TY - JOUR
T1 - Self-expanding Portico Valve Versus Balloon-expandable SAPIEN XT Valve in Patients With Small Aortic Annuli
T2 - Comparison of Hemodynamic Performance
AU - Del Trigo, María
AU - Dahou, Abdellaziz
AU - Webb, John G.
AU - Dvir, Danny
AU - Puri, Rishi
AU - Abdul-Jawad Altisent, Omar
AU - Campelo-Parada, Francisco
AU - Thompson, Chris
AU - Leipsic, Jonathon
AU - Stub, Dion
AU - Delarochellière, Robert
AU - Paradis, Jean Michel
AU - Dumont, Eric
AU - Doyle, Daniel
AU - Mohammadi, Siamak
AU - Pasian, Sergio
AU - Côté, Melanie
AU - Pibarot, Philippe
AU - Rodés-Cabau, Josep
PY - 2016/5
Y1 - 2016/5
N2 - INTRODUCTION AND OBJECTIVES: The self-expanding Portico valve is a new transcatheter aortic valve system yielding promising preliminary results, yet there are no comparative data against earlier generation transcatheter aortic valve systems. The aim of this study was to compare the hemodynamic performance of the Portico and balloon-expandable SAPIEN XT valves in a case-matched study with echocardiographic core laboratory analysis.METHODS: Twenty-two patients underwent transcatheter aortic valve implantation with the Portico 23-mm valve and were matched for aortic annulus area and mean diameter measured by multidetector computed tomography, left ventricular ejection fraction, body surface area, and body mass index with 40 patients treated with the 23-mm SAPIEN XT. Mean aortic annulus diameters were 19.6±1.3mm by transthoracic echocardiography and 21.4±1.2mm by computed tomography, with no significant between-group differences. Doppler echocardiographic images were collected at baseline and at 1-month of follow-up and were analyzed in a central echocardiography core laboratory.RESULTS: There were no significant between-group differences in residual mean transaortic gradients (SAPIEN XT: 10.4±3.7mmHg; Portico: 9.8±1.1mmHg; P=.49) and effective orifice areas (SAPIEN XT: 1.36±0.27cm(2); Portico, 1.37±.29cm(2); P=.54). Rates of severe prosthesis-patient mismatch (effective orifice area<0.65cm(2)/m(2)) were similar (SAPIEN XT: 13.5%; Portico: 10.0%; P=.56). No between-group differences were found in the occurrence of moderate-severe paravalvular leaks (5.0% vs 4.8% of SAPIEN XT and Portico respectively; P=.90).CONCLUSIONS: Transcatheter aortic valve implantation with the self-expanding Portico system yielded similar short-term hemodynamic performance compared with the balloon-expandable SAPIEN XT system for treating patients with severe aortic stenosis and small annuli. Further prospective studies with longer-term follow-up and in patients with larger aortic annuli are required.
AB - INTRODUCTION AND OBJECTIVES: The self-expanding Portico valve is a new transcatheter aortic valve system yielding promising preliminary results, yet there are no comparative data against earlier generation transcatheter aortic valve systems. The aim of this study was to compare the hemodynamic performance of the Portico and balloon-expandable SAPIEN XT valves in a case-matched study with echocardiographic core laboratory analysis.METHODS: Twenty-two patients underwent transcatheter aortic valve implantation with the Portico 23-mm valve and were matched for aortic annulus area and mean diameter measured by multidetector computed tomography, left ventricular ejection fraction, body surface area, and body mass index with 40 patients treated with the 23-mm SAPIEN XT. Mean aortic annulus diameters were 19.6±1.3mm by transthoracic echocardiography and 21.4±1.2mm by computed tomography, with no significant between-group differences. Doppler echocardiographic images were collected at baseline and at 1-month of follow-up and were analyzed in a central echocardiography core laboratory.RESULTS: There were no significant between-group differences in residual mean transaortic gradients (SAPIEN XT: 10.4±3.7mmHg; Portico: 9.8±1.1mmHg; P=.49) and effective orifice areas (SAPIEN XT: 1.36±0.27cm(2); Portico, 1.37±.29cm(2); P=.54). Rates of severe prosthesis-patient mismatch (effective orifice area<0.65cm(2)/m(2)) were similar (SAPIEN XT: 13.5%; Portico: 10.0%; P=.56). No between-group differences were found in the occurrence of moderate-severe paravalvular leaks (5.0% vs 4.8% of SAPIEN XT and Portico respectively; P=.90).CONCLUSIONS: Transcatheter aortic valve implantation with the self-expanding Portico system yielded similar short-term hemodynamic performance compared with the balloon-expandable SAPIEN XT system for treating patients with severe aortic stenosis and small annuli. Further prospective studies with longer-term follow-up and in patients with larger aortic annuli are required.
KW - Aortic regurgitation
KW - Aortic stenosis
KW - Desajuste prótesis-paciente
KW - Estenosis aórtica
KW - Implante percutáneo de válvula aórtica
KW - Insuficiencia aórtica
KW - Prosthesis-patient mismatch
KW - Transcatheter aortic valve implantation
UR - http://www.scopus.com/inward/record.url?scp=84951953734&partnerID=8YFLogxK
U2 - 10.1016/j.rec.2015.08.019
DO - 10.1016/j.rec.2015.08.019
M3 - Article
C2 - 26739827
AN - SCOPUS:84951953734
SN - 0300-8932
VL - 69
SP - 501
EP - 508
JO - Revista Espanola de Cardiologia
JF - Revista Espanola de Cardiologia
IS - 5
ER -