Transcatheter Aortic Valve Replacement With Next-Generation Self-Expanding Devices: A Multicenter, Retrospective, Propensity-Matched Comparison of Evolut PRO Versus Acurate neo Transcatheter Heart Valves.

Pagnesi, Matteo; Kim, Won-Keun; Conradi, Lenard; Barbanti, Marco; Stefanini, Giulio G; Zeus, Tobias; Pilgrim, Thomas; Schofer, Joachim; Zweiker, David; Testa, Luca; Taramasso, Maurizio; Hildick-Smith, David; Abizaid, Alexandre; Wolf, Alexander; Van Mieghem, Nicolas M; Sedaghat, Alexander; Wöhrle, Jochen; Khogali, Saib; Van der Heyden, Jan A S; Webb, John G; ... (2019). Transcatheter Aortic Valve Replacement With Next-Generation Self-Expanding Devices: A Multicenter, Retrospective, Propensity-Matched Comparison of Evolut PRO Versus Acurate neo Transcatheter Heart Valves. JACC. Cardiovascular Interventions, 12(5), pp. 433-443. Elsevier 10.1016/j.jcin.2018.11.036

Text Transcatheter Aortic Valve Replacement With Next-Generation Self-Expanding Devices.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (413kB)

OBJECTIVES

The aim of this study was to compare transcatheter aortic valve replacement (TAVR) with the Acurate neo (NEO) and Evolut PRO (PRO) devices.

BACKGROUND

The NEO and PRO bioprostheses are 2 next-generation self-expanding devices developed for TAVR.

METHODS

The NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) registry retrospectively included patients who underwent transfemoral TAVR with either NEO or PRO valves at 24 centers between January 2012 and March 2018. One-to-one propensity score matching resulted in 251 pairs. Pre-discharge and 30-day Valve Academic Research Consortium (VARC)-2 defined outcomes were evaluated. Binary logistic regression was performed to adjust the treatment effect for propensity score quintiles.

RESULTS

A total of 1,551 patients (n = 1,263 NEO; n = 288 PRO) were included. The mean age was 82 years, and the mean Society of Thoracic Surgeons score was 5.1%. After propensity score matching (n = 502), VARC-2 device success (90.6% vs. 91.6%; p = 0.751) and pre-discharge moderate to severe (II+) paravalvular aortic regurgitation (7.3% vs. 5.7%; p = 0.584) were comparable between the NEO and PRO groups. Furthermore, there were no significant differences in any 30-day clinical outcome between matched NEO and PRO pairs, including all-cause mortality (3.2% vs. 1.2%; p = 0.221), stroke (2.4% vs. 2.8%; p = 1.000), new permanent pacemaker implantation (11.0% vs. 12.8%; p = 0.565), and VARC-2 early safety endpoint (10.6% vs. 10.4%; p = 1.000). Logistic regression on the unmatched cohort confirmed a similar risk of VARC-2 device success, paravalvular aortic regurgitation II+, and 30-day clinical outcomes after NEO and PRO implantation.

CONCLUSIONS

In this multicenter registry, transfemoral TAVR with the NEO and PRO bioprostheses was associated with high device success, acceptable rates of paravalvular aortic regurgitation II+, and good 30-day clinical outcomes. After adjusting for potential confounders, short-term outcomes were similar between the devices.

Interest & Impact

Downloads

1 since deposited on 12 Feb 2020
0 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item