Results of new-generation balloon vs. self-expandable transcatheter heart valves for bicuspid aortic valve stenosis

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Magdalena Erlebach¹  Hendrik Ruge¹  Rüdiger Lange¹  Oliver Deutsch¹  Keti Vitanova¹  Markus Krane² 

[1] Department of Cardiovascular Surgery, German Heart Centre Munich, Munich, Germany;Department of Surgery, Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States;

关键词: TAVR - transcatheter aortic valve replacement;    bicuspid aortic valve (BAV);    balloon-expandable valve;    self-expandable valve;    retrospective cohort study;   

DOI  :  10.3389/fcvm.2023.1252163

 received in 2023-07-03, accepted in 2023-08-17,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundData comparing new-generation self-expandable (SEV, Evolut R/PRO) vs. balloon-expandable (BEV, SAPIEN 3/3Ultra) transcatheter heart valve replacement (TAVR) in bicuspid aortic valve stenosis (BAV) is limited. Our aim was to compare 30-day results of SEV and BEV implantations in patients with BAV.MethodsA total of 2009 patients underwent TAVR between April 2015 and June 2021 at our Centre. From our institutional registry, we identified 106 consecutive patients with BAV who underwent TAVR using SEV and BEV.ResultsA 106 patients (n = 68 BEV; n = 38 SEV) were included. Mean age was 74.6 ± 8.8 years (BEV) vs.75.3 ± 8.7 years (SEV) (p = 0.670) and Society of Thoracic Surgeons score was 2.6 ± 1.9 (BEV) vs. 2.6 ± 1.6 (SEV) (p = 0.374), respectively. Device landing zone calcium volume (DLZ-CV) was 1168 ± 811 vs. 945 ± 850 mm3 (p = 0.192). Valve Academic Research Consortium (VARC)-3 device success at 30 days was similar (BEV 80.9% vs. SEV 86.8%; p = 0.433). More post-dilatations were performed in SEVs (23.5% BEV vs. 52.6% SEV; p = 0.002). Overall mean gradient at 30 days follow-up was 11.9 ± 4.6 mmHG (BEV) vs. 9.2 ± 3.0 mmHG (SEV) (p = 0.002). A mild-moderate degree of paravalvular leak (PVL) was detected more often in the SEV group (7.4% vs. 13.2%; p = 0.305). A trend towards higher rate of permanent pacemaker implantation was observed in SEV (11.8% vs. 23.7%; p = 0.109).ConclusionsTreatment of BAV revealed similar performance using BEV and SEV. In this retrospective cohort study, hemodynamics were more favorable with the SEV, although there was a trend toward more PVL and significantly more post-dilations.

【 授权许可】

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© 2023 Deutsch, Vitanova, Ruge, Erlebach, Krane and Lange.