Safety and Performance Outcomes of a Self-Expanding Transcatheter Aortic Heart Valve: The BIOVALVE Trials.


Journal

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

Informations de publication

Date de publication:
27 01 2020
Historique:
received: 18 12 2018
revised: 20 05 2019
accepted: 30 07 2019
pubmed: 21 10 2019
medline: 6 10 2020
entrez: 21 10 2019
Statut: ppublish

Résumé

The aim of this study was to assess the safety and performance of a newly introduced transfemoral self-expanding supra-annular transcatheter heart valve. Transcatheter aortic valve replacement has become an established procedure, and newer transcatheter heart valves aim to supplement the current armamentarium. BIOVALVE-I is a prospective, single-center feasibility study enrolling 13 high-risk patients with severe aortic stenosis, and BIOVALVE-II is a multicenter pilot study enrolling a further 55 patients under the same protocol. Patients' mean age was 82.4 ± 5.3 years, 57.4% had concomitant coronary artery disease, 50.0% had renal insufficiency stage ≥3, 32.4% had diabetes mellitus, 29.4% had current anemia, 19.1% had chronic obstructive pulmonary disease, 19.1% were frail, and 17.6% had prior cerebrovascular events. The primary endpoint, early safety according to the Valve Academic Research Consortium-2 guidelines, was observed in 13 patients (19.1%). One patient (1.5%) died through 30 days of a noncardiac cause, and 4 patients (7.8%) died through 180 days. Disabling stroke occurred at 30 days in 1 patient (1.5%) and at 180 days in 2 patients (3.2%). New permanent pacemakers up to 30 days were implanted in 9 patients (13.4%). Two patients (3.8%) had moderate or severe paravalvular leakage at 30 days and 4 (9.1%) at 6 months, mean effective orifice area was 2.0 ± 0.4 cm Clinical outcomes with the Biovalve self-expanding transcatheter heart valve were similar to those seen in other first-in-human studies with first-generation devices for severe aortic stenosis.

Sections du résumé

OBJECTIVES
The aim of this study was to assess the safety and performance of a newly introduced transfemoral self-expanding supra-annular transcatheter heart valve.
BACKGROUND
Transcatheter aortic valve replacement has become an established procedure, and newer transcatheter heart valves aim to supplement the current armamentarium.
METHODS
BIOVALVE-I is a prospective, single-center feasibility study enrolling 13 high-risk patients with severe aortic stenosis, and BIOVALVE-II is a multicenter pilot study enrolling a further 55 patients under the same protocol.
RESULTS
Patients' mean age was 82.4 ± 5.3 years, 57.4% had concomitant coronary artery disease, 50.0% had renal insufficiency stage ≥3, 32.4% had diabetes mellitus, 29.4% had current anemia, 19.1% had chronic obstructive pulmonary disease, 19.1% were frail, and 17.6% had prior cerebrovascular events. The primary endpoint, early safety according to the Valve Academic Research Consortium-2 guidelines, was observed in 13 patients (19.1%). One patient (1.5%) died through 30 days of a noncardiac cause, and 4 patients (7.8%) died through 180 days. Disabling stroke occurred at 30 days in 1 patient (1.5%) and at 180 days in 2 patients (3.2%). New permanent pacemakers up to 30 days were implanted in 9 patients (13.4%). Two patients (3.8%) had moderate or severe paravalvular leakage at 30 days and 4 (9.1%) at 6 months, mean effective orifice area was 2.0 ± 0.4 cm
CONCLUSIONS
Clinical outcomes with the Biovalve self-expanding transcatheter heart valve were similar to those seen in other first-in-human studies with first-generation devices for severe aortic stenosis.

Identifiants

pubmed: 31629751
pii: S1936-8798(19)31763-7
doi: 10.1016/j.jcin.2019.07.058
pii:
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

157-166

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020. Published by Elsevier Inc.

Auteurs

Ulrich Schäfer (U)

Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany. Electronic address: schaefer.kardiologie@marienkrankenhaus.org.

Jörg Kempfert (J)

Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.

Stefan Verheye (S)

Interventional Cardiology, ZNA Middelheim Hospital, Antwerp, Belgium.

Francesco Maisano (F)

Division of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland.

Holger Thiele (H)

Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany.

Martin Landt (M)

Heart Center, Segeberger Kliniken (Academic Teaching Hospital of the Universities of Kiel, Lübeck, and Hamburg), Bad Segeberg, Germany.

Michael Haude (M)

Medical Clinic I Städtische Kliniken Neuss Lukaskrankenhaus, Neuss, Germany.

Tanja K Rudolph (TK)

Clinic for Cardiology, Angiology, and Pneumology and Intensive Care Medicine, Heart Center of the University Clinic Cologne, Cologne, Germany.

Hüseyin Ince (H)

Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany; Department of Cardiology, Universitätsmedizin Rostock, Rostock, Germany.

Stephan Kische (S)

Department of Cardiology, Vivantes Klinikum im Friedrichshain und Am Urban, Berlin, Germany; Department of Cardiology, Universitätsmedizin Rostock, Rostock, Germany.

Hendrik Treede (H)

Department of Cardiac Surgery, Mid-German Heart Centre, University Hospital Halle, Halle, Germany.

Pim Tonino (P)

Department of Cardiology, Catharina Ziekenhuis, Eindhoven, the Netherlands.

Lenard Conradi (L)

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

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