Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Scotti, A; Baggio, S; Pagnesi, M; Barbanti, M; Adamo, M; Eitan, A; Estevez-Loureiro, R; Veulemans, V; Toggweiler, S; Mylotte, D; De Marco, F; Giannini, F; Ferlini, M; Naber, CK; Buono, A; Schofer, J; Rottbauer, W; Van Mieghem, NM; Khogali, S; Taramasso, M; Pilgrim, T; Sinning, JM; Zweiker, D; Montorfano, M; Van der Heyden, JAS; Brugaletta, S; Ielasi, A; Hamm, CW; Vanhaverbeke, M; Costa, G; Massussi, M; Alarcon, R; Zeus, T; Lunardi, M; Testa, L; Di Ienno, L; Lanzillo, G; Wolf, A; Maffeo, D; Ziviello, F; Saccocci, M; Windecker, S; Sedaghat, A; Schmidt, A; Brouwer, J; Regueiro, A; Reimers, B; Kim, WK; Sondergaard, L; Colombo, A; Mangieri, A; Latib, A.
Temporal Trends and Contemporary Outcomes After Transcatheter Aortic Valve Replacement With Evolut PRO/PRO plus Self-Expanding Valves: Insights From the NEOPRO/NEOPRO-2 Registries
CIRC-CARDIOVASC INTE. 2023; 16(1): e012538
Doi: 10.1161/CIRCINTERVENTIONS.122.012538
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Schmidt Albrecht
- Zweiker David
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- Abstract:
- Background:In recent years, transcatheter aortic valve replacement (TAVR) techniques and technology have continuously improved. Data regarding the impact of these advancements on outcomes in large real-world settings are still limited. The aim of this study was to investigate temporal trends and assess contemporary outcomes after TAVR with Evolut PRO/PRO+ supra-annular self-expanding valves. Methods:This study included patients enrolled in the multicenter NEOPRO (A Multicenter Comparison of Acurate NEO Versus Evolut PRO Transcatheter Heart Valves) and NEOPRO-2 (A Multicenter Comparison of ACURATE NEO2 Versus Evolut PRO/PRO+ Transcatheter Heart Valves 2) registries who underwent transfemoral TAVR with Evolut PRO/PRO+. Procedural dates (August 2017 through November 2021) were stratified in quartiles (Q) and used to investigate temporal trends in TAVR outcomes. Predischarge, 30-day Valve Academic Research Consortium-3 defined, and 1-year outcomes were evaluated. Results:In total, 1616 patients from 28 centers were included. Over time, patients had lower Society of Thoracic Surgeon-Predicted Risk of Mortality score (Q1-4, 4.1% [2.8-6.3%], 3.7% [2.6-5.3%], 3.3% [2.4-4.9%], 2.9% [2.2-4.3%]; P<0.001) and more moderate or heavy valve calcification (Q1-4, 80%, 80%, 82%, 88%; P=0.038). Overall Valve Academic Research Consortium-3 technical success was 94.1%, with 30-day and 1-year all-cause mortality of 2.4% and 10%, respectively. Throughout the study period, procedures were associated with higher rates of 30-day device success (Q1-4, 81.2%, 82.2%, 82.0%, 88.0%; Cochran-Armitage P=0.023) and early safety (Q1-4, 66.8%, 67.5%, 74.0%, 77.6%; Cochran-Armitage P<0.001), with fewer permanent pacemaker implantations (Q1-4: 15.3%, 20.0%, 12.1%, 11.6%; Cochran-Armitage P=0.023) and residual mild or greater paravalvular leaks (Q1-4, 50.4%, 42.1%, 36.5%, 35.8%; Cochran-Armitage P<0.001). Conclusions:TAVR with Evolut PRO/PRO+ self-expanding valve is safe and effective. Despite the treatment of heavier calcified anatomies, procedural outcomes are improving over time with less need for pacemaker implantation and less significant paravalvular leaks.
- Find related publications in this database (Keywords)
- aortic stenosis
- bioprosthesis
- heart valve prosthesis
- pacemaker
- transcatheter aortic valve replacement
- treatment outcome