Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses.
Eur Heart J Cardiovasc Imaging
; 19(1): 39-46, 2018 01 01.
Article
em En
| MEDLINE
| ID: mdl-28158582
ABSTRACT
Aims:
Patients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR. Methods andresults:
This is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm2 vs. 1.02 ± 0.05 cm2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01).Conclusion:
Patients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Estenose da Valva Aórtica
/
Complicações Pós-Operatórias
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Próteses Valvulares Cardíacas
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Implante de Prótese de Valva Cardíaca
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Remodelação Ventricular
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Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Animals
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Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Eur Heart J Cardiovasc Imaging
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Dinamarca