Al Musa, T., Uddin, A., Dobson, L.E. et al. (7 more authors) (2018) Cardiovascular magnetic resonance assessment of 1st generation CoreValve and 2nd generation Lotus valves. Journal of Interventional Cardiology, 31 (3). pp. 391-399. ISSN 0896-4327
Abstract
Objectives We sought to compare using serial CMR, the quantity of AR and associated valve hemodynamics, following the first‐generation CoreValve (Medtronic, Minneapolis, MN) and the second‐generation Lotus valve (Boston Scientific, Natick, MA).
Background Aortic regurgitation (AR) following Transcatheter Aortic Valve Replacement (TAVR) confers a worse prognosis and can be accurately quantified using cardiovascular magnetic resonance (CMR). Second generation valves have been specifically designed to reduce paravalvular AR and improve clinical outcomes.
Methods Fifty‐one patients (79.0 ± 7.7 years, 57% male) were recruited and imaged at three time points: immediately pre‐ and post‐TAVR, and at 6 months.
Results CMR‐derived AR fraction immediately post‐TAVR was greater in the CoreValve compared to Lotus group (11.7 ± 8.4 vs. 4.3 ± 3.4%, P = 0.001), as was the frequency of ≥moderate AR (9/24 (37.5%) versus 0/27, P < 0.001). However, at 6 months AR fraction had improved significantly in the CoreValve group such that the two valve designs were comparable (6.4 ± 5.0 vs 5.6 ± 5.3%, P = 0.623), with no patient in either group having ≥moderate AR. The residual peak pressure gradient immediately following TAVR was significantly lower with CoreValve compared to Lotus (14.1 ± 5.6 vs 25.4 ± 11.6 mmHg, P = 0.001), but again by 6 months the two valve designs were comparable (16.5 ± 9.4 vs 19.7 ± 10.5 mmHg, P = 0.332). There was no difference in the degree of LV reverse remodeling between the two valves at 6 months.
Conclusion Immediately post‐TAVR, there was significantly less AR but a higher residual peak pressure gradient with the Lotus valve compared to CoreValve. However, at 6 months both devices had comparable valve hemodynamics and LV reverse remodeling.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018, Wiley Periodicals, Inc. This is an author produced version of a paper subsequently published in Journal of Interventional Cardiology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | aortic regurgitation; Boston lotus valve; cardiovascular magnetic resonance; medtronic CoreValve; reverse remodeling; transcatheter aortic valve replacement |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 25 Mar 2019 13:01 |
Last Modified: | 25 Apr 2019 00:40 |
Status: | Published |
Publisher: | Wiley |
Refereed: | Yes |
Identification Number: | 10.1111/joic.12512 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:144046 |