Balloon Versus Self-Expandable Valve for the Treatment of Bicuspid Aortic Valve Stenosis: Insights From the BEAT International Collaborative Registrys.


Journal

Circulation. Cardiovascular interventions
ISSN: 1941-7632
Titre abrégé: Circ Cardiovasc Interv
Pays: United States
ID NLM: 101499602

Informations de publication

Date de publication:
07 2020
Historique:
entrez: 11 7 2020
pubmed: 11 7 2020
medline: 22 6 2021
Statut: ppublish

Résumé

Large data comparing the performance of new-generation self-expandable versus balloon-expandable transcatheter heart valves in bicuspid aortic stenosis are lacking. We aim to compare the safety and performance of balloon-expandable and self-expandable transcatheter heart valves in the treatment of bicuspid aortic stenosis. The BEAT (balloon versus self-expandable valve for the treatment of bicuspid aortic valve stenosis) registry included 353 consecutive patients who underwent transcatheter aortic valve implantation using new-generation Evolut R/PRO or Sapien 3 valves in bicuspid aortic valve. A total of 353 patients (n=242 [68.6%] treated with Sapien 3 and n=111 [68.6%] treated with Evolut R (n=70)/PRO [n=41]) were included. Mean age was 77.8±8.3 years and mean Society of Thoracic Surgeons Predicted Risk of Mortality was 4.4±3.3%. Valve Academic Research Consortium-2 device success was similar between Sapien 3 and Evolut R/PRO (85.6% versus 87.2%; Our study confirms the feasibility of both Sapien 3 and Evolut R/PRO implantation in bicuspid aortic valve anatomy; a higher rate of moderate-severe paravalvular aortic regurgitation was observed in the Evolut R/PRO group at 1-year follow-up in the matched cohort, although patients treated with balloon-expandable valve had a higher rate of annular rupture.

Sections du résumé

BACKGROUND
Large data comparing the performance of new-generation self-expandable versus balloon-expandable transcatheter heart valves in bicuspid aortic stenosis are lacking. We aim to compare the safety and performance of balloon-expandable and self-expandable transcatheter heart valves in the treatment of bicuspid aortic stenosis.
METHODS
The BEAT (balloon versus self-expandable valve for the treatment of bicuspid aortic valve stenosis) registry included 353 consecutive patients who underwent transcatheter aortic valve implantation using new-generation Evolut R/PRO or Sapien 3 valves in bicuspid aortic valve.
RESULTS
A total of 353 patients (n=242 [68.6%] treated with Sapien 3 and n=111 [68.6%] treated with Evolut R (n=70)/PRO [n=41]) were included. Mean age was 77.8±8.3 years and mean Society of Thoracic Surgeons Predicted Risk of Mortality was 4.4±3.3%. Valve Academic Research Consortium-2 device success was similar between Sapien 3 and Evolut R/PRO (85.6% versus 87.2%;
CONCLUSIONS
Our study confirms the feasibility of both Sapien 3 and Evolut R/PRO implantation in bicuspid aortic valve anatomy; a higher rate of moderate-severe paravalvular aortic regurgitation was observed in the Evolut R/PRO group at 1-year follow-up in the matched cohort, although patients treated with balloon-expandable valve had a higher rate of annular rupture.

Identifiants

pubmed: 32646304
doi: 10.1161/CIRCINTERVENTIONS.119.008714
doi:

Types de publication

Comparative Study Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e008714

Commentaires et corrections

Type : CommentIn
Type : CommentIn
Type : CommentIn

Auteurs

Antonio Mangieri (A)

GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.M., F.G., A.L., F.G., A.C.).
San Raffaele Scientific Institute, Milan, Italy (A.M., M.P., M.M.).

Didier Tchetchè (D)

Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse (D.T., C.D.B.).

Won-Keun Kim (WK)

Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany (W.-K.K.).

Matteo Pagnesi (M)

San Raffaele Scientific Institute, Milan, Italy (A.M., M.P., M.M.).

Jean-Malte Sinning (JM)

Cardiology Department, University Hospital Bonn, Germany (J.-M.S., G.N.).

Uri Landes (U)

Cardiology Department, Rabin Medical Center, Petah Tikva, Israel (U.L., R.K.).

Ran Kornowski (R)

Cardiology Department, Rabin Medical Center, Petah Tikva, Israel (U.L., R.K.).

Ole De Backer (O)

The Heart Center-Rigshospitalet, Copenhagen, Denmark (O.D.B., L.S.).

Georg Nickenig (G)

Cardiology Department, University Hospital Bonn, Germany (J.-M.S., G.N.).

Alfonso Ielasi (A)

Istituto clinic Sant'Ambrogio, Milan, Italy (A.I.).

Chiara De Biase (C)

Groupe CardioVasculaire Interventionnel, Clinique Pasteur, Toulouse (D.T., C.D.B.).

Lars Søndergaard (L)

The Heart Center-Rigshospitalet, Copenhagen, Denmark (O.D.B., L.S.).

Federico De Marco (F)

Department of Cardiology, Istituto Clinico San Donato, Milan, Italy (F.D.M.).

Matteo Montorfano (M)

San Raffaele Scientific Institute, Milan, Italy (A.M., M.P., M.M.).

Mauro Chiarito (M)

Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy (M.C., D.R., G.S., P.P.).

Damiano Regazzoli (D)

Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy (M.C., D.R., G.S., P.P.).

Giulio Stefanini (G)

Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy (M.C., D.R., G.S., P.P.).

Patrizia Presbitero (P)

Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy (M.C., D.R., G.S., P.P.).

Stefan Toggweiler (S)

Heart Center Lucerne, Luzerner Kantonsspital, Switzerland (S.T.).

Corrado Tamburino (C)

Cardiology Division, CAST Policlinico Hospital, University of Catania, Italy (C.T.).

Sebastiano Immè (S)

Centro cuore Morgagni, Catania, Italy (S.I.).

Giuseppe Tarantini (G)

Interventional Cardiology unit, University of Padova, Italy (G.T.).

Horst Sievert (H)

Cardiovascular Center Frankfurt, Germany (H.S.).
Anglia Ruskin University, Chelmsford, United Kingdom (H.S.).

Ulrich Schäfer (U)

UKE Hamburg, Germany (U.S.).

Jörg Kempfert (J)

Deutsches Herzzentrum Berlin, Charité Universitätsmedizin, Germany (J.K.).

Jochen Wöehrle (J)

Ulm University, Germany (J.W.).

Francesco Gallo (F)

GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.M., F.G., A.L., F.G., A.C.).

Alessandra Laricchia (A)

GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.M., F.G., A.L., F.G., A.C.).
Department of Cardiology, Montefiore Medical Center, New York (A.L.).

Francesco Giannini (F)

GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.M., F.G., A.L., F.G., A.C.).

Antonio Colombo (A)

GVM Care and Research, Maria Cecilia Hospital, Cotignola, Ravenna, Italy (A.M., F.G., A.L., F.G., A.C.).
Centro Cuore Columbus, GVM care and research, Milan, Italy (A.C.).

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