title: Findings of a mixed transfemoral aortic valve implantation program using Edwards and CoreValve devices.
abstract: OBJECTIVE
  Transfemoral implantation of an Edwards SAPIEN (ES) or Medtronic CoreValve (MCV) aortic valve prosthesis is an alternative to surgical replacement for patients with severe aortic stenosis and a high surgical risk. The study's aim was to compare results obtained with these two devices.
  
  
  METHODS
  Prospective observational study of transfemoral prosthesis implantation performed at our center.
  
  
  RESULTS
  Of the 76 patients (age 83 ± 6 years, 63% female, logistic EuroSCORE 18 ± 9) included, 50 were assigned the ES and 26 the MCV device. There was no difference between the groups in age, sex, functional class, valve area, associated conditions, or EuroSCORE. Implantation was successful in 84% of the ES group and 100% of the MCV group (P = .04). There were three cases of tamponade, two aortic dissections and one valve malposition in the ES group. The two groups had similar vascular access complication rates (26% vs. 23%; P=NS), but pacemaker need was greater with the MCV (10% vs. 39%; P = .003). Mortality rates at 30 days were 12% and 20% (P = NS) in the ES and MCV groups, respectively, and at 1 year, 24% and 20% (P = NS), respectively. After a follow-up of 367 ± 266 days in the ES group and 172 ± 159 days in the MCV group, three patients died. Clinical improvement was maintained in other patients and no echocardiographic changes were observed.
  
  
  CONCLUSIONS
  In-hospital mortality, the complication rate and medium-term outcomes were similar with the two devices. The only difference observed was a higher implantation success rate with the MCV, although at the expense of a greater frequency of atrioventricular block.
authors.affiliation: Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. rhernandez_antolin@hotmail.com
authors.forename: Rosa Ana
authors.initials: RA
authors.lastname: Hernández-Antolín
authors.forename: Eulogio
authors.initials: E
authors.lastname: García
authors.forename: Santiago
authors.initials: S
authors.lastname: Sandoval
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: Ana
authors.initials: A
authors.lastname: Cuadrado
authors.forename: Javier
authors.initials: J
authors.lastname: Serrano
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Obeso
authors.forename: Raquel
authors.initials: R
authors.lastname: Del Valle
authors.forename: Camino
authors.initials: C
authors.lastname: Bañuelos
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
authors.forename: Fernando
authors.initials: F
authors.lastname: Guerrero
authors.forename: Jerónimo
authors.initials: J
authors.lastname: Heredia
authors.forename: Juan Carlos Martín
authors.initials: JC
authors.lastname: Benítez
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: García-Rubira
authors.forename: Enrique
authors.initials: E
authors.lastname: Rodríguez
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D005260:Female; D005263:Femoral Artery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design