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Comparison of hemodynamic performance of self-expandable CoreValve versus balloon-expandable Edwards SAPIEN aortic valves inserted by catheter for aortic stenosis

Nombela-Franco, Luis, Ruel, Marc, Radhakrishnan, Sam, Webb, John G., Hansen, Marc, Labinaz, Marino, Thompson, Chris, Fremes, Stephen, Dumont, Eric, DeLarochellière, Robert, Doyle, Daniel, Urena, Marina, Mok, Michael, Ribeiro, Henrique Barbosa, Roifman, Idan, Watkins, Stuart, Dumesnil, Jean G., Pibarot, Philippe and Rodés-Cabau, Josep 2013, Comparison of hemodynamic performance of self-expandable CoreValve versus balloon-expandable Edwards SAPIEN aortic valves inserted by catheter for aortic stenosis, The American journal of cardiology, vol. 111, no. 7, pp. 1026-1033, doi: 10.1016/j.amjcard.2012.11.063.

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Title Comparison of hemodynamic performance of self-expandable CoreValve versus balloon-expandable Edwards SAPIEN aortic valves inserted by catheter for aortic stenosis
Author(s) Nombela-Franco, Luis
Ruel, Marc
Radhakrishnan, Sam
Webb, John G.
Hansen, Marc
Labinaz, Marino
Thompson, Chris
Fremes, Stephen
Dumont, Eric
DeLarochellière, Robert
Doyle, Daniel
Urena, Marina
Mok, Michael
Ribeiro, Henrique Barbosa
Roifman, Idan
Watkins, Stuart
Dumesnil, Jean G.
Pibarot, Philippe
Rodés-Cabau, Josep
Journal name The American journal of cardiology
Volume number 111
Issue number 7
Start page 1026
End page 1033
Total pages 8
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2013-04-01
ISSN 0002-9149
1879-1913
Keyword(s) Aged, 80 and over
Analysis of Variance
Angioplasty, Balloon, Coronary
Aortic Valve Insufficiency
Aortic Valve Stenosis
Biomarkers
Bioprosthesis
Cardiac Catheterization
Chi-Square Distribution
Echocardiography, Doppler
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Hemodynamics
Humans
Male
Prospective Studies
Statistics, Nonparametric
Treatment Outcome
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Summary Transcatheter aortic valve implantation with the self-expandable CoreValve (CV) and the balloon-expandable Edwards SAPIEN (ES) bioprostheses has been widely used for the treatment of severe aortic stenosis. However, a direct comparison of the hemodynamic results associated with these 2 prostheses is lacking. The aim of the present study was to compare the hemodynamic performance of both bioprostheses. A total of 41 patients who underwent transcatheter aortic valve implantation with the CV prosthesis were matched 1:1 for prosthesis size (26 mm), aortic annulus size, left ventricular ejection fraction, body surface area, and body mass index with patients who underwent transcatheter aortic valve implantation with the ES prosthesis. Doppler-echocardiographic data were prospectively collected before the intervention and at hospital discharge, and all examinations were sent to, and analyzed in, a central echocardiography core laboratory. The mean transprosthetic residual gradient was lower (p = 0.024) in the CV group (7.9 ± 3.1 mm Hg) than in the ES group (9.7 ± 3.8 mm Hg). The effective orifice area tended to be greater in the CV group (1.58 ± 0.31 cm(2) vs 1.49 ± 0.24 cm(2), p = 0.10). The incidence of severe prosthesis-patient mismatch was, however, similar between the 2 groups (effective orifice area indexed to the body surface area ≤0.65 cm(2)/m(2); CV 9.8%, ES 9.8%, p = 1.0). The incidence of paravalvular aortic regurgitation was greater with the CV (grade 1 or more in 85.4%, grade 2 or more in 39%) than with the ES (grade 1 or more in 58.5%, grade 2 or more in 22%; p = 0.001). The number and extent of paravalvular leaks were greater in the CV group (p <0.01 for both comparisons). In conclusion, transcatheter aortic valve implantation with the CV prosthesis was associated with a lower residual gradient but a greater rate of paravalvular aortic regurgitation compared to the ES prosthesis. The potential clinical consequences of the differences in hemodynamic performance between these transcatheter heart valves needs to be addressed in future studies.
Language eng
DOI 10.1016/j.amjcard.2012.11.063
Field of Research 110201 Cardiology (incl Cardiovascular Diseases)
1102 Cardiovascular Medicine And Haematology
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2013, Elsevier Inc
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073387

Document type: Journal Article
Collection: School of Medicine
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