Author + information
- Marissa Donatelle1,
- Ivandito Kuntjoro2,
- Paolo Del Sole1,
- Michael Ragosta3,
- Michael Salerno4,
- Azeem Latib5 and
- Scott Lim4
- 1Universita Vita-Salute San Raffeale, Milan, Milan, Italy
- 2Advanced Valve Center University Of Virginia, Charlottesville, Virginia, United States
- 3university of virginia, Charlottesville, Virginia, United States
- 4UVA Medical Center, Charlottesville, Virginia, United States
- 5Interventional Cardiology Institute San Raffaele Hospital, Milan, Milan, Italy
Transcatheter aortic valve replacement (TAVR) maybe complicated by paravalvular leak (PVL). There are two TAVR valves used the most in the United States and Europe: self-expandable (SE) and balloon expandable (BE). We sought to demonstrate PVL progression based on valve type.
Patients were from 3 institutions; 2 in Virginia, USA (University of Virginia Medical Center and Bon Secours St. Mary’s Hospital) and 1 in Milan, Italy (Ospedale San Raffaele). Patients were included if they received a TAVR with either a SE or BE valve from 1-1-09 to 3-1-16. Exclusion criteria: incomplete transthoracic echocardiogram (TTE) follow up, or valve-in-valve procedure. Severity of PVL was obtained at 3 time points via TTE report at post-procedure, 1 month and 1 year. Data was analyzed using Wilcoxon signed rank test for statistical difference at all three time points.
Of 1,215 TAVRs performed, 341 were included, 122 from University of Virginia, 23 from Bon Secours, and 196 from Ospedale San Raffaele. There were 62% BE (Sapien series, Edwards LifeSciences, Irvine, CA) and 38% SE (CoreValve series, Medtronic, Minneapolis, MN) valves implanted. SE valves had higher PVL post procedure (0.54 ± 0.1) verses BE valves (0.33 ± 0.07) however both valves had similar PVL at 1 year. From post procedure to 1 year: 18% SE valves increased and 22% decreased PVL; conversely 23% of BE valves increased and 18% decreased PVL.
There is more PVL with SE valves acutely, however there is no significant difference at 1 year. Therefore, a trend is seen in decreasing PVL in SE valves and increasing in BE valves over time.
STRUCTURAL: Valvular Disease: Aortic