Aortic Regurgitation in Patients Undergoing Transcatheter Aortic Valve Replacement with the Self-Expanding CoreValve Versus the Balloon-Expandable SAPIEN XT Valve

Sarkis Kiramijyan, Marco A. Magalhaes, Edward Koifman, Romain Didier, Ricardo O. Escarcega, Nevin C. Baker, Smita I. Negi, Sa'ar Minha, Rebecca Torguson, Gai Jiaxiang, Federico M. Asch, Zuyue Wang, Petros Okubagzi, Michael A. Gaglia, Itsik Ben-Dor, Lowell F. Satler, Augusto D. Pichard, Ron Waksman

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups. A multivariate logistic regression analysis was completed to evaluate for correlates of the primary end point. The secondary end points included the change in severity of AR at 30-day and 1-year follow-up. A total of 223 consecutive patients (53% men, mean age 82 years) who had transfemoral TAVR with either a CV (n = 119) or XT (n = 104) were evaluated. The rates of post-TAVR AR in the groups were similar, and there was no evidence of more-than-moderate AR in either group. There were significant differences in the rates of intraprocedural balloon postdilation with the CV (17.1%) versus XT valve (5.8%; p = 0.009) and in the rates of intraprocedural implantation of a second valve-in-valve prosthesis with the CV (9.9%) versus XT valve (2.2%; p = 0.036). There were no significant differences in inhospital safety outcomes between the 2 groups. In conclusion, the incidence of post-TAVR AR is similar between the CV and the XT valve when performed by experienced operators using optimal intraprocedural strategies, as deemed appropriate, to mitigate the severity of AR.

Original languageEnglish
Pages (from-to)1502-1510
Number of pages9
JournalAmerican Journal of Cardiology
Volume117
Issue number9
DOIs
StatePublished - 1 May 2016
Externally publishedYes

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