Key result
Balloon-expandable valves link to similar or marginally lower immediate transvalvular gradients versus self-expanding valves.
Why the study?
Self-expanding valves have been associated with superior hemodynamics versus balloon-expandable valves, but invasive gradients between valve types for similarly sized valves had not been directly compared.
Do balloon-expandable valves improve invasive transvalvular gradients compared to self-expanding valves in patients undergoing TAVR?
Observational (n=499)
Yes
Do balloon-expandable valves improve invasive transvalvular gradients compared to self-expanding valves in patients undergoing TAVR?
The apparent hemodynamic superiority of self-expanding valves on echocardiography may not be reflected in invasive hemodynamic assessments, where balloon-expandable valves show similar or marginally lower gradients.
Answers are grounded in this paper and cite their sources.
Comparable invasive gradients with balloon-expandable valves should not alter valve selection; leaves open whether echocardiographic differences reflect true hemodynamics or artifacts.
Self-expanding valves have been associated with superior hemodynamics versus balloon-expandable valves. Our aim was to compare invasive gradients between valve types for similarly sized valves. Patients who underwent transcatheter aortic valve replacement (TAVR) at the Malcom Randall Veterans Affairs Medical Center and the Bern University Hospital were considered for this analysis. From 1623 subjects who underwent TAVR, a total of 566 had available invasive hemodynamic data. After applying exclusion criteria, we included 499 for analysis. With immediate invasive hemodynamic assessment, balloon- expandable valves were associated with similar/marginally lower transvalvular gradients versus self-expanding valves. With postoperative echocardiography within 24 hours, self-expanding valves were associated with lower Doppler gradients versus balloon-expandable valves for all size categories.
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Bavry et al. (2020) conducted an observational in Transcatheter aortic valve replacement (n=499). Balloon-expandable valves vs. Self-expanding valves was evaluated on Invasive transvalvular gradients. Balloon-expandable valves were associated with similar or marginally lower immediate invasive transvalvular gradients versus self-expanding valves.
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