title: Effective orifice area and hemodynamic performance of the transcatheter Edwards Sapien 3 prosthesis: short-term and 1-year follow-up.
abstract: The Edwards Sapien 3 heart valve prosthesis (S3) is commonly used for transcatheter aortic valve implantation (TAVI) and is available in three sizes. To date no data has been published on the effective orifice area (EOA) and the hemodynamic performance of the three different S3 sizes. The aim of this study was to measure the size-specific EOA and hemodynamic performance of the S3 in short-term and 1-year follow-up.
  
  
  
  One hundred and thirteen consecutive patients treated by TAVI with a S3 prosthesis at the Heart Clinic Zurich between May 2014 and July 2015 were included. Clinical data were extracted from the Swiss TAVI registry. The EOA was calculated using Doppler echocardiography (peri-interventionally and at discharge) and by 3D-biplane transoesophageal echocardiography (peri-interventionally). Mean transvalvular gradients (dPmean) were additionally calculated with Doppler echocardiography at 30 days and 1 year. Results were analysed separately for the 23 mm (n = 42; 37%), 26 mm (n = 46; 41%), and 29 mm (n = 25; 22%) prostheses. At discharge, the EOAs were 1.6 ± 0.2 cm2 (23 mm S3), 2.0 ± 0.2 cm2 (26 mm S3), and 2.7 ± 0.2 cm2 (29 mm S3), p < 0.001. The dPmeans at discharge were 10.9 ± 6.0 mmHg (23 mm S3), 10.4 ± 3.5 mmHg (26 mm S3), and 8.9 ± 2.8 mmHg (29 mm S3), p = 0.235, and did not significantly change over time within any of the S3 sizes.
  
  
  
  Post-TAVI, the EOAs of the three different S3 prosthesis sizes differ significantly, the transvalvular gradients, however, are comparable. Mean transvalvular gradients remain stable over time and document good prosthesis function after 1 year.
authors.affiliation: University of Zurich, Faculty of Medicine, Rämistrasse 71, 8006 Zurich, Switzerland.
authors.forename: Mischa
authors.initials: M
authors.lastname: Külling
authors.affiliation: Swiss Federal Institute of Technology (ETH), Department of Statistics, Rämistrasse 101, 8092 Zurich, Switzerland.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Külling
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Christophe
authors.initials: C
authors.lastname: Wyss
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Hürlimann
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Ivano
authors.initials: I
authors.lastname: Reho
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Sacha
authors.initials: S
authors.lastname: Salzberg
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Ines
authors.initials: I
authors.lastname: Bühler
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.affiliation: Heart Clinic Zurich, Hirslanden, Witellikerstrasse 40, 8032 Zurich, Switzerland.
authors.forename: Patric
authors.initials: P
authors.lastname: Biaggi
mesh_terms: D000704:Analysis of Variance; D001021:Aortic Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D016014:Linear Models; D008297:Male; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013557:Switzerland; D062606:Tertiary Care Centers; D013997:Time Factors; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: Edwards Sapien 3; TAVI; effective orifice area; percutaneous aortic valve implantation; transvalvular gradient