Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis.

Noble, Stephane; Stortecky, Stefan; Heg, Dik; Tuller, David; Jeger, Raban; Toggweiler, Stefan; Ferrari, Enrico; Nietlispach, Fabian; Taramasso, Maurizio; Maisano, Francesco; Grünenfelder, Jürg; Jüni, Peter; Huber, Christoph; Carrel, Thierry; Windecker, Stephan; Wenaweser, Peter Martin; Roffi, Marco (2017). Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis. EuroIntervention, 12(18), e2170-e2176. Europa Digital & Publishing 10.4244/EIJ-D-16-00677

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AIMS Data on procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI) with the new generation self-expanding Medtronic Evolut-R prosthesis in comparison with its predecessor, the Medtronic CoreValve, are scarce. METHODS AND RESULTS In a nationwide, prospective, multi-center cohort study outcomes of consecutive transfemoral TAVI patients treated with the new- generation Medtronic Evolut-R (September 2014 - February 2016) and the Medtronic CoreValve (February 2011 - February 2016) were investigated. Events were reported according to VARC-2 and adjudicated by a clinical event committee. During the study period, 317 and 678 consecutive patients underwent TAVI with the Evolut-R and the CoreValve bioprosthesis, respectively. Baseline clinical characteristics between the groups were comparable, although Evolut-R patients were lower risk according to the STS score (4.8±3.4% vs. 6.9±5.0%, p<0.001) and logistic EuroSCORE (17.3±13% vs. 20.1±13%, p=0.009). Implantation of the Evolut-R was associated with a lower use of predilatation (48.1% vs. 72.4%, p<0.001), a shorter procedure time (67.9±36min vs. 76.7±42min, p=0.002), and less contrast dye use during the procedure (155.2±98ml vs. 208.0±117ml, p<0.001). Post-procedural mean gradient was comparable (7.4±4.7 mmHg vs. 7.5±5.0 mmHg), as were the 30-day rates of moderate to severe aortic regurgitation (8.5% vs. 10.5%), major vascular (9.8% vs. 10.3%) and life-threatening bleeding complications (5.4% vs. 5.3%), disabling stroke (1.9% vs. 1.6%), all-cause mortality (3.2% vs. 3.4%) as well as permanent pacemaker implantation (22.1% vs. 23.4%). CONCLUSIONS 30-day clinical outcomes were favorable and comparable between the Evolut-R and the CoreValve bioprosthesis.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

UniBE Contributor:

Stortecky, Stefan; Heg, Dierik Hans; Carrel, Thierry; Windecker, Stephan and Wenaweser, Peter Martin

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Judith Liniger

Date Deposited:

14 Aug 2017 10:16

Last Modified:

07 Dec 2017 07:50

Publisher DOI:

10.4244/EIJ-D-16-00677

PubMed ID:

28067197

BORIS DOI:

10.7892/boris.93488

URI:

https://boris.unibe.ch/id/eprint/93488

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