Comparison of Edwards SAPIEN 3 versus SAPIEN XT in transfemoral transcatheter aortic valve implantation: Difference of valve selection in the real world. Issue 3 (March 2017)

• Record Type: Journal Article
• Authors: Arai, Takahide; Lefèvre, Thierry; Hovasse, Thomas; Morice, Marie-Claude; Garot, Philippe; Benamer, Hakim; Unterseeh, Thierry; Hayashida, Kentaro; Watanabe, Yusuke; Bouvier, Erik; Cormier, Bertrand; Chevalier, Bernard
• Is Part Of: Journal of cardiology. Volume 69:Issue 3(2017:Mar.)
• Page Start: 565
• Page End: 569
• Publication Date: 2017-03
• Subjects: Severe symptomatic aortic stenosis -- Transcatheter aortic valve implantation -- SAPIEN 3 -- SAPIEN XT; Cardiology -- Periodicals; 616.12
• DOI: 10.1016/j.jjcc.2016.04.012
• Languages: English
• ISSNs: 0914-5087

Abstract

Abstract: Background: The SAPIEN 3 (S3; Edwards Lifescience, Irvine, CA, USA) is a new-generation percutaneous aortic valve with better profile, more precise handling and positioning, designed to reduce the risk of post-procedural paravalvular aortic leak (PVL). The aim of this study was to compare the S3 valve and SAPIEN XT valve (SXT). Methods: The last 89 transfemoral transcatheter aortic valve implantation (TAVI) cases using SXT were compared to the first 111 cases using the S3. Results: Patient age and logistic EuroSCORE were similar (83.1 years vs 83.0 years and 18.2% vs 16.6%) in the S3 and SXT groups, respectively as were other baseline characteristics. The ratio of valve diameter/calculated annulus average diameter (CAAD) by multi-detector row computed tomography was significantly lower in the S3 group (1.06 vs 1.09, p < 0.001) as was the annular area oversizing percentage (11.3% vs 20.5%, p < 0.001). Furthermore, a smaller valve was selected in S3 cases with borderline CAAD compared to SXT cases. Nevertheless, the frequency of paravalvular aortic leakage (PVL) ≥2 tended to be reduced in the S3 group (5% vs 9%, p = 0.339). The rate of major vascular complications was significantly lower with S3 (3% vs 12%, p = 0.013). In addition, 30-day mortality was significantly lower in the S3 group (0% vs 5%, p = 0.044). Conclusions: Although TAVI using S3 tended to be carried out with a less oversized valve compared to TAVI using SXT, the frequency of post-procedural PVL ≥2 tended to be lower in the S3 group. The outcomes including vascular complications and 30-day mortality showed a trend in favor of the S3 group.