Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis.

Details

Serval ID
serval:BIB_616EB08B83B1
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis.
Journal
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Author(s)
Noble S., Stortecky S., Heg D., Tueller D., Jeger R., Toggweiler S., Ferrari E., Nietlispach F., Taramasso M., Maisano F., Grünenfelder J., Jüni P., Huber C., Carrel T., Windecker S., Wenaweser P., Roffi M.
ISSN
1969-6213 (Electronic)
ISSN-L
1774-024X
Publication state
Published
Issued date
07/04/2017
Peer-reviewed
Oui
Volume
12
Number
18
Pages
e2170-e2176
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Data on procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI) with the new-generation self-expanding Medtronic Evolut R prosthesis in comparison with its predecessor, the Medtronic CoreValve, are scarce. The aim of this study was to assess the safety and efficacy of the Evolut R device compared with the former-generation CoreValve.
In a nationwide, prospective, multicentre cohort study, outcomes of consecutive transfemoral TAVI patients treated with the new-generation Medtronic Evolut R (September 2014 - February 2016) and the Medtronic CoreValve (February 2011 - February 2016) were investigated. Events were reported according to VARC-2 and adjudicated by a clinical events committee. During the study period, 317 and 678 consecutive patients underwent TAVI with the Evolut R and the CoreValve bioprosthesis, respectively. Baseline clinical characteristics between the groups were comparable, although Evolut R patients were lower risk according to the STS score (4.8±3.4% vs. 6.9±5.0%, p<0.001) and logistic EuroSCORE (17.3±13% vs. 20.1±13%, p=0.009). Implantation of the Evolut R was associated with a lower use of predilatation (48.1% vs. 72.4%, p<0.001), a shorter procedure time (67.9±36 min vs. 76.7±42 min, p=0.002), and less contrast dye use during the procedure (155.2±98 ml vs. 208.0±117 ml, p<0.001). Post-procedural mean gradient was comparable (7.4±4.7 mmHg vs. 7.5±5.0 mmHg), as were the 30-day rates of moderate to severe aortic regurgitation (8.5% vs. 10.5%), major vascular (9.8% vs. 10.3%) and life-threatening bleeding complications (5.4% vs. 5.3%), disabling stroke (1.9% vs. 1.6%), all-cause mortality (3.2% vs. 3.4%) as well as permanent pacemaker implantation (22.1% vs. 23.4%).
Thirty-day clinical outcomes were favourable and comparable between the Evolut R and the CoreValve bioprosthesis.

Pubmed
Create date
07/04/2017 16:56
Last modification date
20/08/2019 14:18
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