Performance of the CoreValve Evolut R and PRO in Severely Calcified Anatomy: A Propensity Score Matched Analysis.
Aged, 80 and over
Aortic Valve
/ pathology
Aortic Valve Stenosis
/ diagnosis
Bioprosthesis
Calcinosis
/ diagnosis
Female
Follow-Up Studies
Heart Valve Prosthesis
Humans
Male
Propensity Score
Prosthesis Design
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Transcatheter Aortic Valve Replacement
/ methods
Treatment Outcome
Aortic valve stenosis
Calcified anatomy
Evolut PRO
Evolut R
Paravalvular leakage
Transcatheter aortic valve replacement
Journal
Heart, lung & circulation
ISSN: 1444-2892
Titre abrégé: Heart Lung Circ
Pays: Australia
ID NLM: 100963739
Informations de publication
Date de publication:
Dec 2020
Dec 2020
Historique:
received:
23
08
2019
revised:
02
05
2020
accepted:
11
05
2020
pubmed:
11
7
2020
medline:
13
5
2021
entrez:
11
7
2020
Statut:
ppublish
Résumé
The CoreValve Evolut R and PRO (Medtronic, Minneapolis, MN, USA) are among the newest-generation of self-expandable transcatheter aortic valve replacement (TAVR) devices and show excellent results. Treating patients with severely calcified (SC) native aortic valve anatomy may be challenging because of the increased risk of periprocedural complications. This study investigated the performance of Evolut R and PRO in this special patient subset. Patients who underwent TAVR with the CoreValve Evolut R or PRO (n=381) from September 2015 to March 2018 were divided by aortic valve calcification extent. Patients with SC aortic valve anatomy (n=98; men, >2,062 and women, >1,377 Agatston units) were compared with those with non-severely calcified (NCS) aortic valve anatomy after 1:2 propensity score matching. Outcomes were evaluated according to the updated valve academic research consortium criteria. Patients with SC anatomy were older (83 years vs 80 years, p<0.001) and had a smaller aortic valve area (0.63 cm The CoreValve Evolut R and PRO showed good clinical safety profiles and excellent haemodynamic results in patients with SC anatomy and who more often required permanent pacemaker implantation.
Sections du résumé
BACKGROUND
BACKGROUND
The CoreValve Evolut R and PRO (Medtronic, Minneapolis, MN, USA) are among the newest-generation of self-expandable transcatheter aortic valve replacement (TAVR) devices and show excellent results. Treating patients with severely calcified (SC) native aortic valve anatomy may be challenging because of the increased risk of periprocedural complications. This study investigated the performance of Evolut R and PRO in this special patient subset.
METHODS
METHODS
Patients who underwent TAVR with the CoreValve Evolut R or PRO (n=381) from September 2015 to March 2018 were divided by aortic valve calcification extent. Patients with SC aortic valve anatomy (n=98; men, >2,062 and women, >1,377 Agatston units) were compared with those with non-severely calcified (NCS) aortic valve anatomy after 1:2 propensity score matching. Outcomes were evaluated according to the updated valve academic research consortium criteria.
RESULTS
RESULTS
Patients with SC anatomy were older (83 years vs 80 years, p<0.001) and had a smaller aortic valve area (0.63 cm
CONCLUSION
CONCLUSIONS
The CoreValve Evolut R and PRO showed good clinical safety profiles and excellent haemodynamic results in patients with SC anatomy and who more often required permanent pacemaker implantation.
Identifiants
pubmed: 32646637
pii: S1443-9506(20)30265-1
doi: 10.1016/j.hlc.2020.05.096
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1847-1855Informations de copyright
Copyright © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.