45 Transcatheter Aortic Valve Replacement: A Comparison of The Direct Flow Medical and Sapian 3 Aortic Valves A – Single Centre Experience. (3rd June 2016)

• Record Type: Journal Article
• Authors: Jabbar, Avais; Mohammed, Ashfaq; Khurana, Ayush; Kenny, Antoinette; Das, Rajiv; Zaman, Azfar; Edwards, Richard
• Is Part Of: Heart. Volume 102(2016)Supplement 6
• Page Start: A32
• Page End: A33
• Publication Date: 2016-06-03
• Subjects: Transcatheter aortic valve replacement -- Sapien 3 valve -- Direct Flow Medical valve; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2016-309890.45
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Introduction: Transcatheter aortic valve replacement (TAVR) is an option for patients with severe aortic stenosis who are declined conventional surgery. The Direct Flow Medical (DFM) valve is a non-metallic, double ring valve which is repositionable and retrievable and is relatively new to the UK market. Aims: The Freeman Hospital is the highest DFM volume centre in the UK. We wanted to compare the safety of this valve with the more established Sapien 3 (S3) TAVR valve. Methods: We retrospectively assessed all the S3 and DFM TAVR procedures performed under general and local anaesthetic at our centre since 04/11/2014 when we first started using DFM. Of 71 patients, 44 had the S3 valve inserted and 27 had the DFM valve inserted. The delivery approach was trans-femoral in all patients. In the DFM group 74% of the valves were inserted under local anaesthetic (LA) compared to 26% under general anaesthetic (GA) whereas in the S3 group 88% valves were inserted under LA and 12% under GA. Results: Both groups were similar with respect to age (82 vs 80.9), comorbidities, and EuroScore (15.9 vs 16.8). The severity of aortic stenosis was significantly greater in the S3 group (mean/peak gradient 46.5 vs 39; p = 0.018 and 77.3 vs 64.2mmHg; p < 0.005). Skin open to skin closure was significantly shorter in the S3 group (145 mins vs 101 mins; p < 0.001). There were no deaths or strokes in either group. 1 patient in the DFM group needed permanent pacing post procedure. 1 patient in the DFM group developed moderate aortic regurgitation. The mean gradient and peak gradient was significantly higher in the DFM group post procedure (17.9 vs 12.3; p = 0.016, and 31.1 vs 23.8mmHg; p = 0.013). In both groups there was no relationship between the size of the valve and the peak gradient using regression analysis (DFM; p = 0.181 and S3; p = 0.44). There was no difference in the mean number of days in hospital between both groups (2.6 vs 2.8; p = 0.47). Conclusions: There were no differences in safety between the Sapien 3 and DFM valves although we found the mean and peak gradients to be significantly higher with the DFM valve post procedure.