Transcatheter aortic valve implantation using the SAPIEN 3 valve to treat aortic regurgitation: The French multicentre S3AR study - 17/02/23
, Marina Urena a, Oualid Zouaghi b, Francisco Campelo-Parada c, Patrick Ohlmann d, Gilles Rioufol e, Eric Van Belle f, Frédéric Pinaud g, Nicolas Meneveau h, Patrick Staat b, Olivier Morel d, François Derimay e, Flavien Vincent f, Frédéric Rouleau g, Eric Brochet a, Caroline Chong-Nguyen a, Dominique Himbert a
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Highlights |
• | Patients with pure AR on non-calcified valves are contraindicated for surgery. |
• | TAVI could be an interesting alternative to surgery in this setting. |
• | Few data exist on the use of the balloon-expandable SAPIEN 3 THV. |
• | TAVI for pure AR using the SAPIEN 3 THV seems technically feasible. |
• | However, the procedure may be challenging and requires specific precautions. |
Abstract |
Background |
Transcatheter aortic valve implantation now has a major role in the treatment of patients with severe aortic stenosis. However, evidence is scarce on its feasibility and safety to treat patients with pure aortic regurgitation.
Aims |
We sought to evaluate the results of transcatheter aortic valve implantation using the balloon-expandable SAPIEN 3 transcatheter heart valve (Edwards Lifesciences, Irvine, CA, USA) in patients with pure aortic regurgitation on native non-calcified valves.
Methods |
We conducted a retrospective and prospective French multicentre observational study. We included all patients with symptomatic severe pure aortic regurgitation on native non-calcified valves, contraindicated to or at high risk for surgical valve replacement, who underwent transcatheter aortic valve implantation using the SAPIEN 3 transcatheter heart valve.
Results |
A total of 37 patients (male sex, 73%) with a median age of 81years (interquartile range 69–85years) were screened using transthoracic echocardiography and computed tomography and were included at eight French centres. At baseline, 83.8% of patients (n=31) had dyspnoea New York Heart Association class≥III. The device success rate was 94.6% (n=35). At 30days, the all-cause mortality rate was 8.1% (n=3) and valve migration occurred in 10.8% of cases (n=4). Dyspnoea New York Heart Association class≤II was seen in 86.5% of patients (n=32), and all survivors had aortic regurgitation grade≤1. At 1-year follow-up, all-cause mortality was 16.2% (n=6), 89.7% (n=26/29) of survivors were in New York Heart Association class≤II and all had aortic regurgitation grade≤2.
Conclusion |
Transcatheter aortic valve implantation using the SAPIEN 3 transcatheter heart valve seems promising to treat selected high-risk patients with pure aortic regurgitation on non-calcified native valves, contraindicated to surgical aortic valve replacement.
Le texte complet de cet article est disponible en PDF.Keywords : Aortic regurgitation, Transcatheter aortic valve implantation, Balloon-expandable transcatheter heart valve, Non-calcified aortic valve
Abbreviations : AR, AS, CE, CT, LVEF, NYHA, SPAP, TAVI, THV, TTE, VARC
Plan
| ☆ | Tweet: The S3AR study suggests the technical feasibility and good 1-year clinical outcome of TAVI with SAPIEN 3 transcatheter heart valves in inoperable patients with severe aortic regurgitation on native and non-calcified aortic valves. The procedure requires some technical precautions. |
Vol 116 - N° 2
P. 98-105 - février 2023 Retour au numéro
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