Open Access
Thorac Cardiovasc Surg 2018; 66(S 01): S1-S110
DOI: 10.1055/s-0038-1628114
Short Presentations
Sunday, February 18, 2018
DGTHG: Valvular Heart Disease
Georg Thieme Verlag KG Stuttgart · New York

Rapid Deployment Aortic Valve Replacement versus Transcatheter Aortic Valve Replacement: A Comparison of Two Self-expanding and Stented Aortic Bio-prostheses

S. Gerfer
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
,
O. Liakopoulos
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
,
V. Mauri
2   Department of Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
,
G. Schlachtenberger
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
,
Y. H. Choi
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
,
T. Rudolph
2   Department of Cardiology, Heart Center, University Hospital of Cologne, Cologne, Germany
,
N. Madershahian
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
,
T. Wahlers
1   Department of Cardiothoracic Surgery, Heart Center, University Hospital of Cologne, Cologne, Germany
› Institutsangaben
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Publikationsverlauf

Publikationsdatum:
22. Januar 2018 (online)

 
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    Objective: This single-center study directly compared clinical and echocardiographic outcomes in patients undergoing aortic valve replacement (AVR) either with a self-expanding surgical rapid deployment valve (RDV) Sorin Perceval S (PER) or transcatheter aortic valve replacement (TAVR) Symetis Acurate Neo (SYM).

    Methods: A total of 168 patients with aortic valve stenosis underwent AVR between 2012 and 2017 as single procedure RDAVR (PER n = 34; Age: 74 ± 8 years) versus TAVR (SYM = 134; age: 83 ± 5 years). We extracted and analyzed relevant perioperative data from our institutional database to compare the self-expanding, stented bioprostheses PER and SYM with respect to clinical and hemodynamic outcomes.

    Results: Preoperative characteristic of PER and SYM patients showed comparable body-mass index and surface area and EuroSCORE > 6.5. Preoperative echocardiography including ejection fraction, effective orifice area (EOA) peak and mean pressure gradients (PPG/MPG) were comparable in both groups. Implanted prosthesis size (PER 23.7 ± 1.5 vs. SYM 24.6 ± 1.4 mm) was larger in SYM and peak and mean PG (25 ± 13 vs 18 ± 7 mm Hg; 13 ± 7 vs 9 ± 4 mm Hg) showed higher gradients in PER. The rate of postoperative mild (PVL) (2.9 vs 70%; p < 0.05) and higher-degree PVL (9.7 vs. 0%) was higher in SYM compared with the PER group. Indexed EOA (PER 0.83 ± 0.1; SYM 0.93 ± 0.2) was similar between both groups and no patient prosthesis mismatch (iEOA< 0.65 cm2/m2) was identified. The need for new pacemaker implantation (8.8 vs. 8.9%), stroke rates (2.9 vs. 1.5%) and 30-day mortality (2.9 vs. 0.8%) was comparable for PER and SYM patients, respectively.

    Conclusion: RDAVR with PER showed higher postoperative PPG and MPG, but significant lower overall PVL rates. Early clinical outcomes were comparable between PER and SYM.


     

    Die Autoren geben an, dass kein Interessenkonflikt besteht.

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