Early versus newer generation devices for transcatheter aortic valve implantation in routine clinical practice: a propensity score matched analysis

Pilgrim, Thomas; Lee, Joe K T; O’Sullivan, Crochan J; Stortecky, Stefan; Ariotti, Sara; Franzone, Anna; Lanz, Jonas; Heg, Dik; Asami, Masahiko; Praz, Fabien; Siontis, George C M; Vollenbroich, René; Räber, Lorenz; Valgimigli, Marco; Roost, Eva; Windecker, Stephan (2018). Early versus newer generation devices for transcatheter aortic valve implantation in routine clinical practice: a propensity score matched analysis. Open Heart, 5(1), e000695. B M J Group 10.1136/openhrt-2017-000695

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Abstract Aim Contemporary data comparing early versus newer generation transcatheter heart valve (THV) devices in routine clinical practice are lacking. We sought to compare the safety and efficacy of early versus newer generation THVs in unselected patients undergoing transcatheter aortic valve implantation (TAVI). Methods and results We performed a propensity score matched analysis of patients undergoing transfemoral TAVI at a single centre with early versus newer generation devices between 2007 and 2016. Patients were matched for balloon-expandable versus self-expandable valves and Society of Thoracic Surgeons score. The primary end point was the Valve Academic Research Consortium (VARC)-2 early safety composite end point at 30 days. Among the 391 matched pairs, no differences between early (21.2%) and newer generation (20.8%) THVs regarding the early safety composite end point (HR 0.98, 95% CI 0.72 to 1.33, P=0.88) were observed. The rates of valve embolisation (0.8% vs 4.2%, P=0.005), bleeding events (24.8% vs 32.0%, P=0.028) and moderate-to-severe paravalvular regurgitation (PVR) (3.1% vs 12.1%, P<0.001) were lower among patients receiving newer generation devices. Conversely, patients treated with early generation THVs less frequently experienced annulus rupture (0% vs 2.0%, P=0.008). Conclusion Newer compared with early generation THV devices were associated with a lower rate of valve embolisation, PVR and bleeding events.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern

UniBE Contributor:

Pilgrim, Thomas; Stortecky, Stefan; Ariotti, Sara; Franzone, Anna; Lanz, Jonas; Heg, Dierik Hans; Asami, Masahiko; Praz, Fabien; Siontis, Georgios; Vollenbroich, René; Räber, Lorenz; Valgimigli, Marco; Roost, Eva and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2053-3624

Publisher:

B M J Group

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

23 Jan 2018 11:28

Last Modified:

14 Feb 2018 09:23

Publisher DOI:

10.1136/openhrt-2017-000695

PubMed ID:

29387427

BORIS DOI:

10.7892/boris.109921

URI:

https://boris.unibe.ch/id/eprint/109921

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