title: Comparison of acute elastic recoil between the SAPIEN-XT and SAPIEN valves in transfemoral-transcatheter aortic valve replacement.
abstract: BACKGROUND
  The SAPIEN-XT is a newer generation balloon-expandable valve created of cobalt chromium frame, as opposed to the stainless steel frame used in the older generation SAPIEN valve. We sought to determine if there was difference in acute recoil between the two valves.
  
  
  METHODS
  All patients who underwent transfemoral-transcatheter aortic valve replacement using the SAPIEN-XT valve at the Cleveland Clinic were included. Recoil was measured using biplane cine-angiographic image analysis of valve deployment. Acute recoil was defined as [(valve diameter at maximal balloon inflation) - (valve diameter after deflation)]/valve diameter at maximal balloon inflation (reported as percentage). Patients undergoing SAPIEN valve implantation were used as the comparison group.
  
  
  RESULTS
  Among the 23 mm valves, the mean (standard deviation-SD) acute recoil was 2.77% (1.14) for the SAPIEN valve as compared to 3.75% (1.52) for the SAPIEN XT valve (P = 0.04). Among the 26 mm valves, the mean (SD) acute recoil was 2.85% (1.4) for the SAPIEN valve as compared to 4.32% (1.63) for the SAPIEN XT valve (P = 0.01). Multivariable linear regression analysis demonstrated significantly greater adjusted recoil in the SAPIEN XT valves as compared to the SAPIEN valves by 1.43% [(95% CI: 0.69-2.17), P < 0.001]. However, the residual peak gradient was less for SAPIEN XT compared to SAPIEN valves [18.86 mm Hg versus 23.53 mm Hg (P = 0.01)]. Additionally, no difference in paravalvular leak was noted between the two valve types (P = 0.78).
  
  
  CONCLUSIONS
  The SAPIEN XT valves had significantly greater acute recoil after deployment compared to the SAPIEN valves. Implications of this difference in acute recoil on valve performance need to be investigated in future studies.
authors.affiliation: Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, 44195.
authors.forename: Aatish
authors.initials: A
authors.lastname: Garg
authors.forename: Akhil
authors.initials: A
authors.lastname: Parashar
authors.forename: Shikhar
authors.initials: S
authors.lastname: Agarwal
authors.forename: Olcay
authors.initials: O
authors.lastname: Aksoy
authors.forename: Muhammad
authors.initials: M
authors.lastname: Hammadah
authors.forename: Kanhaiya Lal
authors.initials: KL
authors.lastname: Poddar
authors.forename: Rishi
authors.initials: R
authors.lastname: Puri
authors.forename: Lars G
authors.initials: LG
authors.lastname: Svensson
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.forename: E Murat
authors.initials: EM
authors.lastname: Tuzcu
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods*; D002858:Chromium Alloys; D002932:Cineangiography; D004548:Elasticity; D005260:Female; D005263:Femoral Artery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D009820:Ohio; D011474:Prosthesis Design; D011677:Punctures; D012042:Registries; D013193:Stainless Steel; D016896:Treatment Outcome
chemical_list: D002858:Chromium Alloys; D013193:Stainless Steel
keywords: aortic valve disease; percutaneous intervention; transcatheter valve implantation