Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement With the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve

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• 作者：Sarkis Kiramijyan ; MD ; Marco A. Magalhaes ; MD ; Edward Koifman ; MD ; Romain Didier ; MD ; Ricardo O. Escarcega ; MD ; Nevin C. Baker ; DO ; Smita I. Negi ; MD ; Sa'ar Minha ; MD ; Rebecca Torguson ; MPH ; Gai Jiaxiang ; MSPH ; Federico M. Asch ; MD ; Zuyue Wang ; MD ; Petros Okubagzi ; MD ; Michael A. Gaglia Jr. ; MD ; Itsik Ben-Dor ; MD ; Lowell F. Satler ; MD ; Augusto D. Pichard ; MD ; Ron Waksman ; MD ; ^{ron.waksman@medstar.net" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Cardiology
• 出版年：2016
• 出版时间：1 May 2016
• 年：2016
• 卷：117
• 期：9
• 页码：1502-1510
• 全文大小：1008 K

文摘

The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR.