Gidon Y Perlman1, Philipp Blanke1, Danny Dvir1, Gregor Pache2, Thomas Modine3, Marco Barbanti4, Erik W Holy5, Hendrik Treede6, Philipp Ruile2, Franz-Josef Neumann2, Caterina Gandolfo7, Francesco Saia8, Corrado Tamburino4, George Mak1, Christopher Thompson1, David Wood1, Jonathon Leipsic1, John G Webb9. 1. Department of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. 2. Departments of Radiology and Cardiology, University Heart Center Freiburg-Bad Krozingen, Germany. 3. Department of Cardiovascular Surgery, Hôpital Cardiologique, Lille, France. 4. Department of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy. 5. Cardiology, University Heart Center, University Hospital Zurich, Zurich, Switzerland. 6. Department of Cardiovascular Surgery, University Heart Center, Hamburg, Germany. 7. Ospedale Civico, Palermo, Italy. 8. Cardiovascular Department, Institute of Cardiology, University of Bologna, Policlinico St. Orsola-Malpighi, Bologna, Italy. 9. Department of Cardiology, St. Paul's Hospital, Vancouver, British Columbia, Canada. Electronic address: John.webb@vch.ca.
Abstract
OBJECTIVES: This study evaluated the results of transcatheter aortic valve replacement (TAVR) in bicuspid aortic stenosis (AS) using a new-generation TAVR device. BACKGROUND: A bicuspid AS is often considered a relative contraindication to TAVR. Although initial reports have demonstrated feasibility using early-generation devices, outcomes have not matched those seen with tricuspid AS. Paravalvular aortic regurgitation (AR) has been particularly problematic. METHODS: We collected baseline characteristics, procedural data, and 30-day clinical follow-up findings from 8 centers in Europe and Canada that had performed TAVR in bicuspid AS using the SAPIEN 3 valve. RESULTS: 51 patients underwent TAVR using the SAPIEN 3 valve. Patient mean age was 76.2 ± 9.3 years and the Society of Thoracic Surgeons predicted risk of mortality scores were 5.2 ± 3.7%. Bicuspid valve types were: type 0, 11.8%; type 1, 82.3%; and type 2, 1.9%. There were no cases of valve embolization or need for a second valve. Post-dilation was performed in 7.8%. The mean aortic gradient decreased from 49.4 ± 16.0 mm Hg to 11.2 ± 4.7 mm Hg. Post-implantation AR was none/trivial in 63% and mild in 37%. There were no cases of moderate or severe AR. At 30-day follow-up, there were 2 deaths (3.9%), 2 major vascular complications, and 12 patients (23.5%) required pacemaker implantation. CONCLUSIONS: TAVR in bicuspid AS using a new-generation device was feasible and effective with favorable valve performance and no cases of moderate or severe AR.
OBJECTIVES: This study evaluated the results of transcatheter aortic valve replacement (TAVR) in bicuspid aortic stenosis (AS) using a new-generation TAVR device. BACKGROUND: A bicuspid AS is often considered a relative contraindication to TAVR. Although initial reports have demonstrated feasibility using early-generation devices, outcomes have not matched those seen with tricuspid AS. Paravalvular aortic regurgitation (AR) has been particularly problematic. METHODS: We collected baseline characteristics, procedural data, and 30-day clinical follow-up findings from 8 centers in Europe and Canada that had performed TAVR in bicuspid AS using the SAPIEN 3 valve. RESULTS: 51 patients underwent TAVR using the SAPIEN 3 valve. Patient mean age was 76.2 ± 9.3 years and the Society of Thoracic Surgeons predicted risk of mortality scores were 5.2 ± 3.7%. Bicuspid valve types were: type 0, 11.8%; type 1, 82.3%; and type 2, 1.9%. There were no cases of valve embolization or need for a second valve. Post-dilation was performed in 7.8%. The mean aortic gradient decreased from 49.4 ± 16.0 mm Hg to 11.2 ± 4.7 mm Hg. Post-implantation AR was none/trivial in 63% and mild in 37%. There were no cases of moderate or severe AR. At 30-day follow-up, there were 2 deaths (3.9%), 2 major vascular complications, and 12 patients (23.5%) required pacemaker implantation. CONCLUSIONS: TAVR in bicuspid AS using a new-generation device was feasible and effective with favorable valve performance and no cases of moderate or severe AR.
Authors: Wolfgang von Scheidt; A Welz; M Pauschinger; T Fischlein; V Schächinger; H Treede; R Zahn; M Hennersdorf; J M Albes; R Bekeredjian; M Beyer; J Brachmann; C Butter; L Bruch; H Dörge; W Eichinger; U F W Franke; N Friedel; T Giesler; R Gradaus; R Hambrecht; M Haude; H Hausmann; M P Heintzen; W Jung; S Kerber; H Mudra; T Nordt; L Pizzulli; F-U Sack; S Sack; B Schumacher; G Schymik; U Sechtem; C Stellbrink; C Stumpf; H M Hoffmeister Journal: Clin Res Cardiol Date: 2019-08-13 Impact factor: 5.460
Authors: Salvatore Pasta; Stefano Cannata; Giovanni Gentile; Marzio Di Giuseppe; Federica Cosentino; Francesca Pasta; Valentina Agnese; Diego Bellavia; Giuseppe M Raffa; Michele Pilato; Caterina Gandolfo Journal: Med Biol Eng Comput Date: 2020-02-06 Impact factor: 2.602
Authors: Raj R Makkar; Sung-Han Yoon; Martin B Leon; Tarun Chakravarty; Michael Rinaldi; Pinak B Shah; Eric R Skipper; Vinod H Thourani; Vasilis Babaliaros; Wen Cheng; Alfredo Trento; Sreekanth Vemulapalli; Samir R Kapadia; Susheel Kodali; Michael J Mack; Gilbert H L Tang; Tsuyoshi Kaneko Journal: JAMA Date: 2019-06-11 Impact factor: 56.272