잠시만 기다려 주세요. 로딩중입니다.

Comparing the Procedural and Clinical Outcomes of Sapien XT and Sapien 3 Valves in Transcatheter Aortic Valve Replacement in Korean Patients

Korean Circulation Journal 2020년 50권 10호 p.907 ~ 922
국형돈, 장덕현, 양경숙, 주형준, 박재형, 홍순준, 임도선, 최승혁, 최영진, 장기육, 유철웅,
소속 상세정보
국형돈 ( Kook Hyung-Don ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine
장덕현 ( Jang Duck-Hyun ) - Yuseong Sun Hospital Department of Internal Medicine
양경숙 ( Yang Kyung-Sook ) - Korea University college of Medicine Department of Biostatistics
주형준 ( Joo Hyung-Joon ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine
박재형 ( Park Jae-Hyoung ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine
홍순준 ( Hong Soon-Jun ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine
임도선 ( Lim Do-Sun ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine
최승혁 ( Choi Seung-Hyuk ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Internal Medicine
최영진 ( Choi Young-Jin ) - Sejong General Hospital Department of Internal Medicine Division of Cardiology
장기육 ( Chang Ki-Yuk ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Internal Medicine
유철웅 ( Yu Cheol-Woong ) - Korea University College of Medicine Korea University Anam Hospital Department of Internal Medicine

Abstract


Background and Objectives: The Sapien 3 (S3) valve has not been compared to the Sapien XT (SXT) valve in Korea. We compared procedural and clinical outcomes between the 2 devices.

Methods: A total of 189 patients who underwent transcatheter aortic valve replacement (TAVR) with S3 (n=95) or SXT (n=94) valve was analyzed. The primary endpoint was cardiovascular mortality at 1 year. The median follow-up duration was 438 days.

Results: The Society of Thoracic Surgeons score was similar between the 2 groups. The device success rate (90.4% vs. 97.9%; p=0.028) was higher in the S3 than in the SXT. The S3 showed significantly fewer cases of moderate or severe paravalvular leakage (PVL) (16.7% vs. 0.0%; p=0.001) than the SXT. However, effective orifice area (EOA) (2.07±0.61 vs. 1.70±0.49 cm2; p<0.001) was smaller in the S3. Multivariable Cox regression analysis showed the S3 was associated with significantly fewer cardiovascular mortality at 1 year compared to the SXT (5.4% vs. 1.1%; hazard ratio, 0.031; 95% confidence interval, 0.001?0.951; p=0.047). Periprocedural complication rates, composite of disabling stroke or all-cause mortality, all-cause mortality, and disabling stroke at 1 year were similar between the 2 groups.

Conclusions: Cardiovascular mortality was lower in the S3 group than in the SXT group over 1 year of follow-up. The reduction in PVL was attributed to the higher device success rate of TAVR with the S3 valve. However, the benefit of S3 obtained at the expense of reduced EOA should be meticulously re-evaluated in larger studies during long-term follow-up.

키워드

Transcatheter aortic valve replacement; Aortic valve stenosis

원문 및 링크아웃 정보

 

등재저널 정보

SCI(E)
KCI
KoreaMed
KAMS