Early clinical and procedural outcomes in large series of 34-mm self-expanding transcatheter aortic valve replacement

Authors

Zuber S. Ali, Advocate Aurora HealthFollow
Payal Sharma, Advocate Aurora HealthFollow
Tadele W. Mengesha, Advocate Aurora HealthFollow
Ahmed Dalmar, Advocate Aurora HealthFollow
Khawaja A. Ammar, Advocate Aurora HealthFollow
Suhail Allaqaband, Advocate Aurora HealthFollow
Daniel O'Hair, Advocate Aurora HealthFollow
Bijoy K. Khandheria, Advocate Aurora HealthFollow
Renuka Jain, Advocate Aurora HealthFollow
Tanvir Bajwa MD, Advocate Aurora HealthFollow

Recommended Citation

Ali Z, Sharma P, Mengesha T, et al. Early clinical and procedural outcomes in large series of 34-mm self-expanding transcatheter aortic valve replacement. Catheter Cardiovasc Interv. 2020;96(4):940-946. doi: 10.1002/ccd.28634

Affiliations

Aurora Cardiovascular and Thoracic Services, Department of Internal Medicine, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Research

Abstract

OBJECTIVES: We aimed to evaluate early clinical and procedural outcomes with the 34-mm Evolut R transcatheter aortic valve replacement (TAVR) prosthesis.

BACKGROUND: The 34-mm Evolut R (Medtronic, Minneapolis, MN) self-expanding TAVR prosthesis was designed to treat patients with larger annuli.

METHODS: Clinical, demographic, procedural, and echocardiographic data on consecutive patients who underwent TAVR with a 34-mm Evolut R prosthesis at our institution were collected and analyzed.

RESULTS: One hundred ninety-six patients underwent TAVR with this prosthesis from November 2016 to July 2018, a majority (n = 188, 96%) through transfemoral access and with conscious sedation (n = 182, 93%). Mean age, Society of Thoracic Surgery risk score, and follow-up were 82 ± 8 years, 5.4 ± 5%, and 8.2 ± 5.3 months, respectively. Mean aortic valve (AV) peak velocity was 4.0 ± 0.6 m/s, mean AV gradient was 38 ± 13 mmHg, AV area was 0.79 ± 0.23 cm2 ; calcium score was 3,503 ± 1,970 Agatston units, and perimeter was 85 ± 4.3 mm. Device implantation was successful in all but one patient. Postprocedure mean AV peak velocity, AV mean gradient, and AV area were 1.9 ± 0.4 m/s, 7 ± 3 mmHg, and 2.6 ± 0.7 cm2 , respectively. New pacemaker requirement rate was 16%, and moderate paravalvular leak was present in six patients (3%), which improved to mild in three patients at 6-month follow-up. In-hospital, 30-day, 6-month, and 12-month survival rates were 98%, 96% (hospital discharge), 96% (30-day), 89% (6-month), and 83% (12-month).

CONCLUSION: These data demonstrate high success and good procedural, echocardiographic, and clinical outcomes of 34-mm Evolut R in patients with large annuli.

Document Type

Article

PubMed ID

31797524