Gomes, Bruna;
Geis, Nicolas A.;
Chorianopoulos, Emmanuel;
Meder, Benjamin;
Leuschner, Florian;
Katus, Hugo A.;
Bekeredjian, Raffi
Improvements of Procedural Results With a New‐Generation Self‐Expanding Transfemoral Aortic Valve Prosthesis in Comparison to the Old‐Generation Device
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Media type:
E-Article
Title:
Improvements of Procedural Results With a New‐Generation Self‐Expanding Transfemoral Aortic Valve Prosthesis in Comparison to the Old‐Generation Device
Contributor:
Gomes, Bruna;
Geis, Nicolas A.;
Chorianopoulos, Emmanuel;
Meder, Benjamin;
Leuschner, Florian;
Katus, Hugo A.;
Bekeredjian, Raffi
imprint:
Wiley, 2017
Published in:Journal of Interventional Cardiology
Language:
English
DOI:
10.1111/joic.12356
ISSN:
0896-4327;
1540-8183
Origination:
Footnote:
Description:
<jats:sec><jats:title>Objectives</jats:title><jats:p>In this study, we compare procedural results of our first Evolut R (Medtronic, Minneapolis, MN, USA) implantations with the last CoreValve implantations. Main endpoints include paravalvular regurgitation, major vascular complications, stroke, and pacemaker implantation.</jats:p></jats:sec><jats:sec><jats:title>Background</jats:title><jats:p>The evolution of transcatheter aortic valve replacement (TAVR) was possible due to various technical improvements, leading to better periprocedural and long‐term outcome. The newly designed Evolut R valve has the potential to further improve TAVR's performance.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We retrospectively analyzed our first 100 consecutive patients who received the Evolut R valve with the last 100 consecutive patients who received the CoreValve prosthesis between July 2013 and February 2016. Only patients treated with a 26 mm or 29 mm bioprosthesis were included.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>No significant differences in patient characteristics were noticed. Both angiography and echocardiography after TAVR showed significantly higher rates of “none or trace” regurgitation in the Evolut R group (angiography: 67% Evolut R vs. 29.3% CoreValve; P < 0.001; echocardiography: 68% Evolut R vs. 46.5% CoreValve; P < 0.05). No significant differences were seen in 30‐day mortality (7% CoreValve vs. 1% Evolut R), stroke rates (3% CoreValve vs. 2% Evolut R), pacemaker implantation rates (24% CoreValve vs. 23% Evolut R), and major vascular complications (6% CoreValve vs. 1% Evolut R). Implantations were significantly higher with the Evolut R prosthesis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>TAVR with the new Evolut R resulted in significantly lower paravalvular regurgitation. This may be due to redesigned cell geometry and higher precision during implantations, as well as the ability to resheath a malpositioned valve.</jats:p></jats:sec>