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One year follow-up of the multi-centre European PARTNER transcatheter heart valve study

BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis. AIMS: PARTNER EU is the first study to evaluate prospectively the procedural and mid-term outcomes of transfemoral (TF) or transapical (TA) implantati...

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Autores principales: Lefèvre, Thierry, Kappetein, Ari Pieter, Wolner, Ernst, Nataf, Patrick, Thomas, Martyn, Schächinger, Volker, De Bruyne, Bernard, Eltchaninoff, Hélène, Thielmann, Matthias, Himbert, Dominique, Romano, Mauro, Serruys, Patrick, Wimmer-Greinecker, Gerhard
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021390/
https://www.ncbi.nlm.nih.gov/pubmed/21075775
http://dx.doi.org/10.1093/eurheartj/ehq427
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author Lefèvre, Thierry
Kappetein, Ari Pieter
Wolner, Ernst
Nataf, Patrick
Thomas, Martyn
Schächinger, Volker
De Bruyne, Bernard
Eltchaninoff, Hélène
Thielmann, Matthias
Himbert, Dominique
Romano, Mauro
Serruys, Patrick
Wimmer-Greinecker, Gerhard
author_facet Lefèvre, Thierry
Kappetein, Ari Pieter
Wolner, Ernst
Nataf, Patrick
Thomas, Martyn
Schächinger, Volker
De Bruyne, Bernard
Eltchaninoff, Hélène
Thielmann, Matthias
Himbert, Dominique
Romano, Mauro
Serruys, Patrick
Wimmer-Greinecker, Gerhard
author_sort Lefèvre, Thierry
collection PubMed
description BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis. AIMS: PARTNER EU is the first study to evaluate prospectively the procedural and mid-term outcomes of transfemoral (TF) or transapical (TA) implantation of the Edwards SAPIEN® valve involving a multi-disciplinary approach. METHODS AND RESULTS: Primary safety endpoints were 30 days and 6 months mortality. Primary efficacy endpoints were haemodynamic and functional improvement at 12 months. One hundred and thirty patients (61 TF, 69 TA), aged 82.1 ± 5.5 years were included. TA patients had higher logistic EuroSCORE (33.8 vs. 25.7%, P = 0.0005) and more peripheral disease (49.3 vs. 16.4%, P< 0.0001). Procedures were aborted in four TA (5.8%) and six TF cases (9.8%). Valve implantation was successful in the remaining patients in 95.4 and 96.4%, respectively. Thirty days and 6 months survival were 81.2 and 58.0% (TA) and 91.8 and 90.2% (TF). In both groups, mean aortic gradient decreased from 46.9 ± 18.1 to 10.9 ± 5.4 mmHg 6 months post-TAVI. In total, 78.1 and 84.8% of patients experienced significant improvement in New York Heart Association (NYHA) class, whereas 73.9 and 72.7% had improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores in TA and TF cohorts, respectively. CONCLUSION: This first team-based multi-centre European TAVI registry shows promising results in high-risk patients treated by TF or TA delivery. Survival rates differ significantly between TF and TA groups and probably reflect the higher risk profile of the TA cohort. Optimal patient screening, approach selection, and device refinement may improve outcomes.
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spelling pubmed-30213902011-01-18 One year follow-up of the multi-centre European PARTNER transcatheter heart valve study Lefèvre, Thierry Kappetein, Ari Pieter Wolner, Ernst Nataf, Patrick Thomas, Martyn Schächinger, Volker De Bruyne, Bernard Eltchaninoff, Hélène Thielmann, Matthias Himbert, Dominique Romano, Mauro Serruys, Patrick Wimmer-Greinecker, Gerhard Eur Heart J Fasttrack BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as a new therapeutic option in high-risk patients with severe aortic stenosis. AIMS: PARTNER EU is the first study to evaluate prospectively the procedural and mid-term outcomes of transfemoral (TF) or transapical (TA) implantation of the Edwards SAPIEN® valve involving a multi-disciplinary approach. METHODS AND RESULTS: Primary safety endpoints were 30 days and 6 months mortality. Primary efficacy endpoints were haemodynamic and functional improvement at 12 months. One hundred and thirty patients (61 TF, 69 TA), aged 82.1 ± 5.5 years were included. TA patients had higher logistic EuroSCORE (33.8 vs. 25.7%, P = 0.0005) and more peripheral disease (49.3 vs. 16.4%, P< 0.0001). Procedures were aborted in four TA (5.8%) and six TF cases (9.8%). Valve implantation was successful in the remaining patients in 95.4 and 96.4%, respectively. Thirty days and 6 months survival were 81.2 and 58.0% (TA) and 91.8 and 90.2% (TF). In both groups, mean aortic gradient decreased from 46.9 ± 18.1 to 10.9 ± 5.4 mmHg 6 months post-TAVI. In total, 78.1 and 84.8% of patients experienced significant improvement in New York Heart Association (NYHA) class, whereas 73.9 and 72.7% had improved Kansas City Cardiomyopathy Questionnaire (KCCQ) scores in TA and TF cohorts, respectively. CONCLUSION: This first team-based multi-centre European TAVI registry shows promising results in high-risk patients treated by TF or TA delivery. Survival rates differ significantly between TF and TA groups and probably reflect the higher risk profile of the TA cohort. Optimal patient screening, approach selection, and device refinement may improve outcomes. Oxford University Press 2011-01 2010-11-12 /pmc/articles/PMC3021390/ /pubmed/21075775 http://dx.doi.org/10.1093/eurheartj/ehq427 Text en Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2010. For permissions please email: journals.permissions@oup.com http://creativecommons.org/licenses/by-nc/2.5/uk/ The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oup.com.
spellingShingle Fasttrack
Lefèvre, Thierry
Kappetein, Ari Pieter
Wolner, Ernst
Nataf, Patrick
Thomas, Martyn
Schächinger, Volker
De Bruyne, Bernard
Eltchaninoff, Hélène
Thielmann, Matthias
Himbert, Dominique
Romano, Mauro
Serruys, Patrick
Wimmer-Greinecker, Gerhard
One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title_full One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title_fullStr One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title_full_unstemmed One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title_short One year follow-up of the multi-centre European PARTNER transcatheter heart valve study
title_sort one year follow-up of the multi-centre european partner transcatheter heart valve study
topic Fasttrack
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021390/
https://www.ncbi.nlm.nih.gov/pubmed/21075775
http://dx.doi.org/10.1093/eurheartj/ehq427
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