Isaac Pascual1, Daniel Hernández-Vaquero1, Alberto Alperi2, Marcel Almendarez3, Pablo Avanzas4, Dimitri Kalavrouziotis2, Rebeca Lorca3, Jules Mesnier2, Luis Arboine5, Siamak Mohammadi2, Raquel Del Valle3, Eric Dumont2, Victor Leon6, Robert De Larochelliere2, Josep Rodés-Cabau2, Cesar Moris1. 1. Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain; Research Institute of the Principado de Asturias, Oviedo, Spain; Department of Medicine, Faculty of Medicine, University of Oviedo, Oviedo, Spain. 2. Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada. 3. Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain; Research Institute of the Principado de Asturias, Oviedo, Spain. 4. Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain; Research Institute of the Principado de Asturias, Oviedo, Spain; Department of Medicine, Faculty of Medicine, University of Oviedo, Oviedo, Spain. Electronic address: avanzas@secardiologia.es. 5. Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain; Interventional Cardiology Department, Unidad Médica de Alta Especialidad, Hospital de Cardiología 34, Monterrey, Mexico. 6. Heart Area, Hospital Universitario Central de Asturias, Oviedo, Spain.
Abstract
OBJECTIVES: The aim of this study was to determine if modifying the classical implantation technique for self-expanding (SE) transcatheter aortic valve replacement to a novel cusp-overlapping projection (COP) technique results in a higher implantation depth (ID) and subsequently reduces the rate of permanent pacemaker implantation (PPMI). BACKGROUND: The COP technique presents the potential benefit of an optimized ID to reduce the rate of PPMI. However, only a few studies have compared clinical outcomes with those achieved using the standard technique. This is the first study to systematically evaluate this approach for SE transcatheter heart valves (THVs) in different populations METHODS: Beginning in February 2015, 444 patients were consecutively included. Propensity score matching was used to control baseline characteristics because of the observational nature of the study. In total, 161 pairs of patients were analyzed. Three methods were used to measure ID (noncoronary cusp [NCC] to the THV, mean of the NCC and the left coronary cusp [LCC] to the THV, and the deepest edge from the LCC and the NCC to the THV). RESULTS: ID was significantly higher in COP cases when measuring from the NCC (4.2 mm vs 5.3 mm; P < 0.001) and the mean from the NCC and the LCC (5.3 mm vs 5.9 mm; P = 0.04), but not from the deepest edge. The PPMI rate was lower in the COP group: 19 (11.8%) vs 35 (21.7%) (P = 0.03; relative risk: 0.54; 95% CI: 0.32-0.91). CONCLUSIONS: The present study showed that the COP technique significantly reduces PPMI in SE THV implantation compared with the classical implantation technique, with similar rates of complications.
OBJECTIVES: The aim of this study was to determine if modifying the classical implantation technique for self-expanding (SE) transcatheter aortic valve replacement to a novel cusp-overlapping projection (COP) technique results in a higher implantation depth (ID) and subsequently reduces the rate of permanent pacemaker implantation (PPMI). BACKGROUND: The COP technique presents the potential benefit of an optimized ID to reduce the rate of PPMI. However, only a few studies have compared clinical outcomes with those achieved using the standard technique. This is the first study to systematically evaluate this approach for SE transcatheter heart valves (THVs) in different populations METHODS: Beginning in February 2015, 444 patients were consecutively included. Propensity score matching was used to control baseline characteristics because of the observational nature of the study. In total, 161 pairs of patients were analyzed. Three methods were used to measure ID (noncoronary cusp [NCC] to the THV, mean of the NCC and the left coronary cusp [LCC] to the THV, and the deepest edge from the LCC and the NCC to the THV). RESULTS: ID was significantly higher in COP cases when measuring from the NCC (4.2 mm vs 5.3 mm; P < 0.001) and the mean from the NCC and the LCC (5.3 mm vs 5.9 mm; P = 0.04), but not from the deepest edge. The PPMI rate was lower in the COP group: 19 (11.8%) vs 35 (21.7%) (P = 0.03; relative risk: 0.54; 95% CI: 0.32-0.91). CONCLUSIONS: The present study showed that the COP technique significantly reduces PPMI in SE THV implantation compared with the classical implantation technique, with similar rates of complications.
Authors: Oliver Maier; Kerstin Piayda; Stephan Binnebößel; Nora Berisha; Shazia Afzal; Amin Polzin; Kathrin Klein; Ralf Westenfeld; Patrick Horn; Christian Jung; Malte Kelm; Verena Veulemans; Tobias Zeus Journal: Front Cardiovasc Med Date: 2022-08-31
Authors: Philipp Maximilian Doldi; Lukas Stolz; Felix Escher; Julius Steffen; Jonas Gmeiner; Daniel Roden; Marie Linnemann; Kornelia Löw; Simon Deseive; Thomas J Stocker; Martin Orban; Hans Theiss; Konstantinos Rizas; Adrian Curta; Sebastian Sadoni; Joscha Buech; Dominik Joskowiak; Sven Peterss; Christian Hagl; Steffen Massberg; Jörg Hausleiter; Daniel Braun Journal: J Clin Med Date: 2022-03-12 Impact factor: 4.241