TRANSCATHETER AORTIC VALVE REPLACEMENT WITH THE NAVITOR SYSTEM: REAL-WORLD UNITED KINGDOM EXPERIENCE.

Efficacy Navitor Safety TAVR

Journal

The American journal of cardiology
ISSN: 1879-1913
Titre abrégé: Am J Cardiol
Pays: United States
ID NLM: 0207277

Informations de publication

Date de publication:
29 Apr 2024
Historique:
received: 04 02 2024
revised: 05 04 2024
accepted: 19 04 2024
medline: 2 5 2024
pubmed: 2 5 2024
entrez: 1 5 2024
Statut: aheadofprint

Résumé

The Navitor (THV) is the latest iteration of the Portico self-expanding valve system. Early prospective studies have shown promising outcomes, however there is a lack of complementary 'real-world' data. To assess early safety and efficacy outcomes of the Navitor Transcatheter Heart Valve (THV) using registry data from six high-volume UK TAVR centers. Demographic, procedural and in-hospital outcome data were retrieved from six UK centers. The primary safety end-point was 30-day mortality. Primary efficacy end-points were procedural success, mean aortic gradient, and ≥moderate paravalvular leak (PVL). Secondary endpoints included rates of new pacemaker implantation (PPM), stroke and vascular injury. 574 patients (Mean age 83.4 years; 54.5% female) underwent Navitor TAVR between January 2020 and May 2023. The 30-day mortality in this patient cohort was 1.6%. Procedural success was 98.1%, mean echo-derived gradient post-TAVR was 7.7±4.8mmHg (95% CI [7.2, 8.3], p<0.001) and 5.1% of patients had ≥moderate PVL (p̂=0.051, 95% CI [0.035, 0.073, p<0.001). New PPM to discharge was required in 11% (p̂ =0.119, 95% CI [0.088, 0.158], p<0.001), stroke occurred in 1.2% of patients (p̂= 0.017, 95% CI [0.006, 0.036], p<0.001) and significant vascular injury in 1.6% (p̂= 0.014, 95% CI [0.005, 0.032], p<0.001). Early procedural outcomes with Navitor TAVR compare favorably to new generation THVs. Procedural success was high with a low incidence of complications.

Sections du résumé

BACKGROUND BACKGROUND
The Navitor (THV) is the latest iteration of the Portico self-expanding valve system. Early prospective studies have shown promising outcomes, however there is a lack of complementary 'real-world' data.
AIMS OBJECTIVE
To assess early safety and efficacy outcomes of the Navitor Transcatheter Heart Valve (THV) using registry data from six high-volume UK TAVR centers.
METHODS METHODS
Demographic, procedural and in-hospital outcome data were retrieved from six UK centers. The primary safety end-point was 30-day mortality. Primary efficacy end-points were procedural success, mean aortic gradient, and ≥moderate paravalvular leak (PVL). Secondary endpoints included rates of new pacemaker implantation (PPM), stroke and vascular injury.
RESULTS RESULTS
574 patients (Mean age 83.4 years; 54.5% female) underwent Navitor TAVR between January 2020 and May 2023. The 30-day mortality in this patient cohort was 1.6%. Procedural success was 98.1%, mean echo-derived gradient post-TAVR was 7.7±4.8mmHg (95% CI [7.2, 8.3], p<0.001) and 5.1% of patients had ≥moderate PVL (p̂=0.051, 95% CI [0.035, 0.073, p<0.001). New PPM to discharge was required in 11% (p̂ =0.119, 95% CI [0.088, 0.158], p<0.001), stroke occurred in 1.2% of patients (p̂= 0.017, 95% CI [0.006, 0.036], p<0.001) and significant vascular injury in 1.6% (p̂= 0.014, 95% CI [0.005, 0.032], p<0.001).
CONCLUSION CONCLUSIONS
Early procedural outcomes with Navitor TAVR compare favorably to new generation THVs. Procedural success was high with a low incidence of complications.

Identifiants

pubmed: 38692400
pii: S0002-9149(24)00321-7
doi: 10.1016/j.amjcard.2024.04.036
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Apurva H Bharucha (AH)

King's College Hospital, London, United Kingdom [Co-ordinating center].

Ritesh Kanyal (R)

King's College Hospital, London, United Kingdom [Co-ordinating center].

Michael Mullen (M)

Barts Health NHS Trust, London, United Kingdom.

Kush Patel (K)

Barts Health NHS Trust, London, United Kingdom.

David Smith (D)

Morriston Cardiac Centre, Swansea, United Kingdom.

Joy Shome (J)

Morriston Cardiac Centre, Swansea, United Kingdom.

Daniel J Blackman (DJ)

Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

Suleman Aktaa (S)

Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

Paul D Williams (PD)

James Cook University Hospital, Middlesbrough, United Kingdom.

Saib Khogali (S)

New Cross Hospital, Wolverhampton, United Kingdom.

Rafal Dworakowski (R)

King's College Hospital, London, United Kingdom [Co-ordinating center].

Mehdi Eskandari (M)

King's College Hospital, London, United Kingdom [Co-ordinating center].

Jonathan Byrne (J)

King's College Hospital, London, United Kingdom [Co-ordinating center].

Philip MacCarthy (P)

King's College Hospital, London, United Kingdom [Co-ordinating center]. Electronic address: philip.maccarthy@nhs.net.

Classifications MeSH