Author + information
- Sarkis Kiramijyan,
- Marco A. Magalhaes,
- Edward Koifman,
- Ricardo O. Escarcega,
- Nevin C. Baker,
- Rebecca Torguson,
- Michael J. Lipinski,
- Hideaki Ota,
- Smita I. Negi,
- Romain Didier,
- Thibault Lhermusier,
- Won Yu Kang,
- Wenjie Tian,
- Petros Okubagzi,
- William O. Suddath,
- Itsik Ben-Dor,
- Lowell F. Satler,
- Augusto D. Pichard and
- Ron Waksman
Aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) has been associated with worse outcomes, and a direct comparison of the rates of AR between a self-expanding and a balloon-expandable system is not well established. The study retrospectively examined the rates and severity of AR post TAVR in an experienced high-volume tertiary center.
We compared the AR at hospital discharge among patients who underwent transfemoral TAVR with the CoreValve (CV) vs. the SAPIEN XT Valve (XT). The baseline, procedural and post-procedural characteristics were compared. The prevalence of total AR was assessed by pre-discharge transthoracic echocardiogram and was categorized in the degree of severity as none or trace, mild, mild-to-moderate, moderate, moderate-to-severe or severe.
Overall, a total 188 patients (54% male, mean 82 years) who had transfemoral TAVR with either a CV (n=101) or an XT (n=87) were evaluated. There were no statistically significant differences in the rates of any degree of aortic regurgitation with the CV vs. the XT (Figure). In addition, there was no evidence of more than moderate aortic regurgitation in either group. Of note, there was a significant difference in the rates of intra-procedural, post-valve implant re-ballooning with the CV (15%) vs. the XT (5%), p=0.022.
The prevalence of post-TAVR AR in an experienced high-volume center is similar between the CV and the XT valve when performed by experienced operators with optimal post-valve implant re-ballooning, as deemed appropriate.
|Characteristic||CV (n=101)||XT (n=87)||p-Value|
|Re-ballooning post valve implant||15% (14/94)||5% (4/86)||p=0.022|
|No or trace pre-DC AR||21% (17/83)||26% (20/78)||p=0.437|
|Mild pre-DC AR||68% (56/83)||64% (50/78)||p=0.653|
|Mild-to-moderate pre-DC AR||8% (7/83)||5% (4/78)||p=0.406|
|Moderate pre-DC AR||4% (3/83)||5% (4/78)||p=0.713|
|Moderate-to-severe pre-DC AR||0%||0%||------|
|Severe pre-DC AR||0%||0%||------|