Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:735-42 - Vol. 71 Num.09 DOI: 10.1016/j.rec.2017.10.025

Comparison of the Hemodynamic Performance of the Balloon-expandable SAPIEN 3 Versus Self-expandable Evolut R Transcatheter Valve: A Case-matched Study

Eduardo Enríquez-Rodríguez a, Ignacio J. Amat-Santos b, Pilar Jiménez-Quevedo a, Irene Martín-Morquecho b, Gabriela Tirado-Conte a, María José Pérez-Vizcayno a, José Juan Gómez de Diego c, Roman Arnold b, Andrés Aldazábal a, Paol Rojas b, Alberto de Agustín c, María Del Trigo a, Hipólito Gutiérrez b, José A. San Román b, Carlos Macaya a, Luis Nombela-Franco a,

a Departamento de Cardiología Intervencionista, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, IdISSC, Madrid, Spain
b Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), CIBERCV, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
c Departamento de Imagen Cardiaca, Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain

Keywords

Transcatheter aortic valve implantation. SAPIEN 3. Evolut R.

Abstract

Introduction and objectives

The SAPIEN 3 (S3) valve and the Medtronic Evolut R (EVR) are second-generation transcatheter valves, designed to further reduce the rate of paravalvular aortic regurgitation (AoR). The aim of this study was to compare the 2 devices in terms of valve performance in a case-matched study with independent echocardiographic analysis.

Methods

Of a population of 201 patients who underwent transcatheter aortic valve implantation, 144 patients (S3, n = 80; EVR, n = 64) were matched according to aortic annulus diameter and aortic valve calcium score, as assessed by computed tomography. All echocardiographic examinations collected at baseline and at 1- and 6-month follow-up were centrally analyzed.

Results

The 2 groups were well balanced in baseline clinical and echocardiographic characteristics. The EVR valve showed a better hemodynamic profile as assessed by peak aortic gradient (EVR 13 ± 7 vs S3 20 ± 10 mmHg; P < .001), mean aortic gradient (EVR 7 ± 3 vs S3 11 ± 6 mmHg; P < .001), and Doppler velocity index (EVR 0.65 ± 0.15 vs S3 0.51 ± 0.16; P < .001). The rate of moderate-severe or any paravalvular (≥ mild) AoR was higher in the EVR group (11% and 50%) than in the S3 group (2.5% and 21%; P < .05, respectively), with a larger number of paravalvular jets (P < .001).

Conclusions

In a case-matched cohort of transcatheter aortic valve implantation patients, the S3 valve was associated with a lower rate of paravalvular AoR but also with a higher residual gradient than the EVR system.

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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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