| Dokumentenart: | Artikel | ||||
|---|---|---|---|---|---|
| Titel eines Journals oder einer Zeitschrift: | Circulation: Cardiovascular Interventions | ||||
| Verlag: | Lippincott | ||||
| Ort der Veröffentlichung: | PHILADELPHIA | ||||
| Band: | 10 | ||||
| Nummer des Zeitschriftenheftes oder des Kapitels: | 10 | ||||
| Datum: | 2017 | ||||
| Institutionen: | Medizin > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie | ||||
| Identifikationsnummer: |
| ||||
| Stichwörter / Keywords: | HIGH-RISK PATIENTS; EDWARDS SAPIEN XT; HEART-VALVES; REPLACEMENT; PROSTHESIS; MISMATCH; IMPLANTATION; STENOSIS; TRIAL; DURABILITY; follow-up studies; heart valve prosthesis; pacemaker, artificial; propensity score; transcatheter aortic valve replacement | ||||
| Dewey-Dezimal-Klassifikation: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin | ||||
| Status: | Veröffentlicht | ||||
| Begutachtet: | Ja, diese Version wurde begutachtet | ||||
| An der Universität Regensburg entstanden: | Ja | ||||
| Dokumenten-ID: | 39709 |
Web of ScienceZusammenfassung
Background-Surgical aortic valve replacement in patients with small annular dimensions is challenging because they are at increased risk for prosthesis-patient mismatch and impaired outcomes. Transcatheter aortic valve replacement might be a good alternative; however, comparative data on different transcatheter heart valves are missing. Methods and Results-This multicenter, propensity ...
Zusammenfassung
Background-Surgical aortic valve replacement in patients with small annular dimensions is challenging because they are at increased risk for prosthesis-patient mismatch and impaired outcomes. Transcatheter aortic valve replacement might be a good alternative; however, comparative data on different transcatheter heart valves are missing. Methods and Results-This multicenter, propensity score-matched study compared hemodynamics and early clinical outcomes in 246 patients with an aortic annulus area <400 mm(2) undergoing transcatheter aortic valve replacement with either a self-expanding transcatheter heart valve (Symetis ACURATE neo, n=129) or a balloon-expandable transcatheter heart valve (Edwards SAPIEN 3, n=117). The 1: 1 propensity score matching resulted in 92 matched pairs. For ACURATE neo versus SAPIEN 3-treated patients, 30-day mortality (0.0% versus 1.0%), 1-year mortality (8.3% versus 13.3%), incidence of stroke (3.3% versus 2.2%), life-threatening bleeding (1.1% versus 1.1%), and major vascular complications (2.2% versus 6.5%), as well as pacemaker implantation rate (12.0% versus 15.2%), were similar. Paravalvular regurgitation >= moderate was rare in both groups (4.5% versus 3.6%). The ACURATE neo presented lower mean transvalvular gradients (9.3 versus 14.5 mm Hg; P<0.001), larger indexed effective orifice areas (0.96 versus 0.80 cm(2)/m(2); P=0.003), and lower rates of severe prosthesis-patient mismatch (3% versus 22%; P=0.004). Hemodynamics were sustained at 1-year follow-up. Conclusions-Albeit a similar safety profile with low clinical event rates, transcatheter aortic valve replacement with the ACURATE neo valve resulted in lower transvalvular gradients and consequently less prosthesis-patient mismatch compared with the SAPIEN 3 in patients with small annulus. These results emphasize the need of careful prosthesis selection in each individual patient.
Metadaten zuletzt geändert: 25 Nov 2020 15:47
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