Self-expanding and balloon-expandable valves in low risk TAVR patients.
Int J Cardiol
; 395: 131431, 2024 Jan 15.
Article
em En
| MEDLINE
| ID: mdl-37832606
ABSTRACT
BACKGROUND:
Recent randomized studies have broadened the indication of transcatheter aortic valve replacement (TAVR) to also include low-surgical-risk patients. However, the data on self-expanding (SE) and balloon-expandable (BE) valves in low-risk patients remain sparse.METHODS:
The current study is a post hoc analysis of combined data from both LRT 1.0 and 2.0 trials comparing BE and SE transcatheter heart valves.RESULTS:
A total of 294 patients received a BE valve, and 102 patients received an SE valve. The 30-day clinical outcomes were similar across both groups except for stroke (4.9% vs. 0.7%, p = 0.014) and permanent pacemaker implantation (17.8% vs. 5.8%, p < 0.001), which were higher in the SE cohort than the BE cohort. No difference was observed in terms of paravalvular leak (≥moderate) between the groups (0% vs. 1.5%, p = 0.577). SE patients had higher aortic valve area (1.92 ± 0.43 mm2 vs. 1.69 ± 0.45 mm2, p < 0.001) and lower mean gradient (8.93 ± 3.53 mmHg vs. 13.41 ± 4.73 mmHg, p < 0.001) than BE patients. In addition, the rate of subclinical leaflet thrombosis was significantly lower in SE patients (5.6% vs. 13.8%, p = 0.038).CONCLUSION:
In this non-randomized study assessing SE and BE valves in low-risk TAVR patients, SE valves are associated with better hemodynamics and lesser leaflet thrombosis, with increased rates of stroke and permanent pacemaker implantation at 30 days; however, this could be due to certain patient-dependent factors not fully evaluated in this study. The long-term implications of these outcomes on structural valve durability remain to be further investigated. CLINICAL TRIAL REGISTRY LRT 1.0 NCT02628899 LRT 2.0 NCT03557242.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
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Trombose
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Próteses Valvulares Cardíacas
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Acidente Vascular Cerebral
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Substituição da Valva Aórtica Transcateter
Limite:
Humans
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos