Transfemoral Aortic Valve Implantation in Patients With an Annulus Dimension Suitable for Either the Edwards Valve or the CoreValve

The aim of this study was to compare the outcomes of transcatheter aortic valve implantation using the Edwards SAPIEN valve and the Medtronic Core Valve in patients with annulus of intermediate size (20 to 25 mm). From October 2008 to April 2012, 662 consecutive patients who underwent transcatheter aortic valve implantation were studied at 2 French centers. After propensity score matching, a total of 192 patients with intermediatesized aortic annulus who had received either Edwards (n = 96, mean age 82.4 +/- 7.9 years, 48% men, 61.9% receiving the 26-mm valve) or Core Valve (n = 96, mean age 82.5 +/- 7.7 years, 50% men, 64.6% receiving the 29-mm valve) prostheses through the transfemoral approach were studied. Adequate reduction in postprocedural mean pressure gradients was achieved with the Edwards valve and the Core Valve (10.9 +/- 4.7 vs 9.1 +/- 4.4 mm Hg, respectively, p <0.01). Major vascular complications (5.2% vs 3.1%, p = 0.36), device success (95.8% vs 93.8%, p = 0.52), and 30-day survival (90.6% vs 89.6%, p = 0.81) were similar. The incidence of postprocedural aortic regurgitation grade >= 2/4 and new pacemaker implantation was more frequent in the Core Valve group (14.3% vs 35.5%, p <0.01, and 4.2% vs 18.8%, p <0.01, respectively). There was no significant difference in 1-year cumulative survival rates in the Edwards valve group compared with the Core Valve group (80.1 +/- 4.2% vs 75.6 +/- 4.9%,,log-rank p = 0.31). In conclusion, in patients with annulus of intermediate size, similar device success and short-term and midterm outcomes were achieved with either of the valves, irrespective of the specific complications related to each valve. (C) 2013 Elsevier Inc. All rights reserved.