The aim of this study was to compare the outcomes of transcatheter aortic valve implantation
using the Edwards SAPIEN valve and the Medtronic CoreValve in patients with annulus
of intermediate size (20 to 25 mm). From October 2008 to April 2012, 662 consecutive
patients who underwent transcatheter aortic valve implantation were studied at 2 French
centers. After propensity score matching, a total of 192 patients with intermediate-sized
aortic annulus who had received either Edwards (n = 96, mean age 82.4 ± 7.9 years,
48% men, 61.9% receiving the 26-mm valve) or CoreValve (n = 96, mean age 82.5 ± 7.7 years,
50% men, 64.6% receiving the 29-mm valve) prostheses through the transfemoral approach
were studied. Adequate reduction in postprocedural mean pressure gradients was achieved
with the Edwards valve and the CoreValve (10.9 ± 4.7 vs 9.1 ± 4.4 mm Hg, respectively,
p <0.01). Major vascular complications (5.2% vs 3.1%, p = 0.36), device success (95.8%
vs 93.8%, p = 0.52), and 30-day survival (90.6% vs 89.6%, p = 0.81) were similar.
The incidence of postprocedural aortic regurgitation grade ≥2/4 and new pacemaker
implantation was more frequent in the CoreValve group (14.3% vs 35.5%, p <0.01, and
4.2% vs 18.8%, p <0.01, respectively). There was no significant difference in 1-year
cumulative survival rates in the Edwards valve group compared with the CoreValve group
(80.1 ± 4.2% vs 75.6 ± 4.9%, log-rank p = 0.31). In conclusion, in patients with annulus
of intermediate size, similar device success and short-term and midterm outcomes were
achieved with either of the valves, irrespective of the specific complications related
to each valve.
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Article Info
Publication History
Published online: June 10, 2013
Accepted:
April 11,
2013
Received in revised form:
April 11,
2013
Received:
February 4,
2013
Footnotes
See page 711 for disclosure information.
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
