Virtanen, M.P.O., Eskola, M., Savontaus, M. et al. Mid-term outcomes of Sapien 3 versus Perimount Magna Ease for treatment of severe aortic stenosis. J Cardiothorac Surg 15, 157 (2020). https://doi.org/10.1186/s13019-020-01203-1
Mid-term outcomes of Sapien 3 versus Perimount Magna Ease for treatment of severe aortic stenosis
|Author:||Virtanen, Marko P. O.1,2; Eskola, Markku1,2; Savontaus, Mikko3;|
1Heart Hospital, Tampere University Hospital, Tampere, Finland
2Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
3Heart Center, Turku University Hospital, and Department of Surgery, University of Turku, Turku, Finland
4Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland
5Department of Surgery, Oulu University Hospital and Research Unit of Surgery, Anesthesia and Intensive Care, Faculty of Medicine, University of Oulu, Oulu, Finland
6Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
7Heart Center, Kuopio University Hospital, Kuopio, Finland
8National Centre of Global Health, Istituto Superiore di Sanità, Rome, Italy
|Online Access:||PDF Full Text (PDF, 0.7 MB)|
|Persistent link:|| http://urn.fi/urn:nbn:fi-fe2020090868941
|Publish Date:|| 2020-06-29
Background: There is limited information on the longer-term outcome after transcatheter aortic valve replacement (TAVR) with new-generation prostheses compared to surgical aortic valve replacement (SAVR). The aim of this study was to compare the mid-term outcomes after TAVR with Sapien 3 and SAVR with Perimount Magna Ease bioprostheses for severe aortic stenosis.
Methods: In a retrospective study, we included patients who underwent transfemoral TAVR with Sapien 3 or SAVR with Perimount Magna Ease bioprosthesis between January 2008 and October 2017 from the nationwide FinnValve registry. Propensity score matching was performed to adjust for differences in the baseline characteristics. The Kaplan-Meir method was used to estimate late mortality.
Results: A total of 2000 patients were included (689 in the TAVR cohort and 1311 in the SAVR cohort). Propensity score matching resulted in 308 pairs (STS score, TAVR 3.5 ± 2.2% vs. SAVR 3.5 ± 2.8%, p = 0.918). In-hospital mortality was 3.6% after SAVR and 1.3% after TAVR (p = 0.092). Stroke, acute kidney injury, bleeding and atrial fibrillation were significantly more frequent after SAVR, but higher rate of vascular complications was observed after TAVR. The cumulative incidence of permanent pacemaker implantation at 4 years was 13.9% in the TAVR group and 6.9% in the SAVR group (p = 0.0004). At 4-years, all-cause mortality was 20.6% for SAVR and 25.9% for TAVR (p = 0.910). Four-year rates of coronary revascularization, prosthetic valve endocarditis and repeat aortic valve intervention were similar between matched cohorts.
Conclusions: The Sapien 3 bioprosthesis achieves comparable midterm outcomes to a surgical bioprosthesis with proven durability such as the Perimount Magna Ease. However, the Sapien 3 bioprosthesis was associated with better early outcome.
Journal of cardiothoracic surgery
|Type of Publication:||
A1 Journal article – refereed
|Field of Science:||
3121 General medicine, internal medicine and other clinical medicine
3126 Surgery, anesthesiology, intensive care, radiology
This study was financially partly supported by the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital. MPOV received personal research grants from Aarne Koskelo Foundation and from Paavo Ilmari Ahvenainen Foundation.
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