TY - JOUR
T1 - Center Valve Preference and Outcomes of Transcatheter Aortic Valve Replacement
T2 - Insights From the AMTRAC Registry
AU - Witberg, Guy
AU - Landes, Uri
AU - Talmor-Barkan, Yeela
AU - Richter, Ilan
AU - Barbanti, Marco
AU - Valvo, Roberto
AU - De Backer, Ole
AU - Ooms, Joris F.
AU - Islas, Fabian
AU - Marroquin, Luis
AU - Sedaghat, Alexander
AU - Sugiura, Atsushi
AU - Masiero, Giulia
AU - Armario, Xavier
AU - Fiorina, Claudia
AU - Arzamendi, Dabit
AU - Santos-Martinez, Sandra
AU - Fernández-Vázquez, Felipe
AU - Baz, Jose A.
AU - Steblovnik, Klemen
AU - Mauri, Victor
AU - Adam, Matti
AU - Merdler, Ilan
AU - Hein, Manuel
AU - Ruile, Philipp
AU - Codner, Pablo
AU - Grasso, Carmelo
AU - Branca, Luca
AU - Estévez-Loureiro, Rodrigo
AU - Benito-González, Tomás
AU - Amat-Santos, Ignacio J.
AU - Mylotte, Darren
AU - Bunc, Matjaz
AU - Tarantini, Giuseppe
AU - Nombela-Franco, Luis
AU - Søndergaard, Lars
AU - Van Mieghem, Nicolas M.
AU - Finkelstein, Ariel
AU - Kornowski, Ran
N1 - Publisher Copyright:
© 2022 American College of Cardiology Foundation
PY - 2022/6/27
Y1 - 2022/6/27
N2 - 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.
AB - 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.
KW - TAVR
KW - aortic stenosis
KW - balloon-expandable valve
KW - self-expandable valve
UR - http://www.scopus.com/inward/record.url?scp=85132388439&partnerID=8YFLogxK
U2 - 10.1016/j.jcin.2022.05.004
DO - 10.1016/j.jcin.2022.05.004
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C2 - 35738747
AN - SCOPUS:85132388439
SN - 1936-8798
VL - 15
SP - 1266
EP - 1274
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 12
ER -