Hemodynamics of self-expanding versus balloon-expandable transcatheter heart valves in relation to native aortic annulus anatomy
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Hemodynamics of self-expanding versus balloon-expandable transcatheter heart valves in relation to native aortic annulus anatomy. / Schmidt, Sarah; Fortmeier, Vera; Ludwig, Sebastian; Wienemann, Hendrik; Körber, Maria Isabel; Lee, Samuel; Meertens, Max; Macherey, Sascha; Iliadis, Christos; Kuhn, Elmar; Eghbalzadeh, Kaveh; Bleiziffer, Sabine; Baldus, Stephan; Schofer, Niklas; Rudolph, Tanja Katharina; Adam, Matti; Mauri, Victor.
in: CLIN RES CARDIOL, Jahrgang 111, Nr. 12, 12.2022, S. 1336-1347.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Hemodynamics of self-expanding versus balloon-expandable transcatheter heart valves in relation to native aortic annulus anatomy
AU - Schmidt, Sarah
AU - Fortmeier, Vera
AU - Ludwig, Sebastian
AU - Wienemann, Hendrik
AU - Körber, Maria Isabel
AU - Lee, Samuel
AU - Meertens, Max
AU - Macherey, Sascha
AU - Iliadis, Christos
AU - Kuhn, Elmar
AU - Eghbalzadeh, Kaveh
AU - Bleiziffer, Sabine
AU - Baldus, Stephan
AU - Schofer, Niklas
AU - Rudolph, Tanja Katharina
AU - Adam, Matti
AU - Mauri, Victor
N1 - © 2022. The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - OBJECTIVES: This study aimed to compare hemodynamic characteristics of different self-expanding (SE) and balloon-expandable (BE) transcatheter heart valves (THV) in relation to native aortic annulus anatomy.BACKGROUND: A patient centered THV selection becomes increasingly important as indications for transcatheter aortic valve replacement (TAVR) are extended towards lower risk populations.METHODS: Hemodynamic parameters including mean gradient (MG), effective orifice area (EOA), Doppler velocity index (DVI), degree of paravalvular regurgitation (PVR) and patient-prosthesis mismatch (PPM) were compared by valve type, label size and in relation to quintiles of native aortic annulus area.RESULTS: 2609 patients were treated at 3 centers in Germany with SAPIEN 3 (n = 1146), ACURATE Neo (n = 649), Evolut R (n = 546) or Evolut Pro (n = 268) THV. SE THVs provided superior hemodynamics in terms of larger EOA, higher DVI and lower MG compared to BE THV, especially in patients with small aortic annuli. Severe PPM was less frequent in SE treated patients. The rate of PVR ≥ moderate was comparable for SE and BE devices in smaller annular dimensions, but remarkably lower for BE TAVR in large aortic annular dimensions (> 547.64 mm2) (2% BE THV vs. > 10% for SE THV; p < 0.001).CONCLUSIONS: Patients with small aortic annular dimensions may benefit hemodynamically from SE THV. With increasing annulus size, BE THV may have advantages since PVR ≥ moderate occurs less frequently.
AB - OBJECTIVES: This study aimed to compare hemodynamic characteristics of different self-expanding (SE) and balloon-expandable (BE) transcatheter heart valves (THV) in relation to native aortic annulus anatomy.BACKGROUND: A patient centered THV selection becomes increasingly important as indications for transcatheter aortic valve replacement (TAVR) are extended towards lower risk populations.METHODS: Hemodynamic parameters including mean gradient (MG), effective orifice area (EOA), Doppler velocity index (DVI), degree of paravalvular regurgitation (PVR) and patient-prosthesis mismatch (PPM) were compared by valve type, label size and in relation to quintiles of native aortic annulus area.RESULTS: 2609 patients were treated at 3 centers in Germany with SAPIEN 3 (n = 1146), ACURATE Neo (n = 649), Evolut R (n = 546) or Evolut Pro (n = 268) THV. SE THVs provided superior hemodynamics in terms of larger EOA, higher DVI and lower MG compared to BE THV, especially in patients with small aortic annuli. Severe PPM was less frequent in SE treated patients. The rate of PVR ≥ moderate was comparable for SE and BE devices in smaller annular dimensions, but remarkably lower for BE TAVR in large aortic annular dimensions (> 547.64 mm2) (2% BE THV vs. > 10% for SE THV; p < 0.001).CONCLUSIONS: Patients with small aortic annular dimensions may benefit hemodynamically from SE THV. With increasing annulus size, BE THV may have advantages since PVR ≥ moderate occurs less frequently.
KW - Humans
KW - Aortic Valve Stenosis/diagnosis
KW - Heart Valve Prosthesis
KW - Aortic Valve/diagnostic imaging
KW - Prosthesis Design
KW - Treatment Outcome
KW - Time Factors
KW - Transcatheter Aortic Valve Replacement/adverse effects
KW - Hemodynamics
U2 - 10.1007/s00392-022-02046-7
DO - 10.1007/s00392-022-02046-7
M3 - SCORING: Journal article
C2 - 35704088
VL - 111
SP - 1336
EP - 1347
JO - CLIN RES CARDIOL
JF - CLIN RES CARDIOL
SN - 1861-0684
IS - 12
ER -