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

Hyungdon Kook, Duck Hyun Jang, Kyung Sook Yang, Hyung Joon Joo, Jae Hyoung Park, Soon Jun Hong, Do Sun Lim, Seung Hyuk Choi, Young Jin Choi, Kiyuk Chang, Cheol Woong Yu

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    1 Citation (Scopus)

    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. Provisio

    Original languageEnglish
    Article numbere122
    JournalKorean Circulation Journal
    Volume50
    DOIs
    Publication statusPublished - 2020

    Keywords

    • Transcatheter aortic valve replacement; Aortic valve stenosis

    ASJC Scopus subject areas

    • Internal Medicine
    • Cardiology and Cardiovascular Medicine

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