Journal article

Publication year: 2017

Pages: 156-160

Journal: International Journal of Cardiology

Volume number: 243

ISSN: 0167-5273

eISSN: 1874-1754

DOI Link: https://doi.org/10.1016/j.ijcard.2017.05.092

Publisher: Elsevier

Abstract: 

Background: The aim of the present study was to investigate whether transfemoral implantation of the Acurate neo transcatheter heart valve without pre-dilation is feasible.

Methods: Between December 2014 and December 2016, 294 patients were treated with the Acurate neo prosthesis at our center. Of these, 72 cases were performed without pre-dilation. The decision to omit pre-dilation was at the discretion of the operator, preferably in the case of mild to moderate aortic valve calcification (AVC). Propensity matching (1: 1) resulted in 48 cases in each group. Main outcomes of interest were device success according to VARC-2 criteria, residual aortic regurgitation (AR) >= 2 degrees, and rate of post-dilation.

Results: Median [IQR] age in patients without pre-dilation was 82.7 years [78.6-85.6], STS score was 4.6% [3.4-6.1], and AVC-score was 1436 AU [1043-1682] with mild and moderate AVC in 63.9% and 36.1% of cases, respectively. Device success was achieved in 94.4% of cases, post-dilation was necessary in 26.4%, and one (1.4%) patient had moderate AR. In the matched population, there were no differences regarding device success, rate of AR >= 2 degrees, need for post-dilation, and post-procedural mean gradient, but the group without pre-dilation had shorter procedure (34.0 min [27.0-38.8] vs. 43.0 min [34.3-52.0]; p < 0.001) and fluoroscopy times (7.4 min [5.7-9.0] vs. 9.9 min [7.9-13.5]; p < 0.001).

Conclusion: In select patients with mild to moderate AVC, transfemoral implantation of the Acurate neo without pre-dilation is feasible and safe. This allows for a straightforward procedure thatmay be performed without rapid pacing in the majority of cases. (C) 2017 Elsevier B.V. All rights reserved.

Harvard Citation style: Kim, W., Liebetrau, C., Renker, M., Rolf, A., Van Linden, A., Arsalan, M., et al. (2017) Transfemoral aortic valve implantation using a self-expanding transcatheter heart valve without pre-dilation, International Journal of Cardiology, 243, pp. 156-160. https://doi.org/10.1016/j.ijcard.2017.05.092

APA Citation style: Kim, W., Liebetrau, C., Renker, M., Rolf, A., Van Linden, A., Arsalan, M., Husser, O., Moellmann, H., Hamm, C., & Walther, T. (2017). Transfemoral aortic valve implantation using a self-expanding transcatheter heart valve without pre-dilation. International Journal of Cardiology. 243, 156-160. https://doi.org/10.1016/j.ijcard.2017.05.092