Gerfer, Stephen ORCID: 0000-0002-6568-6766, Mauri, Victor, Kuhn, Elmar, Adam, Matti, Eghbalzadeh, Kaveh, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Ivanov, Borko, Gaisendrees, Christopher ORCID: 0000-0002-7232-3330, Frerker, Christian, Schmidt, Tobias, Mader, Navid, Rudolph, Tanja, Baldus, Stephan, Liakopoulos, Oliver and Wahlers, Thorsten (2021). Comparison of Self-Expanding RDV Perceval S versus TAVI ACURATE neo /TF. Thorac. Cardiovasc. Surg., 69 (5). S. 420 - 428. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background Rapid deployment aortic valve replacement (RDAVR) and transcatheter aortic valve implantation (TAVI) have emerged as increasingly used alternatives to conventional aortic valve replacement to treat patients at higher surgical risk. Therefore, in this single-center study, we retrospectively compared clinical outcomes and hemodynamic performance of two self-expanding biological prostheses, the sutureless and rapid deployment valve (RDV) Perceval-S (PER) and the transcatheter heart valve (THV) ACURATE neo /TF (NEO) in a 1:1 propensity-score-matching (PSM) patient cohort. Methods A total of 332 consecutive patients with symptomatic aortic valve stenosis underwent either singular RDAVR with PER (119) or TAVI with NEO (213) at our institutions between 2012 and 2017. To compare the unequal patient groups, a 1:1 PSM for preoperative data and comorbidities was conducted. Afterward, 59 patient pairs were compared with regard to relevant hemodynamic parameter, relevant paravalvular leak (PVL), permanent postoperative pacemaker (PPM) implantation rate, and clinical postoperative outcomes. Results Postoperative clinical short-term outcomes presented with slightly higher rates for 30-day all-cause mortality (PER=5.1% vs. NEO=1.7%, p =0.619) and major adverse cardiocerebral event in PER due to cerebrovascular events (transient ischemic attack [TIA]-PER=3.4% vs. TIA-NEO=1.7%, p =0.496 and Stroke-PER=1.7% vs. Stroke-NEO=0.0%, p =1). Moreover, we show comparable PPM rates (PER=10.2% vs. NEO=8.5%, p =0.752). However, higher numbers of PVL (mild-PER=0.0% vs. NEO=55.9%, p =0.001; moderate or higher-PER=0.0% vs. NEO=6.8%, p =0.119) after TAVI with NEO were observed. Conclusion Both self-expanding bioprostheses, the RDV-PER and THV-NEO provide a feasible option in elderly and patients with elevated perioperative risk. However, the discussed PER collective showed more postoperative short-term complications with regard to 30-day all-cause mortality and cerebrovascular events, whereas the NEO showed higher rates of PVL.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gerfer, StephenUNSPECIFIEDorcid.org/0000-0002-6568-6766UNSPECIFIED
Mauri, VictorUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Adam, MattiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eghbalzadeh, KavehUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Djordjevic, IlijaUNSPECIFIEDorcid.org/0000-0002-5810-8626UNSPECIFIED
Ivanov, BorkoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gaisendrees, ChristopherUNSPECIFIEDorcid.org/0000-0002-7232-3330UNSPECIFIED
Frerker, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mader, NavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rudolph, TanjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldus, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liakopoulos, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-582864
DOI: 10.1055/s-0040-1722692
Journal or Publication Title: Thorac. Cardiovasc. Surg.
Volume: 69
Number: 5
Page Range: S. 420 - 428
Date: 2021
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1439-1902
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Cardiac & Cardiovascular Systems; Respiratory System; SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58286

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