P3739Differences in short-term outcome between balloon- and self-expandable TAVR devices relating to more than one generation

Abstract Background Transcatheter aortic valve replacement (TAVR) is the treatment option of choice in inoperable and high-risk patients and only recently even revealed favorable outcome in an intermediate risk cohort. Morbidity- and outcome relevant factors like paravalvular aortic regurgitation, v...

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Veröffentlicht in:European heart journal 2019-10, Vol.40 (Supplement_1)
Hauptverfasser: Veulemans, V V, Klein, K, Maier, O, Wolff, G, Polzin, A, Westenfeld, R, Jung, C, Blehm, A, Lichtenberg, A, Kelm, M, Zeus, T
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Sprache:eng
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Zusammenfassung:Abstract Background Transcatheter aortic valve replacement (TAVR) is the treatment option of choice in inoperable and high-risk patients and only recently even revealed favorable outcome in an intermediate risk cohort. Morbidity- and outcome relevant factors like paravalvular aortic regurgitation, vascular access complications and the need for permanent pacemaker implantation remain key challenges during balloon- and self-expandable valve-improvement. Purpose We aimed to address safety and effectiveness between balloon- and self-expandable TAVR devices relating to more than one generation. Methods Patients treated with TAVR between 2009 and 2018 were categorized into either balloon-expandable (BAVR, n=516) or self-expandable (SAVR, n=974) groups. TAVR endpoints and adverse events were defined according to the Valve Academic Research Consortium-2. Primary endpoint was 30-day mortality. Results Logistic EuroSCORE I as predictor for risk stratification and 30-day mortality was comparable between both cohorts (BAVR/SAVR: 25.7%±5.2 vs 25.5%±2.5; p=n.s). Compared to SAVR devices, BAVR devices had significantly higher periprocedural gradients (BAVR/SAVR: 11.7mmHg±0.1 vs 8.3mmHg±0.8; p=0.0175), lower incidence of new renal replacement therapy (BAVR/SAVR: 1.8% vs 4.6%; p=0.0025), and new permanent pacemaker therapy for conduction disturbances (BAVR/SAVR: 8.3% vs 17.3%; p
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehz745.0593