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Hemodynamic comparison of CoreValve and SAPIEN-XT TAVI valves in Japanese patients

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Abstract

Transcatheter aortic valve implantation (TAVI) is a viable treatment option for high-risk patients with severe aortic stenosis. In Japan, TAVI can be performed using first-generation self-expandable Medtronic CoreValve or balloon-expandable Edwards SAPIEN-XT from 2012. Since the durability and hemodynamic outcomes after transcatheter heart valve (THV) implantation in Japanese patients have not been clearly elucidated, we assessed serial changes in post-TAVI THV performances over a-3-year period by transthoracic echocardiography (TTE). From January 2012 to September 2014, among 83 patients with severe aortic stenosis, 26 underwent TAVI with CoreValve and 57 underwent TAVI with SAPIEN-XT. We assessed the serial changes in first post-implant (FPI) and 3-year post procedure THV hemodynamics by TTE. Valve performance was evaluated by serial assessment of aortic valve mean pressure gradient (PG) and aortic valve area (AVA) assessments. Three-year clinical outcomes were compared between the patients with CoreValve and those with SAPIEN-XT. Seventeen patients with CoreValve and 34 patients with SAPIEN-XT had FPI and 3-year TTEs. The AVA decreased significantly from FPI to 3-year follow-up among patients with SAPIEN-XT, but not among patients with CoreValve. The mean aortic PG decreased significantly from FPI to the 3-year follow-up point among patients with CoreValve; however, it was not significantly different from those with SAPIEN-XT. The absolute change in mean PG from FPI to the 3-year follow-up point decreased significantly among those with CoreValve compared to those with SAPIEN-XT. Clinical outcomes after TAVI were similar for both devices at 3-years after TAVI. In this study, long-term clinical outcomes for CoreValve and SAPIEN XT were similar. The 3-year THV performance of both devices was maintained after TAVI. Serial change in mean aortic PGs for CoreValve decreases significantly from FPI to the 3-year follow-up point compared to that for SAPIEN-XT.

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Acknowledgements

We thank Keiko Aso, who is a clinical research nurse at our hospital, for her enormous help with the data collection.

Funding

This research study did not receive any grants from any funding agency from public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Cardiology, Shonan Kamakura General Hospital, Okamoto 1370-1, Kamakura, 247-8533, Japan

    Koki Shishido, Futoshi Yamanaka, Tomoki Ochiai, Yutaka Tanaka & Shigeru Saito

  2. Department of Cardiovascular Surgery, Shonan Kamakura General Hospital, Kamakura, Japan

    Tsuyoshi Yamabe & Kenichiro Noguchi

  3. Department of Anesthesiology, Shonan Kamakura General Hospital, Kamakura, Japan

    Takashi Ota & Yasuhiro Koide

  4. Department of Surgery, Shonan Kamakura General Hospital, Kamakura, Japan

    Hidemitsu Ogino

Authors
  1. Koki Shishido
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  2. Futoshi Yamanaka
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  3. Tomoki Ochiai
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  4. Tsuyoshi Yamabe
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  9. Yutaka Tanaka
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  10. Shigeru Saito
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Correspondence to Koki Shishido.

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Dr. Saito is a clinical proctor for Edwards Lifesciences and Medtronic. The Authors declare that there is no conflict of interest.

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Shishido, K., Yamanaka, F., Ochiai, T. et al. Hemodynamic comparison of CoreValve and SAPIEN-XT TAVI valves in Japanese patients. Heart Vessels 34, 1674–1683 (2019). https://doi.org/10.1007/s00380-019-01414-0

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  • DOI: https://doi.org/10.1007/s00380-019-01414-0

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