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Aidietis A, Srimahachota S, Dabrowski M, Bilkis V, Buddhari W, Cheung GSH, Nair RK, Mussayev AA, Mattummal S, Chandra P, Mahajan AU, Chmielak Z, Govindan SC, Jose J, Hiremath MS, Chandra S, Shetty R, Mohanan S, John JF, Mehrotra S, Søndergaard L. 30-Day and 1-Year Outcomes With HYDRA Self-Expanding Transcatheter Aortic Valve: The Hydra CE Study. JACC Cardiovasc Interv 2022; 15:93-104. [PMID: 34991828 DOI: 10.1016/j.jcin.2021.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/17/2021] [Accepted: 09/07/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This study sought to evaluate the 30-day and 1-year safety and performance of the Hydra transcatheter aortic valve (THV) (in the treatment of symptomatic severe aortic stenosis in patients at high or extreme surgical risk. BACKGROUND The Hydra THV is a novel repositionable self-expanding system with supra-annular bovine pericardial leaflets. METHODS The Hydra CE study was a premarket, prospective, multicenter, single-arm study conducted across 18 study centers in Europe and Asia-Pacific countries. The primary endpoint was all-cause mortality at 30 days. All endpoints were adjudicated by an independent clinical events committee. RESULTS A total of 157 patients (79.2 ± 7.1 years of age, 58.6% female; Society of Thoracic Surgeons score 4.7 ± 3.4%) were enrolled. Successful implantation was achieved in 94.3% cases. At 30 days, there were 11 (7.0%) deaths, including 9 (5.7%) cardiovascular deaths, of which 5 (3.2%) were device related. At 1 year, there were 23 (14.6%) deaths, including 13 (8.3%) cardiovascular deaths. At 30 days, there were significant improvement of effective orifice area (from 0.7 ± 0.2 cm2 to 1.9 ± 0.6 cm2) and mean aortic valve gradient (from 49.5 ± 18.5 mm Hg to 8.1 ± 3.7 mm Hg), which were sustained up to 1 year. Moderate or severe paravalvular leak was observed in 6.3% of patients at 30 days and 6.9% of patients at 1 year. The rate of new permanent pacemaker implantation was 11.7% at 30 days and 12.4% at 1 year. CONCLUSIONS The Hydra CE study demonstrated that transcatheter aortic valve replacement with Hydra THV offered favorable efficacy at 1 year, providing large effective orifice area and low transvalvular gradient as well as acceptable complication rates with regard to new permanent pacemaker and paravalvular leak. (A Clinical Evaluation of the HYDRA Self Expanding Transcatheter Aortic Valve; NCT02434263).
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Affiliation(s)
- Audrius Aidietis
- Cardiology and Angiology Centre, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Suphot Srimahachota
- Cardiac Center and Division of Cardiovascular Disease, Department of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - Maciej Dabrowski
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Vaildas Bilkis
- Cardiology and Angiology Centre, Vilnius University Hospital Santaros Clinics, Vilnius, Lithuania
| | - Wacin Buddhari
- Cardiac Center and Division of Cardiovascular Disease, Department of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand
| | - Gary S H Cheung
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong SAR
| | - Rajesh K Nair
- Department of Cardiology, Waikato Hospital, Hamilton, New Zealand
| | - Abdurashid A Mussayev
- Catheterization Laboratory, National Research Center for Cardiac Surgery, Astana, Kazakhstan
| | - Shafeeq Mattummal
- Department of Adult Cardiology, ASTER MIMS Hospital, Kozhikode, India
| | - Praveen Chandra
- Division of Interventional Cardiology, Medanta The Medicity Hospital, Gurgaon, India
| | - Ajay U Mahajan
- Department of Cardiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, India
| | - Zbigniew Chmielak
- Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland
| | - Sajeev C Govindan
- Department of Cardiology, Government Medical College, Calicut, India
| | - John Jose
- Department of Cardiology, Cardiology Unit 2, Christian Medical College Hospital, Vellore, India
| | | | - Sharad Chandra
- Department of Cardiology (Lari Heart Center), King George's Medical University, Lucknow, India
| | - Ranjan Shetty
- Department of Cardiology, Manipal Hospital, Bengaluru, India
| | - Sandeep Mohanan
- KMCT Heart Institute, KMCT Medical College Hospital, Kozhikode, India
| | - John F John
- Department of Cardiology, Baby Memorial Hospital, Calicut, India
| | - Sanjay Mehrotra
- Department of Cardiology, NH Institute of Cardiac Sciences, Bangalore, India
| | - Lars Søndergaard
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
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