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Elzomor H, Wienemann H, Rudolph TK, Adam M, Soliman O, Seth A, Leon MB, Figulla HR, Serruys PW. Valve Replacement for Pure Native Aortic Regurgitation From Alpha to Omega. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2023; 47:93-96. [PMID: 36151020 DOI: 10.1016/j.carrev.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/08/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Hesham Elzomor
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland, and CORRIB Research Centre for Advanced Imaging and Core laboratory; Islamic Center of Cardiology and Cardiac Surgery, Al-Azhar University, Cairo, Egypt
| | - Hendrik Wienemann
- Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Tanja K Rudolph
- General and Interventional Cardiology/Angiology, Heart and Diabetes Centre Nordrhine-Westfalia, Bad Oeynhausen, Ruhr-University, Germany
| | - Matti Adam
- Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Osama Soliman
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland, and CORRIB Research Centre for Advanced Imaging and Core laboratory
| | - Ashok Seth
- Fortis Escorts Heart Institute, New Delhi, India
| | - Martin B Leon
- Structural Heart and Valve Center, NewYork-Presbyterian Hospital, Columbia University Irving Medical Center, New York City, NY, USA
| | - Hans R Figulla
- Universitätskliniken, Friedrich-Schiller Universität, Jena, Germany
| | - Patrick W Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway, Ireland, and CORRIB Research Centre for Advanced Imaging and Core laboratory; NHLI, Imperial College London, London, United Kingdom.
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Wang R, Kawashima H, Mylotte D, Rosseel L, Gao C, Aben JP, Abdelshafy M, Onuma Y, Yang J, Soliman O, Tao L, Serruys PW. Quantitative Angiographic Assessment of Aortic Regurgitation After Transcatheter Implantation of the Venus A-valve: Comparison with Other Self-Expanding Valves and Impact of a Learning Curve in a Single Chinese Center. Glob Heart 2021; 16:54. [PMID: 34381675 PMCID: PMC8344958 DOI: 10.5334/gh.1046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 07/20/2021] [Indexed: 01/14/2023] Open
Abstract
Objectives We aimed to compare the quantitative angiographic aortic regurgitation (AR) into the left ventricular out flow tract (LVOT-AR) of five different types of transcatheter self-expanding valves and to investigate the impact of the learning curve on post-TAVR AR. Background Quantitative video densitometric aortography is an objective, accurate, and reproducible tool for assessment of AR following TAVR. Methods and results This retrospective academic core-lab analysis, analyzed 1150 consecutive cine aortograms performed immediately post-TAVR. Quantitative angiographic AR of post-procedural aortography in 181 consecutive patients, who underwent TAVR with the Venus A-valve in a single Chinese center, were compared to the results of Evolut Pro, Evolut R, CoreValve, (Medtronic, Dublin, Ireland) and Acurate Neo (Boston Scientific, Massachusetts, US) transcatheter heart valves (THVs), from a previously published pooled database. Among the 181 aortograms of patients treated with the Venus A-Valve, 113 (62.4%) were analyzable for quantitative assessment of AR. The mean LVOT-AR was 8.9% ± 10.0% with 14.2% of patients having moderate or severe AR in the Venus A-valve group. No significant difference in mean LVOT-AR was observed between Evolut Pro, Evolut R, Acurate Neo, and Venus A-valve. The incidence of LVOT-AR >17%, which correlates with echocardiographic derived ≥ moderate AR, with the Evolut Pro was lower than with the Venus A-valve (5.3% vs. 14.2%, p = 0.034), but was not different from the Evolut R (5.3% vs. 8.8%, p = 0.612), or the Acurate Neo (5.3% vs. 11.3% p = 0.16) systems. A landmark analysis after recruitment of the first half of patients treated with the Venus A valve (N = 56), showed a significantly lower mean LVOT-AR in the second half of the series (11.3% ± 11.9% vs. 6.5% ± 7.1%, p = 0.011). The incidence of LVOT-AR >17% in the latest 57 cases was also numerically lower (7.0% vs. 21.4%, p = 0.857) and compared favorably with the best in class of the self-expanding valves. Conclusion The Venus A-valve has comparable mean LVOT-AR to other self-expanding valves but has a higher rate of moderate or severe AR than the Evolut Pro THV. However, after completion of a learning phase, results improved and compared favorably with the best in class of the commercially available self-expanding valves. These findings should be confirmed in prospective randomized comparisons of AR between different THVs.
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Affiliation(s)
- Rutao Wang
- Department of Cardiology, Xijing Hospital, Xi’an, CN
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
- Department of Cardiology, Radboud University Medical Center, Nijmegen, NL
| | - Hideyuki Kawashima
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
- Amsterdam UMC, University of Amsterdam, Heart Center, Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam, NL
| | - Darren Mylotte
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
| | - Liesbeth Rosseel
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
| | - Chao Gao
- Department of Cardiology, Xijing Hospital, Xi’an, CN
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
- Department of Cardiology, Radboud University Medical Center, Nijmegen, NL
| | | | - Mahmoud Abdelshafy
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
| | - Yoshinobu Onuma
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, Xi’an, CN
| | - Osama Soliman
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
| | - Ling Tao
- Department of Cardiology, Xijing Hospital, Xi’an, CN
| | - Patrick W. Serruys
- Department of Cardiology, National University of Ireland, Galway (NUIG), Galway and CORRIB Research Center for Advanced Imaging and Core laboratory, IE
- NHLI, Imperial College London, London, UK
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