Supra-Annular Versus Intra-Annular Self-Expanding Valves in Small Aortic Annulus: A Propensity Score-Matched Study

被引:0
|
作者
Sa, Michel Pompeu [1 ,2 ]
Ahmad, Danial [1 ,2 ]
Wang, Yisi [2 ]
Thoma, Floyd [2 ]
Makani, Amber [2 ,3 ]
Kliner, Dustin [2 ,3 ]
Toma, Catalin [2 ,3 ]
West, David [1 ,2 ]
Serna-Gallegos, Derek [1 ,2 ]
Sultan, Ibrahim [1 ,2 ]
机构
[1] Univ Pittsburgh, Dept Cardiothorac Surg, Pittsburgh, PA 15213 USA
[2] Univ Pittsburgh, UPMC Heart & Vasc Inst, Med Ctr, 200 Lothrop St, Pittsburgh, PA 15213 USA
[3] Univ Pittsburgh, Dept Intervent Cardiol, Pittsburgh, PA 15213 USA
来源
STRUCTURAL HEART-THE JOURNAL OF THE HEART TEAM | 2025年 / 9卷 / 01期
关键词
Aortic valve disease; Aortic valve replacement; Aortic valve stenosis; Cardiac surgical procedures; Cardiovascular surgical procedures; Heart valve diseases; Heart valve prosthesis implantation; Transcatheter aortic valve replacement; PROSTHESIS-PATIENT MISMATCH; EXPANDABLE VALVES; REPLACEMENT; IMPLANTATION; METAANALYSIS; STENOSIS; IMPACT;
D O I
10.1016/j.shj.2024.100334
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Transcatheter aortic valve replacement (TAVR) with self-expanding valves (SEVs) may have different outcomes with supra-annular valves (SAVs) or intra-annular valves (IAVs) in patients with small aortic annuli (SAA), but this topic remains underexplored. We aimed to evaluate outcomes between different SEVs, namely SAVs (CoreValve/Evolut R/PRO/PRO+/FX) vs. IAVs (Portico/Navitor). Methods: Single-center data with patients with SAA (maximum diameter <23 mm) who underwent TAVR from 2013 to 2023 with SEVs, followed by 1:1 propensity score matching (PSM). Results: We obtained 86 PSM pairs with median age of 83.0 years (SAVs) and 82.0 years (IAVs), with women representing 77.6% of the PSM cohort. After TAVR, we did not find statistically significant differences for the following outcomes: Valve Academic Research Consortium-3 periprocedural mortality, technical success, device success, clinical efficacy, and rates of paravalvular leak were not statistically significantly different, but we found higher rates of permanent pacemaker implantation in the IAV group (1.2 vs. 8.1%; p = 0.029). Despite the larger indexed effective orifice area with SAVs (median 1.0 vs. 0.8 cm(2)/m(2), p = 0.001), we did not find statistically significant differences between the groups in terms of residual mean gradients >20 mmHg (0.0 vs. 2.3%, p = 0.155), and severe prosthesis-patient mismatch (2.3 vs. 5.8%, p = 0.390). No statistically significant difference was observed in survival (log-rank p = 0.950) and stroke (p = 0.6547) between patients who received SAVs and IAVs. For patients with SAA, TAVR with SEV devices is safe. Conclusions: IAVs and SAVs are associated with comparable device performance in terms of hemodynamic structural and nonstructural dysfunction. Randomized data are needed to validate these findings and guide informed device selection.
引用
收藏
页数:6
相关论文
共 50 条
  • [21] The outcome of TAVI in patients with small annulus and the comparison between intra-annular and supra-annular devices in small anulus: From the analysis of the Japanese nationwide registry
    Meguro, K.
    Hashimoto, T.
    Yanagisawa, T.
    Kitamura, T.
    Ako, J.
    EUROPEAN HEART JOURNAL, 2019, 40 : 1083 - 1083
  • [22] Treating patients with excessively large annuli with self-expanding transcatheter aortic valves: insights into supra-annular structures that anchor the prosthesis
    Xiong, Tian-Yuan
    Liao, Yan-Biao
    Li, Yi-Jian
    Chen, Fei
    Ou, Yuanweixiang
    Wang, Xi
    Wang, Zi-Jie
    Li, Xi
    Zhao, Zhen-Gang
    Meng, Wei
    Feng, Yuan
    Chen, Mao
    HERZ, 2021, 46 : 166 - 172
  • [23] Comparison between low versus intermediate-high risk patients in a contemporary real-world multicentre TAVI registry using self-expanding supra-annular valves: a propensity score matched analysis
    Sticchi, Alessandro
    Gallo, Francesco
    Benenati, Stefano
    Won-keun, Kim
    Khokhar, Arif A.
    Zeus, Tobias
    Toggweiler, Stefan
    De Marco, Federico
    Reimers, Bernhard
    Nombela-franco, Luis
    Barbanti, Marco
    Brugaletta, Salvatore
    Piva, Tommaso
    Rodes-cabau, Joseph
    Porto, Italo
    Colombo, Antonio
    Giannini, Francesco
    EUROPEAN HEART JOURNAL SUPPLEMENTS, 2021, 23 (SUPPL G)
  • [24] Comparison between low versus intermediate-high risk patients in a contemporary real-world multicentre TAVI registry using self-expanding supra-annular valves: a propensity score matched analysis
    Sticchi, Alessandro
    Gallo, Francesco
    Benenati, Stefano
    Won-keun, Kim
    Khokhar, Arif A.
    Zeus, Tobias
    Toggweiler, Stefan
    De Marco, Federico
    Reimers, Bernhard
    Nombela-franco, Luis
    Barbanti, Marco
    Brugaletta, Salvatore
    Piva, Tommaso
    Rodes-cabau, Joseph
    Porto, Italo
    Colombo, Antonio
    Giannini, Francesco
    EUROPEAN HEART JOURNAL SUPPLEMENTS, 2021, 23 (0G)
  • [25] In Vivo Frame Geometry of the Navitor Intra-Annular Self-Expanding Valve
    Tang, Gilbert H. L.
    Kobari, Yusuke
    Vinayak, Manish
    Krishnamoorthy, Parasuram
    Safi, Lucy M.
    Lerakis, Stamatios
    Dangas, George D.
    Kini, Annapoorna S.
    De Backer, Ole
    Khera, Sahil
    JACC-CARDIOVASCULAR INTERVENTIONS, 2025, 18 (01) : 138 - 140
  • [26] Transcatheter Aortic Valve Implantation With Intra-Annular Self-Expanding or Balloon-Expandable Valves: The International Multicenter NAVULTRA Registry
    Cannata, Stefano
    Van Mieghem, Nicolas
    De Backer, Ole
    Byrne, Jonathan
    Nombela Franco, Luis
    Tchetche, Didier
    Barbanti, Marco
    Barbato, Emanuele
    Blackman, Daniel
    Amat Santos, Ignacio Jesus
    Bedogni, Francesco
    Gandolfo, Caterina
    Latib, Azeem
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2024, 84 (18) : B387 - B387
  • [27] The Evolut Supra-Annular, Self-Expanding Transcatheter Aortic Bioprosthesis Provides Symmetric Scaffolding for Leaflet Coaptation Despite Variable Annular Morphology
    Puri, Rishi
    Spencer, Julianne
    Tchetche, Didier
    Forrest, John
    Reardon, Michael
    Sanchez, Jorge Zhingre
    Popma, Jeffrey
    Tang, Gilbert
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2022, 80 (12) : B200 - B201
  • [28] Treatment of Symptomatic Severe Aortic Stenosis With a Novel Resheathable Supra-Annular Self-Expanding Transcatheter Aortic Valve System
    Manoharan, Ganesh
    Walton, Antony S.
    Brecker, Stephen J.
    Pasupati, Sanjeevan
    Blackman, Daniel J.
    Qiao, Hongyan
    Meredith, Ian T.
    JACC-CARDIOVASCULAR INTERVENTIONS, 2015, 8 (10) : 1359 - 1367
  • [29] Balloon-Expandable Valve for Treatment of Self-Expanding Supra-Annular Valve Failure
    Strazzieri, Orazio
    Motta, Silvia Crescenzia
    Costa, Giuliano
    Valvo, Roberto
    Reddavid, Claudia
    Frittitta, Valentina
    Dipietro, Elena
    Melfa, Chiara
    Comis, Alessandro
    Sgroi, Carmelo
    Tamburino, Corrado
    Barbanti, Marco
    JACC-CARDIOVASCULAR INTERVENTIONS, 2023, 16 (01) : 118 - 119
  • [30] Hemodynamic comparison of Bioprostheses for complete supra-annular position in patients with small aortic annulus
    Botzenhardt, F
    Eichinger, WB
    Bleiziffer, S
    Guenzinger, R
    Wagner, IM
    Bauernschmitt, R
    Lange, R
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 45 (12) : 2054 - 2060