Third-Generation Balloon and Self-Expandable Valves for Aortic Stenosis in Large and Extra-Large Aortic Annuli From the TAVR-LARGE Registry.


Journal

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

Informations de publication

Date de publication:
08 2020
Historique:
entrez: 8 8 2020
pubmed: 8 8 2020
medline: 22 6 2021
Statut: ppublish

Résumé

Currently, 2 third-generation transcatheter valves, 29-mm Sapien-3 and 34-mm Evolut-R (ER), are indicated for large sized aortic annuli. We analyzed short and 1-year performance of these valves in patients with large (area ≥575 mm A total of 833 patients across 12 centers with symptomatic aortic stenosis and large aortic annuli underwent transcatheter aortic valve replacement with 29-mm Sapien-3 (n=640) or 34-mm ER (n=193). Clinical, anatomic, and procedural characteristics were collected, and Valve Academic Research Consortium-2 outcomes were reported. Median aortic annulus area and perimeter were 617 mm In patients with large and extra-large aortic annuli, transcatheter aortic valve replacement using 29-mm Sapien-3 and 34-mm ER is safe and feasible. Observed differences in clinical outcomes and hemodynamic performance may guide valve choice in this cohort of patients undergoing transcatheter aortic valve replacement.

Sections du résumé

BACKGROUND
Currently, 2 third-generation transcatheter valves, 29-mm Sapien-3 and 34-mm Evolut-R (ER), are indicated for large sized aortic annuli. We analyzed short and 1-year performance of these valves in patients with large (area ≥575 mm
METHODS
A total of 833 patients across 12 centers with symptomatic aortic stenosis and large aortic annuli underwent transcatheter aortic valve replacement with 29-mm Sapien-3 (n=640) or 34-mm ER (n=193). Clinical, anatomic, and procedural characteristics were collected, and Valve Academic Research Consortium-2 outcomes were reported.
RESULTS
Median aortic annulus area and perimeter were 617 mm
CONCLUSIONS
In patients with large and extra-large aortic annuli, transcatheter aortic valve replacement using 29-mm Sapien-3 and 34-mm ER is safe and feasible. Observed differences in clinical outcomes and hemodynamic performance may guide valve choice in this cohort of patients undergoing transcatheter aortic valve replacement.

Identifiants

pubmed: 32757657
doi: 10.1161/CIRCINTERVENTIONS.120.009047
doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

e009047

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Auteurs

Germán Armijo (G)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Gilbert H L Tang (GHL)

Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY (G.H.L.T., A.S.).

Nynke Kooistra (N)

Department of Cardiology, University Medical Center Utrecht, Utrecht University, the Netherlands (N.K., G.E.L., P.S.).

Alfredo Nunes Ferreira-Neto (AN)

Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (A.N.F.-N., T.C., J.R.-C.).

Stefan Toggweiler (S)

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

Ignacio J Amat-Santos (IJ)

Department of Cardiology, Instituto de Ciencias del Corazón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., T.R.-G.).

Lukas S Keller (LS)

Department of Cardiology, University Heart Centre Zurich, Switzerland (L.S.K., O.C.H.).

Marina Urena (M)

Department of Cardiology, Assistance publique-Hôpitaux de Paris, Bichat Hospital, France (M.U., D.H.).

Hasan Ahmad (H)

Division of Cardiology, Westchester Medical Center, Valhalla, New York, NY (H.A., S.Z.).

Jose Tafur Soto (J)

Department of Cardiology, John Ochsner Heart and Vascular Institute, New Orleans, LA (J.T.S., M.A.).

Erika Muñoz-Garcia (E)

Department of Cardiology, Hospital Clínico Universitario Virgen de la Victoria, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Malaga, Spain (E.M.-G., A.J.M.-G.).

Ander Regueiro (A)

Department of Cardiology, Hospital Clinic de Barcelona, Institut Clinic Cardiovascular, IDIBAPS, Spain (A.R.).

Geert E Leenders (GE)

Department of Cardiology, University Medical Center Utrecht, Utrecht University, the Netherlands (N.K., G.E.L., P.S.).

Gabriela Tirado-Conte (G)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Aditya Sengupta (A)

Department of Cardiovascular Surgery, Mount Sinai Health System, New York, NY (G.H.L.T., A.S.).

Angela McInerney (A)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Thomas Couture (T)

Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (A.N.F.-N., T.C., J.R.-C.).

Oscar Cuevas Herreros (O)

Department of Cardiology, University Heart Centre Zurich, Switzerland (L.S.K., O.C.H.).

Tania Rodriguez-Gabella (T)

Department of Cardiology, Instituto de Ciencias del Corazón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Hospital Clínico Universitario de Valladolid, Spain (I.J.A.-S., T.R.-G.).

Annapoorna Kini (A)

Division of Cardiology, Mount Sinai Medical Center, New York, NY (A.K., G.D.D.).

Mohammed Ahmed (M)

Department of Cardiology, John Ochsner Heart and Vascular Institute, New Orleans, LA (J.T.S., M.A.).

Syed Zaid (S)

Division of Cardiology, Westchester Medical Center, Valhalla, New York, NY (H.A., S.Z.).

Nieves Gonzalo (N)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Ivan J Nuñez-Gil (IJ)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Antonio J Muñoz-Garcia (AJ)

Department of Cardiology, Hospital Clínico Universitario Virgen de la Victoria, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Malaga, Spain (E.M.-G., A.J.M.-G.).

Pilar Jimenez-Quevedo (P)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Antonio Fernández-Ortiz (A)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Dominique Himbert (D)

Department of Cardiology, Assistance publique-Hôpitaux de Paris, Bichat Hospital, France (M.U., D.H.).

Fabian Nietlispach (F)

Department of Cardiology, Universitz Hospital Zurich and Hirslanden Klinik Im Park, Zurich, Switzerland (F.N.).

Pieter Stella (P)

Department of Cardiology, University Medical Center Utrecht, Utrecht University, the Netherlands (N.K., G.E.L., P.S.).

George D Dangas (GD)

Division of Cardiology, Mount Sinai Medical Center, New York, NY (A.K., G.D.D.).

Javier Escaned (J)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Carlos Macaya (C)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

Josep Rodés-Cabau (J)

Department of Cardiology, Quebec Heart and Lung Institute, Laval University, Quebec City, Canada (A.N.F.-N., T.C., J.R.-C.).

Luis Nombela-Franco (L)

Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos, Madrid, Spain (G.A., G.T.-C., A.M., N.G., I.J.N.-G., P.J.-Q., A.F.-O., J.E., C.M., L.N.-F.).

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