, Lemos PA, Brito FSD. The Role of Quantitative Aortographic Assessment of Aortic Regurgitation by Videodensitometry in the Guidance of Transcatheter Aortic Valve Implantation. Arq Bras Cardiol 2018; 111:193-202. [PMID: 30183986 PMCID: PMC6122904 DOI: 10.5935/abc.20180139] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/07/2018] [Indexed: 12/26/2022] Open
Abstract
Background Balloon post-dilatation (BPD) is often needed for optimizing transcatheter
heart valve (THV) implantation, since paravalvular leak (PVL) after
transcatheter aortic valve implantation is associated with poor outcome and
mortality. Quantitative assessment of PVL severity before and after BPD is
mandatory to properly assess PVL, thus improving implantation results and
outcomes. Objective To investigate a quantitative angiographic assessment of aortic regurgitation
(AR) by videodensitometry before and after BPD. Methods Videodensitometric-AR assessments (VD-AR) before and after BPD were analysed
in 61 cases. Results VD-AR decreased significantly from 24.0[18.0-30.5]% to 12.0[5.5-19.0]% (p
< 0.001, a two-tailed p < 0.05 defined the statistical significance).
The relative delta of VD-AR after BPD ranged from -100% (improvement) to
+40% (deterioration) and its median value was -46.2%. The frequency of
improvement, no change, and deterioration were 70% (n = 43), 25% (n = 15)
and 5% (n = 3), respectively. Significant AR (VD-AR > 17%) was observed
in 47 patients (77%) before and in 19 patients (31%) after BPD. Conclusions VD-AR after THV implantation provides a quantitative assessment of post-TAVI
regurgitation and can help in the decision-making process on performing BPD
and in determining its efficacy.
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Affiliation(s)
- Yosuke Miyazaki
- Department of Cardiology - Thoraxcenter, Erasmus Medical Center Rotterdam, Rotterdam - Netherlands
| | - Rodrigo Modolo
- Department of Cardiology - the Academic Medical Center - University of Amsterdam, Amsterdam - Netherlands.,Departamento de Medicina Interna - Divisão de Cardiologia - Universidade de Campinas (UNICAMP), Campinas, SP - Brazil
| | - Mohammad Abdelghani
- Department of Cardiology - the Academic Medical Center - University of Amsterdam, Amsterdam - Netherlands
| | - Hiroki Tateishi
- Division of Cardiology - Department of Clinical science and Medicine - Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi - Japan
| | - Rafael Cavalcante
- Department of Cardiology - Thoraxcenter, Erasmus Medical Center Rotterdam, Rotterdam - Netherlands
| | - Carlos Collet
- Department of Cardiology - the Academic Medical Center - University of Amsterdam, Amsterdam - Netherlands
| | - Taku Asano
- Department of Cardiology - the Academic Medical Center - University of Amsterdam, Amsterdam - Netherlands
| | - Yuki Katagiri
- Department of Cardiology - the Academic Medical Center - University of Amsterdam, Amsterdam - Netherlands
| | - Erhan Tenekecioglu
- Department of Cardiology - Thoraxcenter, Erasmus Medical Center Rotterdam, Rotterdam - Netherlands
| | - Rogério Sarmento-Leite
- Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia e Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS - Brazil
| | - José A Mangione
- Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP - Brazil
| | | | - Osama I I Soliman
- Department of Cardiology - Thoraxcenter, Erasmus Medical Center Rotterdam, Rotterdam - Netherlands.,Cardialysis, Rotterdam - Netherlands
| | - Yoshinobu Onuma
- Department of Cardiology - Thoraxcenter, Erasmus Medical Center Rotterdam, Rotterdam - Netherlands.,Cardialysis, Rotterdam - Netherlands
| | | | - Pedro A Lemos
- Hospital Israelita Albert Einstein, São Paulo, SP - Brazil
| | - Fabio S de Brito
- Instituto do Coração (InCor), Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP - Brazil
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8
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Efficacy and safety of new-generation transcatheter aortic valves: insights from the Israeli transcatheter aortic valve replacement registry. Clin Res Cardiol 2018; 108:430-437. [PMID: 30238186 DOI: 10.1007/s00392-018-1372-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/13/2018] [Indexed: 12/19/2022]
Abstract
AIM To compare procedural outcomes of transcatheter aortic valve replacement (TAVR) patients treated with new-generation valves. METHODS We performed a retrospective analysis on an Israeli multicenter registry comprised of four tertiary centers, comparing patient outcomes implanted with the Edwards SAPIEN S3 (ES3) vs. the Medtronic Evolut R (MER) valves. RESULTS The study population included 735 patients (ES3 n = 223; MER n = 512). The use of MER was significantly associated (p < 0.05) with higher rates of post-dilatation (35% vs. 10%), and the need for a second valve (2.7% vs. 0.5%). Procedural device success was comparable between groups (97% vs. 98%, p = 0.76); however, moderate angiographic paravalvular leak was higher (3.3% vs. 0.5%, p = 0.027) for MER vs. ES3, respectively. As compared to MER, 1 month echocardiography revealed higher peak and mean aortic valve gradients for ES3 (12/6 vs. 17/10 mmHg, p < 0.001, respectively). While the safety outcome at 1 month was lower for MER (8.8% vs. 13.9%, p = 0.035), similar 1-month, 1-year, and 3-year all-cause mortality were observed (1.9% vs. 1.3%; 8% vs. 8.5%, and 9.7 vs. 10.3%, for MER vs. ES3, respectively). In a propensity score matching analysis, there was no difference in major outcomes between the groups, including device success and the 1 month safety outcome. CONCLUSION Although favorable efficacy and safety clinical outcomes were observed in this large contemporary registry for both new-generation devices used, some procedural and post-procedural outcomes differ significantly between the two valves.
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9
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Mahtta D, Elgendy IY, Bavry AA. From CoreValve to Evolut PRO: Reviewing the Journey of Self-Expanding Transcatheter Aortic Valves. Cardiol Ther 2017; 6:183-192. [PMID: 29080095 PMCID: PMC5688966 DOI: 10.1007/s40119-017-0100-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Indexed: 12/31/2022] Open
Abstract
Transcatheter aortic valve replacement (TAVR) has become standard therapy for patients with severe aortic stenosis who are deemed at least intermediate risk for surgical valve replacement. Over the past decade, several technological advances have taken place to improve the quality and safety of these devices. The current commercially available valves are broadly grouped into balloon expandable and self-expandable valves. The latest iteration of the self-expandable valve is Medtronic's repositionable valve known as the Evolut PRO system. In this review, we highlight the evidence behind the use of TAVR, improvement in devices over previous generations, clinical evidence behind the CoreValve Evolut PRO system, and the future of TAVR.
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Affiliation(s)
- Dhruv Mahtta
- Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Islam Y Elgendy
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Anthony A Bavry
- Division of Cardiology, Department of Medicine, University of Florida, Gainesville, FL, USA.
- North Florida/South Georgia Veterans Health System, Gainesville, FL, USA.
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10
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Schulz E, Jabs A, Tamm A, Herz P, Schulz A, Gori T, von Bardeleben S, Kasper-König W, Hink U, Vahl CF, Münzel T. Comparison of transcatheter aortic valve implantation with the newest-generation Sapien 3 vs. Direct Flow Medical valve in a single center cohort. Int J Cardiol 2017; 232:186-191. [DOI: 10.1016/j.ijcard.2017.01.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 01/02/2017] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
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