Modern Valves Reduce the Need for a Pacemaker

Courtesy of Dr. Carlos Fava.

Transcatheter aortic valve replacement (TAVR) has already demonstrated benefit for different risk groups, but one of the remaining challenges is the reduction of the need for a pacemaker, which is still high for self-expanding valves compared with expandable balloons.

The study enrolled 203 patients with severe aortic stenosis who underwent TAVR with a CENTERA self-expanding valve (Edwards Lifesciences, Irvine, California).

 

The mean age was 82 years, two thirds of these patients were women, the Society of Thoracic Surgeons score was 6.1, most patients were New York Heart Association functional class III or IV, 33.5% suffered from renal impairment, 7.9% had a prior pacemaker implantation, and their mean ejection fraction was 55%.

 

At 30 days, mortality was 1%, stroke was 4%, disabling stroke was 2.5%, acute myocardial infarction was 1.5%, permanent pacemaker implantation was 4.9%, and major bleeding was 14.4%.


Read also: Bundle Branch Block and Need for Permanent Pacemaker, a Major Challenge after TAVR.


After a 1-year follow-up, overall mortality was 9.1%, cardiovascular mortality was 4.6%, disabling stroke was 4.1%, new pacemaker implantation was 6.5%, and hospital readmission due to cardiac reasons was 6.8%. The mean aortic valve gradient was 8.1 ± 4.7 mmHg, the mean effective orifice area was 1.7 ± 0.42 cm2, and there was no severe or moderate aortic regurgitation.

 

Conclusion

The CENTERA-EU trial demonstrated mid-term safety and effectiveness of the CENTERA valve. In addition to low mortality, it maintained its hemodynamic performance and low need for pacemaker after implantation in high-risk patients with severe aortic stenosis.

 

Courtesy of Dr. Carlos Fava.

 

Original title: 1-Year Outcomes of the CENTERA-EU Trial Assessing a Novel Self-Expanding Transcatheter Heart Valve.

Reference: Didier Tchétché et al. J Am Coll Cardiol Intv 2019;12:673-80


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

Su opinión nos interesa. Puede dejar su comentario, reflexión, pregunta o lo que desee aquí abajo. Será más que bienvenido.

More articles by this author

Prospective Analysis of the Feasibility of the PASCAL System for Transcatheter Mitral Repair: OneForAll Registry

Courtesy of Dr. Juan Manuel Pérez. Mitral transcatheter edge-to-edge repair (M-TEER) is an effective option for patients with severe mitral regurgitation who are at high...

Left Bundle Branch Block after TAVR: What Is Its Impact?

Courtesy of Dr. Juan Manuel Pérez. Left bundle branch block (LBBB) is a common complication following transcatheter aortic valve replacement (TAVR), which can be either...

Multicenter Experience with 3D Intracardiac Echocardiography for Guiding Interventional Cardiac Procedures

Courtesy of Dr. Juan Manuel Pérez. Imaging techniques play a fundamental role in interventional cardiac procedures. Intracardiac echocardiography (ICE) appears as an alternative to transesophageal...

Pathology of Self-Expanding Transcatheter Aortic Bioprostheses and Hypoattenuated Leaflet Thickening

Courtesy of Dr. Juan Manuel Pérez. Despite the available long term followup data on of transcatheter aortic valve replacement (TAVR), bioprosthesis durability continues under debate....

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...

STRIDE: Semaglutide in Patients with Peripheral Arterial Disease and Type II Diabetes

Peripheral arterial disease (PAD) is a severe complication in patients with type II diabetes, primarily affecting peripheral vessels, especially below-the-knee (BTK) arteries. This condition...