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Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement: Insights From the AMTRAC Registry

Research output: Contribution to journalJournal articlepeer-review

  1. Neo-Commissural Alignment During Transcatheter Aortic Valve Replacement: The LACRCO Algorithm

    Research output: Contribution to journalJournal articlepeer-review

  2. Does Subclinical Leaflet Thrombosis Impact the Durability of Bioprosthetic Aortic Valves?

    Research output: Contribution to journalEditorialpeer-review

  1. Neo-Commissural Alignment During Transcatheter Aortic Valve Replacement: The LACRCO Algorithm

    Research output: Contribution to journalJournal articlepeer-review

  2. TAVR for All? The Surgical Perspective

    Research output: Contribution to journalReviewpeer-review

  • Guy Witberg
  • Uri Landes
  • Yeela Talmor-Barkan
  • Ilan Richter
  • Marco Barbanti
  • Roberto Valvo
  • Ole De Backer
  • Joris F Ooms
  • Fabian Islas
  • Luis Marroquin
  • Alexander Sedaghat
  • Atsushi Sugiura
  • Giulia Masiero
  • Xavier Armario
  • Claudia Fiorina
  • Dabit Arzamendi
  • Sandra Santos-Martinez
  • Felipe Fernández-Vázquez
  • Jose A Baz
  • Klemen Steblovnik
  • Victor Mauri
  • Matti Adam
  • Ilan Merdler
  • Manuel Hein
  • Philipp Ruile
  • Pablo Codner
  • Carmelo Grasso
  • Luca Branca
  • Rodrigo Estévez-Loureiro
  • Tomás Benito-González
  • Ignacio J Amat-Santos
  • Darren Mylotte
  • Matjaz Bunc
  • Giuseppe Tarantini
  • Luis Nombela-Franco
  • Lars Søndergaard
  • Nicolas M Van Mieghem
  • Ariel Finkelstein
  • Ran Kornowski
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BACKGROUND: Data on outcomes of transcatheter aortic valve replacement (TAVR) using balloon-expandable valves (BEVs) or self-expandable valves (SEVs) as well as the impact of center valve preference on these outcomes are limited.

OBJECTIVES: The aim of this study was to compare outcomes of TAVR procedures using third-generation BEVs and SEVs stratified by center valve preference.

METHODS: In a multicenter registry (n = 17), 13 centers exhibited valve preference (66.6%-90% of volume) and were included. Outcomes were compared between BEVs and SEVs stratified by center valve preference.

RESULTS: In total, 7,528 TAVR procedures (3,854 with SEVs and 3,674 with BEVs) were included. The mean age was 81 years, and the mean Society of Thoracic Surgeons score was 5.2. Baseline characteristics were similar between BEVs and SEVs. Need for pacemaker implantation was higher with SEVs at BEV- and SEV-dominant centers (17.8% vs 9.3% [P < 0.001] and 12.7% vs 10.0% [P = 0.036], respectively; HR: 1.51; P for interaction = 0.021), risk for cerebrovascular accident was higher with SEVs at BEV-dominant but not SEV-dominant centers (3.6% vs 1.1% [P < 0.001] and 2.2% vs 1.4% [P = 0.162]; HR: 2.08; P for interaction < 0.01). Aortic regurgitation greater than mild was more frequent with SEVs at BEV-dominant centers and similar with BEVs regardless of center dominance (5.2% vs 2.8% [P < 0.001] and 3.4% vs 3.7% [P = 0.504], respectively). Two-year mortality was higher with SEVs at BEV-dominant centers but not at SEV-dominant centers (21.9% vs 16.9% [P = 0.021] and 16.8% vs 16.5% [P = 0.642], respectively; HR: 1.20; P for interaction = 0.032).

CONCLUSIONS: Periprocedural outcomes, aortic regurgitation greater than mild, and 2-year mortality are worse when TAVR is performed using SEVs at BEV-dominant centers. Outcomes are similar regardless of valve type at SEV-dominant centers. The present results stress the need to account for this factor when comparing BEV and SEV outcomes. (The Aortic+Mitral Transcatheter [AMTRAC] Valve Registry; NCT04031274).

Original languageEnglish
JournalJACC: Cardiovascular Interventions
Volume15
Issue number12
Pages (from-to)1266-1274
Number of pages9
ISSN1936-8798
DOIs
Publication statusPublished - 27 Jun 2022

Bibliographical note

Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

    Research areas

  • Aged, 80 and over, Aortic Valve Insufficiency/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Aortic Valve/diagnostic imaging, Heart Valve Prosthesis, Humans, Prosthesis Design, Registries, Risk Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome

ID: 79087195