Early clinical and procedural outcomes in large series of 34-mm self-expanding transcatheter aortic valve replacement

Autor: Khawaja Afzal Ammar, Payal Sharma, Daniel P. O'Hair, Ahmed Dalmar, Zuber Sherefa Ali, Suhail Allaqaband, Tadele W. Mengesha, Bijoy K. Khandheria, Renuka Jain, Tanvir Bajwa
Rok vydání: 2019
Předmět:
Aortic valve
Male
medicine.medical_specialty
Time Factors
Transcatheter aortic
Sedation
medicine.medical_treatment
030204 cardiovascular system & hematology
Prosthesis Design
Prosthesis
Severity of Illness Index
Perimeter
Transcatheter Aortic Valve Replacement
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Valve replacement
Risk Factors
medicine
Humans
Radiology
Nuclear Medicine and imaging
030212 general & internal medicine
Hospital Mortality
Aged
Retrospective Studies
Aged
80 and over
Framingham Risk Score
business.industry
General Medicine
Aortic Valve Stenosis
Recovery of Function
Surgery
medicine.anatomical_structure
Treatment Outcome
Cardiothoracic surgery
Aortic Valve
Heart Valve Prosthesis
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventionsREFERENCES. 96(4)
ISSN: 1522-726X
Popis: Objectives We aimed to evaluate early clinical and procedural outcomes with the 34-mm Evolut R transcatheter aortic valve replacement (TAVR) prosthesis. Background The 34-mm Evolut R (Medtronic, Minneapolis, MN) self-expanding TAVR prosthesis was designed to treat patients with larger annuli. Methods Clinical, demographic, procedural, and echocardiographic data on consecutive patients who underwent TAVR with a 34-mm Evolut R prosthesis at our institution were collected and analyzed. Results One hundred ninety-six patients underwent TAVR with this prosthesis from November 2016 to July 2018, a majority (n = 188, 96%) through transfemoral access and with conscious sedation (n = 182, 93%). Mean age, Society of Thoracic Surgery risk score, and follow-up were 82 ± 8 years, 5.4 ± 5%, and 8.2 ± 5.3 months, respectively. Mean aortic valve (AV) peak velocity was 4.0 ± 0.6 m/s, mean AV gradient was 38 ± 13 mmHg, AV area was 0.79 ± 0.23 cm2 ; calcium score was 3,503 ± 1,970 Agatston units, and perimeter was 85 ± 4.3 mm. Device implantation was successful in all but one patient. Postprocedure mean AV peak velocity, AV mean gradient, and AV area were 1.9 ± 0.4 m/s, 7 ± 3 mmHg, and 2.6 ± 0.7 cm2 , respectively. New pacemaker requirement rate was 16%, and moderate paravalvular leak was present in six patients (3%), which improved to mild in three patients at 6-month follow-up. In-hospital, 30-day, 6-month, and 12-month survival rates were 98%, 96% (hospital discharge), 96% (30-day), 89% (6-month), and 83% (12-month). Conclusion These data demonstrate high success and good procedural, echocardiographic, and clinical outcomes of 34-mm Evolut R in patients with large annuli.
Databáze: OpenAIRE
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