Why the study?
Is transcatheter aortic valve replacement with 29-mm Sapien-3 or 34-mm ER safe and feasible in patients with symptomatic aortic stenosis and large or extra-large aortic annuli?
Is transcatheter aortic valve replacement with 29-mm Sapien-3 or 34-mm ER safe and feasible in patients with symptomatic aortic stenosis and large or extra-large aortic annuli?
Transcatheter aortic valve replacement using 29-mm Sapien-3 or 34-mm ER is safe and feasible in patients with symptomatic aortic stenosis and large or extra-large aortic annuli, demonstrating excellent hemodynamics and comparable mortality.
Supports TAVR in extra-large annuli; extends evidence but leaves open randomized confirmation.
BACKGROUND: or ≥94.2 mm) aortic annuli undergoing transcatheter aortic valve replacement. METHODS: A total of 833 patients across 12 centers with symptomatic aortic stenosis and large aortic annuli underwent transcatheter aortic valve replacement with 29-mm Sapien-3 (n=640) or 34-mm ER (n=193). Clinical, anatomic, and procedural characteristics were collected, and Valve Academic Research Consortium-2 outcomes were reported. RESULTS: =0.009) in the ER group. Thirty-day and 1-year mortality was 2.4% and 9.2%, respectively, without differences between groups. Valve hemodynamics were excellent (mean gradient, 8.8±3.6 mm Hg; 3.3% rate of moderate-severe paravalvular leak) in the extra-large annulus, without differences compared with the large annulus group. CONCLUSIONS: In patients with large and extra-large aortic annuli, transcatheter aortic valve replacement using 29-mm Sapien-3 and 34-mm ER is safe and feasible. Observed differences in clinical outcomes and hemodynamic performance may guide valve choice in this cohort of patients undergoing transcatheter aortic valve replacement.
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Armijo et al. (2020) studied this question.
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