Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve Replacement

Kodali, Susheel; Williams, Mathew; Smith, Craig R.; Svensson, Lars G.; Webb, John G.; Makkar, Raj; Fontana, Gregory P.; Dewey, Todd M.; Thourani, Vinod H.; Pichard, Augusto D.; Fischbein, Michael P.; Szeto, Wilson Y.; Lim, Scott; Greason, Kevin L.; Teirstein, Paul S.; Malaisrie, S. Chris; Douglas, Pamela S.; Hahn, Rebecca T.; Whisenant, Brian; Zajarías, Alan; Wang, Duolao; Akin, Jodi J.; Anderson, William N.; Leon, Martin B.; Investigators, Trial

doi:10.1056/nejmoa1200384

Cited by 2,055 publications

(1,225 citation statements)

References 39 publications

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“…33 In addition, paradoxical septal motion and dyssynchrony of ventricular contraction is common postbypass, an additional element likely contributing to decreased SV after SAVR. Lastly, another explanation may be the greater frequency of paravalvular leak after TAVR vs. SAVR 34 that may alter LV remodeling and limit LV mass regression; however even when the patients with moderate to severe AR were excluded, there was still a greater decrease in LV mass with SAVR compared to TAVR. Furthermore, there was no significant difference in the degree of MR at baseline and by 6 months to explain the difference in LV mass regression.…”

Section: Discussionmentioning

confidence: 99%

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

et al. 2017

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Section: Discussionmentioning

confidence: 99%

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

et al. 2017

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“…Moderate-to-severe PVL after TAVI has been found to impair outcomes [21,22]. The presence of raphes, calcifications and difficulties in accurate positioning of the THV contribute to the risk of PVL in BAV patients.…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic changes after transcatheter aortic valve implantation during sequential follow-ups in patients with bicuspid aortic valve compared with tricuspid aortic valve

et al. 2017

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[-0.25, 5.00] mm Hg, p = 0.57 at 1 month; p = 0.21 at 3 months; 0.96 ± 7.81 vs. 1.53 ± 5.85 mm Hg, p = 0.79 at 6 months; 2.25] vs. 3.00 [-0.50, 7.50] mm Hg, p = 0.07 at 1 year). Moreover, the incidence of ≥ mild PVL was not significantly different in patients with p = 0.14 at 1 month; 45.83% vs. 27.27%, p = 0.19 at 3 months; 30.00% vs. 23.53%, p = 0.89 at 6 months; 30.00% vs. 17.65%, p = 0.56 at 1 year). Conclusions: TAVI is effective and applicable in BAV anatomy with sustained and acceptable mid--term prosthesis hemodynamic performance. (Cardiol J 2017; 24, 4: 350-357)

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“…Transcatheter aortic valve replacement (TAVR) has become the standard of care for inoperable and high surgical risk patients affected by symptomatic severe aortic stenosis (AS) (1,2). Recent studies also suggest favorable results with transfemoral (TF) TAVR compared to conventional surgery in patients at intermediate risk, both for self-expandable and balloon-expandable transcatheter heart valves (THV) (3)(4)(5)(6).…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes and prosthesis performance after transcatheter aortic valve replacement: results of self-expandable and balloon-expandable transcatheter heart valves

Tarantini

Purita

D’Onofrio

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Data on transcatheter aortic valve replacement (TAVR) long-term clinical outcomes and hemodynamic performance of the self-expandable CoreValve (CV) and the balloon-expandable Edwards SAPIEN XT (ES) (Edwards Lifesciences, Irvine, California, USA) transcatheter heart valves (THV) are limited. Therefore, this study aimed to compare long-term clinical outcome data and hemodynamic performance of TAVR with either CV or ES. Results: Out of 171 patients treated with TAVR at our Institution, 87 received a CV and 84 an ES THV.Mean age was 81 [78][79][80][81][82][83][84][85] years, and mean Society of Thoracic Surgeons (STS) score was 7.5% (4.5-13.9%).Hemodynamic success by Valve Academic Research Consortium (VARC) definition was 97.1%. Mean trans-prosthetic gradient remained low and stable during follow-up in both groups (at 5-year 9.2±6.4 versus 12.7±5.1 mmHg, P=0.10). Late prosthesis failure occurred in 4 cases (2.4%). Thirty-day mortality was 4.7%, and estimated survival rates by Kaplan-Meyer after 1, 5 and 8 years were 87.6%, 44.9%, and 24.5%, respectively, without difference between THV groups. Rates of cardiovascular death, stroke, myocardial infarction (MI) and congestive heart failure (CHF) were also similar with CV and ES at long-term followup. History of CHF, pre-existent severe mitral regurgitation, paravalvular leak grade ≥2+, and chronic obstructive pulmonary disease were independent predictors of late mortality at multivariable analysis.Conclusions: Clinical and hemodynamic outcomes of patients treated by self-expandable CV or balloonexpandable ES THV were favorable and similar throughout long-term follow-up, with a rate of prosthesis failure of less than 3%.

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Two-Year Outcomes after Transcatheter or Surgical Aortic-Valve Replacement

Cited by 2,055 publications

References 39 publications

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

A Paradox between LV Mass Regression and Hemodynamic Improvement after Surgical and Transcatheter Aortic Valve Replacement

Hemodynamic changes after transcatheter aortic valve implantation during sequential follow-ups in patients with bicuspid aortic valve compared with tricuspid aortic valve

Long-term outcomes and prosthesis performance after transcatheter aortic valve replacement: results of self-expandable and balloon-expandable transcatheter heart valves

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