eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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1/2021
vol. 17
 
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abstract:
Original paper

Short-term safety and efficacy of transcarotid transcatheter aortic valve implantation with balloon-expandable vs. self-expandable valves

Damian Hudziak
1
,
Wojciech Wańha
2
,
Radosław Gocol
1
,
Radosław Parma
2
,
Andrzej Ochala
2
,
Grzegorz Smolka
2
,
Joanna Ciosek
2
,
Tomasz Darocha
3
,
Marek A. Deja
1
,
Wojciech Wojakowski
2

  1. Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland
  2. Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  3. Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
Adv Interv Cardiol 2021; 17, 1 (63): 75–81
DOI: https://doi.org/10.5114/aic.2021.104772
Online publish date: 2021/03/27
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Introduction
Transfemoral access (TF) is the preferred access for transcatheter aortic valve implantation (TAVI). Transcarotid TAVI (TC-TAVI) is an alternative for patients in whom TF-TAVI is impossible. Two types of valves – balloon-expandable (BE) and self-expandable (SE) – can be used in TC-TAVI procedures. Aim: Comparison of the short-term results of patients treated with TC-TAVI using BE and SE valves.

Material and methods
The retrospective registry included 39 patients in whom the TC-TAVI procedure was performed between 2017 and 2020 (BE-TAVI; n = 10, SE-TAVI; n = 29). Preoperative characteristics, operative and postoperative results, and 30-days mortality were compared.

Results
Patients from the BE-TAVI group had higher surgical risk (EuroSCORE) (10.8% (6.2–14.0) vs. 5.5% (4.3–8.7); p = 0.027). The incidence of chronic obstructive pulmonary disease (COPD) was higher in the SE-TAVI group (34.5% vs. 0%; p = 0.040). In terms of other comorbidities, demographics, preprocedural laboratory results, transthoracic echocardiography (TTE), and multislice computed tomography (MSCT), the two groups were comparable. In both groups, we observed 100% procedural success. The median valve size was larger in the SE-TAVI group (29.0 (26.0–29.0) vs. 26.0 (23.0–26.0); p < 0.001). The hospitalization time was shorter in the BE-TAVI group vs. SE-TAVI (5.8 ±0.6 vs. 6.4 ±0.9; p = 0.043). We did not observe statistically significant differences between BE-TAVI and SE-TAVI in periprocedural and 30-day mortality, or the number of strokes/TIA. Also TTE parameters and NYHA class showed similar improvement at 30 days in both groups.

Conclusions
TC-TAVI using balloon-expandable and self-expandable valves showed similar safety and efficacy in 30 days follow-up.

keywords:

aortic stenosis, transcarotid access, transcatheter aortic valve implantation, balloon-expandable valve, self-expandable valve
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