Comparison of acute elastic recoil between the SAPIEN-XT and SAPIEN valves in transfemoral-transcatheter aortic valve replacement

• Published in: Catheterization and cardiovascular interventions Vol. 85; no. 3; pp. 490 - 496
• Main Authors: Garg, Aatish, Parashar, Akhil, Agarwal, Shikhar, Aksoy, Olcay, Hammadah, Muhammad, Poddar, Kanhaiya Lal, Puri, Rishi, Svensson, Lars G., Krishnaswamy, Amar, Tuzcu, E. Murat, Kapadia, Samir R.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 15.02.2015; Wiley Subscription Services, Inc
• Subjects: Aged; Aged, 80 and over; Aortic Valve - diagnostic imaging; aortic valve disease; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Chromium Alloys; Cineangiography; Elasticity; Female; Femoral Artery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - methods; Humans; Linear Models; Male; Multivariate Analysis; Ohio; percutaneous intervention; Prosthesis Design; Punctures; Registries; Stainless Steel; transcatheter valve implantation; Treatment Outcome; percutaneous intervention; transcatheter valve implantation; aortic valve disease
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.25717

Background The SAPIEN‐XT is a newer generation balloon‐expandable valve created of cobalt chromium frame, as opposed to the stainless steel frame used in the older generation SAPIEN valve. We sought to determine if there was difference in acute recoil between the two valves. Methods All patients who underwent transfemoral–transcatheter aortic valve replacement using the SAPIEN‐XT valve at the Cleveland Clinic were included. Recoil was measured using biplane cine‐angiographic image analysis of valve deployment. Acute recoil was defined as [(valve diameter at maximal balloon inflation) − (valve diameter after deflation)]/valve diameter at maximal balloon inflation (reported as percentage). Patients undergoing SAPIEN valve implantation were used as the comparison group. Results Among the 23 mm valves, the mean (standard deviation—SD) acute recoil was 2.77% (1.14) for the SAPIEN valve as compared to 3.75% (1.52) for the SAPIEN XT valve (P = 0.04). Among the 26 mm valves, the mean (SD) acute recoil was 2.85% (1.4) for the SAPIEN valve as compared to 4.32% (1.63) for the SAPIEN XT valve (P = 0.01). Multivariable linear regression analysis demonstrated significantly greater adjusted recoil in the SAPIEN XT valves as compared to the SAPIEN valves by 1.43% [(95% CI: 0.69–2.17), P < 0.001]. However, the residual peak gradient was less for SAPIEN XT compared to SAPIEN valves [18.86 mm Hg versus 23.53 mm Hg (P = 0.01)]. Additionally, no difference in paravalvular leak was noted between the two valve types (P = 0.78). Conclusions The SAPIEN XT valves had significantly greater acute recoil after deployment compared to the SAPIEN valves. Implications of this difference in acute recoil on valve performance need to be investigated in future studies. © 2014 Wiley Periodicals, Inc.