title: Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement With the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve.
abstract: The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR.
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Kiramijyan
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Magalhaes
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Edward
authors.initials: E
authors.lastname: Koifman
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Romain
authors.initials: R
authors.lastname: Didier
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Ricardo O
authors.initials: RO
authors.lastname: Escarcega
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Nevin C
authors.initials: NC
authors.lastname: Baker
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Smita I
authors.initials: SI
authors.lastname: Negi
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Gai
authors.initials: G
authors.lastname: Jiaxiang
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Federico M
authors.initials: FM
authors.lastname: Asch
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Zuyue
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Petros
authors.initials: P
authors.lastname: Okubagzi
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gaglia
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Itsik
authors.initials: I
authors.lastname: Ben-Dor
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Lowell F
authors.initials: LF
authors.lastname: Satler
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.affiliation: Section of Interventional Cardiology, MedStar Washington Hospital Center, Georgetown University, Washington, D.C.. Electronic address: ron.waksman@medstar.net.
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000628:therapy*; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*; D016896:Treatment Outcome