Thirty-day outcome and vascular complications after transarterial aortic valve implantation using both Edwards SAPIEN™ and Medtronic CoreValve® bioprostheses in a mixed population

Aims: Transcatheter aortic valve implantation (TAVI) is performed through a transarterial approach with encouraging results in "one-type valve" registries. We report 30-day data from a mixed population of patients treated with either Medtronic CoreValve (R) (MCV) or Edwards SAPIEN (TM) (ES) valves. Methods and results: Forty-five patients had TAVI via the transarterial approach (21 MCV and 24 ES). Mean age was 81.8 +/- 4.2 years, Logistic EuroSCORE was 25.2 +/- 8.4%. Procedural success rate was 97.8%. Inhospital death rate was 4.4%. Vascular complication rate was 8.9%. Of MCV patients, 28.6% had a permanent pacemaker vs. 4.2% of ES patients; p=0.02. No additional deaths were observed between discharge and 30 days. NYHA functional class was improved at 30-days: 2.07 +/- 0.4 vs. 3.09 +/- 0.05, p<0.0001. Mean transvalvular gradient was lower: 9.5 +/- 3.28 mmHg vs. 41.9 +/- 14 mmHg, p<0.0001. Overall 30-day MACE rate was 8.9%, similar between MCV and ES patients. Conclusion: A routine policy of TAVI using both MCV and ES valves is feasible without any worsening of procedural success rates and 30-day outcomes. A wider population of high risk patients with aortic stenosis can be offered a transarterial treatment. This could be the next standard of care for teams performing TAVI.