University of Oulu

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

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Author: Virtanen, Marko P. O.1,2; Eskola, Markku1,2; Savontaus, Mikko3;
Organizations: 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
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020090868941
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-06-29
Description:

Abstract

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.

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Series: Journal of cardiothoracic surgery
ISSN: 1749-8090
ISSN-E: 1749-8090
ISSN-L: 1749-8090
Volume: 15
Issue: 1
Article number: 157
DOI: 10.1186/s13019-020-01203-1
OADOI: https://oadoi.org/10.1186/s13019-020-01203-1
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
Subjects:
Funding: 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.
Copyright information: © The Author(s). 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
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