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Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves

Standard

Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves. / Wienemann, Hendrik; Maier, Oliver; Beyer, Martin; Portratz, Max; Tanaka, Tetsu; Mauri, Victor; Ernst, Angela; Waldschmidt, Lara; Kuhn, Elmar; Bleiziffer, Sabine; Wilde, Nihal; Schaefer, Andreas; Zeus, Tobias; Baldus, Stephan; Zimmer, Sebastian; Veulemans, Verena; Rudolph, Tanja Katharina; Adam, Matti.

In: EUROINTERVENTION, Vol. 19, No. 2, 05.06.2023, p. e176-e187.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Wienemann, H, Maier, O, Beyer, M, Portratz, M, Tanaka, T, Mauri, V, Ernst, A, Waldschmidt, L, Kuhn, E, Bleiziffer, S, Wilde, N, Schaefer, A, Zeus, T, Baldus, S, Zimmer, S, Veulemans, V, Rudolph, TK & Adam, M 2023, 'Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves', EUROINTERVENTION, vol. 19, no. 2, pp. e176-e187. https://doi.org/10.4244/EIJ-D-22-01030

APA

Wienemann, H., Maier, O., Beyer, M., Portratz, M., Tanaka, T., Mauri, V., Ernst, A., Waldschmidt, L., Kuhn, E., Bleiziffer, S., Wilde, N., Schaefer, A., Zeus, T., Baldus, S., Zimmer, S., Veulemans, V., Rudolph, T. K., & Adam, M. (2023). Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves. EUROINTERVENTION, 19(2), e176-e187. https://doi.org/10.4244/EIJ-D-22-01030

Vancouver

Wienemann H, Maier O, Beyer M, Portratz M, Tanaka T, Mauri V et al. Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves. EUROINTERVENTION. 2023 Jun 5;19(2):e176-e187. https://doi.org/10.4244/EIJ-D-22-01030

Bibtex

@article{a58d70b1b6da488a8184095eedc96ab1,
title = "Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves",
abstract = "BACKGROUND: Reducing rates of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is important for achieving the best procedural outcomes. The cusp overlap technique (COT) implements procedural steps including an overlap angulation of the right and left coronary cusp to mitigate this complication.AIMS: We investigated the incidence of PPI and complication rates following the COT compared to the standard three-cusp implantation technique (3CT) in an all-comers cohort.METHODS: A total of 2,209 patients underwent TAVI with the self-expanding Evolut platform from January 2016 to April 2022 at five sites. Baseline, procedural and in-hospital outcome characteristics were compared for both techniques before and after one-to-one propensity score matching.RESULTS: A total of 1,151 patients were implanted using the 3CT and 1,058 using the COT. At discharge, the rates of PPI (17.0 vs 12.3%; p=0.002) and moderate/severe paravalvular regurgitation (4.6% vs 2.4%; p=0.006) were significantly reduced with the COT compared with 3CT within the unmatched cohort. Overall procedural success and complication rates were similar; major bleeding was less common in the COT group (7.0% vs 4.6%; p=0.020). These results remained consistent after propensity score matching. In multivariable logistic regression analysis, right bundle branch block (odds ratio [OR] 7.19, 95% confidence interval [CI]: 5.18-10.0; p<0.001) and diabetes mellitus (OR 1.38, 95% CI: 1.05-1.80; p=0.021) emerged as predictors of PPI, whereas the COT (OR 0.63, 95% CI: 0.49-0.82; p<0.001) was protective.CONCLUSIONS: The introduction of the COT was associated with a significant and relevant reduction of PPI and paravalvular regurgitation rates without an increase in complication rates.",
keywords = "Humans, Aortic Valve/surgery, Aortic Valve Stenosis/surgery, Postoperative Complications/epidemiology, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome, Prosthesis Design, Pacemaker, Artificial, Risk Factors",
author = "Hendrik Wienemann and Oliver Maier and Martin Beyer and Max Portratz and Tetsu Tanaka and Victor Mauri and Angela Ernst and Lara Waldschmidt and Elmar Kuhn and Sabine Bleiziffer and Nihal Wilde and Andreas Schaefer and Tobias Zeus and Stephan Baldus and Sebastian Zimmer and Verena Veulemans and Rudolph, {Tanja Katharina} and Matti Adam",
year = "2023",
month = jun,
day = "5",
doi = "10.4244/EIJ-D-22-01030",
language = "English",
volume = "19",
pages = "e176--e187",
journal = "EUROINTERVENTION",
issn = "1774-024X",
publisher = "EUROPA EDITION",
number = "2",

}

RIS

TY - JOUR

T1 - Cusp overlap versus standard three-cusp technique for self-expanding Evolut transcatheter aortic valves

AU - Wienemann, Hendrik

AU - Maier, Oliver

AU - Beyer, Martin

AU - Portratz, Max

AU - Tanaka, Tetsu

AU - Mauri, Victor

AU - Ernst, Angela

AU - Waldschmidt, Lara

AU - Kuhn, Elmar

AU - Bleiziffer, Sabine

AU - Wilde, Nihal

AU - Schaefer, Andreas

AU - Zeus, Tobias

AU - Baldus, Stephan

AU - Zimmer, Sebastian

AU - Veulemans, Verena

AU - Rudolph, Tanja Katharina

AU - Adam, Matti

PY - 2023/6/5

Y1 - 2023/6/5

N2 - BACKGROUND: Reducing rates of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is important for achieving the best procedural outcomes. The cusp overlap technique (COT) implements procedural steps including an overlap angulation of the right and left coronary cusp to mitigate this complication.AIMS: We investigated the incidence of PPI and complication rates following the COT compared to the standard three-cusp implantation technique (3CT) in an all-comers cohort.METHODS: A total of 2,209 patients underwent TAVI with the self-expanding Evolut platform from January 2016 to April 2022 at five sites. Baseline, procedural and in-hospital outcome characteristics were compared for both techniques before and after one-to-one propensity score matching.RESULTS: A total of 1,151 patients were implanted using the 3CT and 1,058 using the COT. At discharge, the rates of PPI (17.0 vs 12.3%; p=0.002) and moderate/severe paravalvular regurgitation (4.6% vs 2.4%; p=0.006) were significantly reduced with the COT compared with 3CT within the unmatched cohort. Overall procedural success and complication rates were similar; major bleeding was less common in the COT group (7.0% vs 4.6%; p=0.020). These results remained consistent after propensity score matching. In multivariable logistic regression analysis, right bundle branch block (odds ratio [OR] 7.19, 95% confidence interval [CI]: 5.18-10.0; p<0.001) and diabetes mellitus (OR 1.38, 95% CI: 1.05-1.80; p=0.021) emerged as predictors of PPI, whereas the COT (OR 0.63, 95% CI: 0.49-0.82; p<0.001) was protective.CONCLUSIONS: The introduction of the COT was associated with a significant and relevant reduction of PPI and paravalvular regurgitation rates without an increase in complication rates.

AB - BACKGROUND: Reducing rates of permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) is important for achieving the best procedural outcomes. The cusp overlap technique (COT) implements procedural steps including an overlap angulation of the right and left coronary cusp to mitigate this complication.AIMS: We investigated the incidence of PPI and complication rates following the COT compared to the standard three-cusp implantation technique (3CT) in an all-comers cohort.METHODS: A total of 2,209 patients underwent TAVI with the self-expanding Evolut platform from January 2016 to April 2022 at five sites. Baseline, procedural and in-hospital outcome characteristics were compared for both techniques before and after one-to-one propensity score matching.RESULTS: A total of 1,151 patients were implanted using the 3CT and 1,058 using the COT. At discharge, the rates of PPI (17.0 vs 12.3%; p=0.002) and moderate/severe paravalvular regurgitation (4.6% vs 2.4%; p=0.006) were significantly reduced with the COT compared with 3CT within the unmatched cohort. Overall procedural success and complication rates were similar; major bleeding was less common in the COT group (7.0% vs 4.6%; p=0.020). These results remained consistent after propensity score matching. In multivariable logistic regression analysis, right bundle branch block (odds ratio [OR] 7.19, 95% confidence interval [CI]: 5.18-10.0; p<0.001) and diabetes mellitus (OR 1.38, 95% CI: 1.05-1.80; p=0.021) emerged as predictors of PPI, whereas the COT (OR 0.63, 95% CI: 0.49-0.82; p<0.001) was protective.CONCLUSIONS: The introduction of the COT was associated with a significant and relevant reduction of PPI and paravalvular regurgitation rates without an increase in complication rates.

KW - Humans

KW - Aortic Valve/surgery

KW - Aortic Valve Stenosis/surgery

KW - Postoperative Complications/epidemiology

KW - Heart Valve Prosthesis

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

KW - Prosthesis Design

KW - Pacemaker, Artificial

KW - Risk Factors

U2 - 10.4244/EIJ-D-22-01030

DO - 10.4244/EIJ-D-22-01030

M3 - SCORING: Journal article

C2 - 37013922

VL - 19

SP - e176-e187

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 2

ER -