1-Year Outcomes of the CENTERA-EU Trial Assessing a Novel Self-Expanding Transcatheter Heart Valve.


Journal

JACC. Cardiovascular interventions
ISSN: 1876-7605
Titre abrégé: JACC Cardiovasc Interv
Pays: United States
ID NLM: 101467004

Informations de publication

Date de publication:
08 04 2019
Historique:
received: 30 09 2018
revised: 30 12 2018
accepted: 11 01 2019
entrez: 6 4 2019
pubmed: 6 4 2019
medline: 17 6 2020
Statut: ppublish

Résumé

The purpose of this study is to report the 1-year results of the CENTERA-EU trial. The CENTERA transcatheter heart valve (THV) (Edwards Lifesciences, Irvine, California) is a low-profile (14-F eSheath compatible), self-expanding nitinol valve, with a motorized delivery system allowing for repositionability. The 30-day results of the CENTERA-EU trial demonstrated the short-term safety and effectiveness of the valve. Implantations were completed in 23 centers in Europe, Australia, and New Zealand. Transfemoral access was used in all patients. Echocardiographic outcomes were adjudicated by a core laboratory at baseline, discharge, 30 days, 6 months, and 1 year. Major adverse clinical events were adjudicated by an independent clinical events committee. Between March 2015 and July 2016, 203 high-risk patients (age 82.7 ± 5.5 years, 67.5% women, 68.0% New York Heart Association functional class III or IV, Society of Thoracic Surgeons score 6.1 ± 4.2%) with severe, symptomatic aortic stenosis underwent transcatheter aortic valve replacement with the CENTERA THV. The primary endpoint of the study was 30-day mortality (1.0%). At 1 year, overall mortality was 9.1%, cardiovascular mortality was 4.6%, disabling stroke was 4.1%, new permanent pacemakers were implanted in 6.5% of patients at risk, and cardiac-related rehospitalization was 6.8%. Hemodynamic parameters were stable at 1 year, with a mean aortic valve gradient of 8.1 ± 4.7 mm Hg, a mean effective orifice area of 1.7 ± 0.42 cm The CENTERA-EU trial demonstrated mid-term safety and effectiveness of the CENTERA THV, with low mortality, sustained improvements in hemodynamic performances, and low incidence of permanent pacemaker implantations in high-risk patients with symptomatic aortic stenosis. (Safety and Performance of the Edwards CENTERA-EU Self-Expanding Transcatheter Heart Valve [CENTERA-2]; NCT02458560).

Sections du résumé

OBJECTIVES
The purpose of this study is to report the 1-year results of the CENTERA-EU trial.
BACKGROUND
The CENTERA transcatheter heart valve (THV) (Edwards Lifesciences, Irvine, California) is a low-profile (14-F eSheath compatible), self-expanding nitinol valve, with a motorized delivery system allowing for repositionability. The 30-day results of the CENTERA-EU trial demonstrated the short-term safety and effectiveness of the valve.
METHODS
Implantations were completed in 23 centers in Europe, Australia, and New Zealand. Transfemoral access was used in all patients. Echocardiographic outcomes were adjudicated by a core laboratory at baseline, discharge, 30 days, 6 months, and 1 year. Major adverse clinical events were adjudicated by an independent clinical events committee.
RESULTS
Between March 2015 and July 2016, 203 high-risk patients (age 82.7 ± 5.5 years, 67.5% women, 68.0% New York Heart Association functional class III or IV, Society of Thoracic Surgeons score 6.1 ± 4.2%) with severe, symptomatic aortic stenosis underwent transcatheter aortic valve replacement with the CENTERA THV. The primary endpoint of the study was 30-day mortality (1.0%). At 1 year, overall mortality was 9.1%, cardiovascular mortality was 4.6%, disabling stroke was 4.1%, new permanent pacemakers were implanted in 6.5% of patients at risk, and cardiac-related rehospitalization was 6.8%. Hemodynamic parameters were stable at 1 year, with a mean aortic valve gradient of 8.1 ± 4.7 mm Hg, a mean effective orifice area of 1.7 ± 0.42 cm
CONCLUSIONS
The CENTERA-EU trial demonstrated mid-term safety and effectiveness of the CENTERA THV, with low mortality, sustained improvements in hemodynamic performances, and low incidence of permanent pacemaker implantations in high-risk patients with symptomatic aortic stenosis. (Safety and Performance of the Edwards CENTERA-EU Self-Expanding Transcatheter Heart Valve [CENTERA-2]; NCT02458560).

Identifiants

pubmed: 30947942
pii: S1936-8798(19)30387-5
doi: 10.1016/j.jcin.2019.01.231
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02458560']

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

673-680

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Didier Tchétché (D)

Groupe Cardiovasculaire Interventionnel, Clinique Pasteur, Toulouse, France. Electronic address: d.tchetche@clinique-pasteur.com.

Stephan Windecker (S)

Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

A Markus Kasel (AM)

Department of Cardiovascular Diseases, German Heart Center, Munich, Germany.

Ulrich Schaefer (U)

Department of Cardiology, Marienkrankenhaus, Hamburg, Germany.

Stephen Worthley (S)

Department of Cardiovascular Medicine, Royal Adelaide Hospital, Adelaide Australia.

Axel Linke (A)

Department of Internal Medicine and Cardiology, Herzzentrum Dresden, Universitätsklinik an der Technischen Universität Dresden, Dresden, Germany.

Mohamed Abdel-Wahab (M)

Cardiology Department, Heart Center and Leipzig Heart Institute, University of Leipzig, Leipzig, Germany.

Herve Le Breton (H)

Service de Cardiologie, CHU Rennes, Rennes, France; U1099, INSERM, Rennes, France; LTSI, Université de Rennes 1, Rennes, France.

Lars Søndergaard (L)

Cardiology Department, Rigshospitalet, Copenhagen, Denmark.

Mark S Spence (MS)

Cardiology Department, Royal Victoria Hospital, Belfast, United Kingdom.

Sonia Petronio (S)

Cardiothoracic and Vascular Department, Ospedale di Cisanelo, Pisa, Italy.

Helmut Baumgartner (H)

Department of Cardiology III: Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Münster, Germany.

Tomas Hovorka (T)

Statistics Department, Edwards Lifesciences, Prague, Czech Republic.

Philipp Blanke (P)

Department of Radiology, University of British Columbia, Vancouver, Canada.

Hermann Reichenspurner (H)

Department of Cardiovascular Surgery, University Heart Center, Hamburg, Germany.

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