Thirty-day outcome and vascular complications after transarterial aortic valve implantation using both Edwards Sapien and Medtronic CoreValve bioprostheses in a mixed population.
OBJECTIVE
Transcatheter aortic valve implantation (TAVI) is performed through a transarterial approach with encouraging results in "one-type valve" registries. We report 30-day data from a mixed population of patients treated with either Medtronic CoreValve (MCV) or Edwards SAPIEN (ES) valves.


RESULTS
Forty-five patients had TAVI via the transarterial approach (21 MCV and 24 ES). Mean age was 81.8+/-4.2 years, Logistic EuroSCORE was 25.2+/-8.4%. Procedural success rate was 97.8%. In-hospital death rate was 4.4%. Vascular complication rate was 8.9%. Of MCV patients, 28.6% had a permanent pacemaker vs. 4.2% of ES patients; p=0.02. No additional deaths were observed between discharge and 30 days. NYHA functional class was improved at 30-days: 2.07+/-0.4 vs. 3.09+/-0.05, p<0.0001. Mean transvalvular gradient was lower: 9.5+/-3.28 mmHg vs. 41.9+/-14 mmHg, p<0.0001. Overall 30-day MACE rate was 8.9%, similar between MCV and ES patients.


CONCLUSIONS
A routine policy of TAVI using both MCV and ES valves is feasible without any worsening of procedural success rates and 30-day outcomes. A wider population of high risk patients with aortic stenosis can be offered a transarterial treatment. This could be the next standard of care for teams performing TAVI.
Tchetche
Didier
D
Clinique Pasteur, Toulouse, France. d.tchetche@clinique-pasteur.com
Dumonteil
Nicolas
N
Sauguet
Antoine
A
Descoutures
Fleur
F
Luz
Andre
A
Garcia
Olivier
O
Soula
Philippe
P
Gabiache
Yannick
Y
Fournial
Gérard
G
Marcheix
Bertrand
B
Carrie
Didier
D
Fajadet
Jean
J
D000369:Aged, 80 and over; D000792:Angiography; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D017548:Echocardiography, Transesophageal; D005260:Female; D005500:Follow-Up Studies; D005602:France; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology*