Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598707
Oral Presentations
Sunday, February 12, 2017
DGTHG: Acquired Heart Disease: Rapid Deployment Valves
Georg Thieme Verlag KG Stuttgart · New York

Rapid Deployment Aortic Valve Replacement versus Transcatheter Valve Implantation: Which Strategy Is Better?

K. Eghbalzadeh
1   Department of Cardiothoracic Surgery, Uniklinik Köln, Köln, Germany
,
S. Ney
2   Uniklinik Köln, Köln, Germany
,
M. Scherner
2   Uniklinik Köln, Köln, Germany
,
E.W. Kuhn
2   Uniklinik Köln, Köln, Germany
,
A. Sabashnikov
2   Uniklinik Köln, Köln, Germany
,
C. Weber
2   Uniklinik Köln, Köln, Germany
,
P.B. Rahmanian
2   Uniklinik Köln, Köln, Germany
,
S. Kaya
2   Uniklinik Köln, Köln, Germany
,
Y.H. Choi
2   Uniklinik Köln, Köln, Germany
,
J. Wippermann
2   Uniklinik Köln, Köln, Germany
,
T. Rudolph
2   Uniklinik Köln, Köln, Germany
,
S. Baldus
2   Uniklinik Köln, Köln, Germany
,
N. Mader
2   Uniklinik Köln, Köln, Germany
,
T. Wahlers
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

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Background: Surgical aortic valve replacement (SAVR) is nowadays discussed whether it remains the gold standard of treatment. In the past 5 years there has been a tremendous development leading toward an increasing proportion of patients undergoing Transcatheter aortic valve implantation (TAVI). We retrospectively compared the Edwards Sapien 3 (S3V) with the rapid deployment valve (RDV), the Edwards Intuity valve (IEV), with regard to post-procedural hemodynamics.

Methods: 245 were analyzed patients who underwent TAVI or SAVR between February 2009 and November 2015. 123 patients were included in the SAVR group and compared with 122 patients undergoing TAVI. Analysis of 123 patients receiving IEV and 125 patients receiving S3V between February 2009 and November 2015 was performed. Transvalvular pressure gradients and the incidence and extent of aortic regurgitation (AR) were compared post-procedurally by echocardiography for each valve size.

Results: Post-procedurally, mean pressure gradients (PG) for the 23 mm valves were 9 (7;11) versus 13 (9;18) (p < 0.001), whereas maximum PG were 16.5 (14;22) vs. 25.5 mm Hg (18;34) (p < 0.001) in IEV and S3V patients, respectively. The 21 mm IEV showed significantly lower transvalvular pressure gradients compared with the 23 mm 3SV: (mean PG: 11 (8;13) versus 13 (9;18) (p < 0.05); maximum PG: 19.5 (13;24 versus 25.5 (18;34) mmHg (p < 0.05). Analysis revealed lower significance levels in post-procedural transvalvular pressure gradients for the larger valves. With respect to AR, the incidence of aortic regurgitation was significantly lower in IEV group (p < 0.05).

Conclusion: IEV showed a lower incidence of paravalvular regurgitation and was associated with significantly lower post-procedural transvalvular pressure gradients in small valve sizes. These data might support the application of rapid deployment aortic valves in patients with small aortic annulus in the TAVI era.