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Thromb Haemost 2016; 115(01): 109-116
DOI: 10.1160/TH15-03-0267
New Technologies, Diagnostic Tools and Drugs
Schattauer GmbH Schattauer

Platelet activation is less enhanced in the new balloon expandable Edwards Sapien 3 valve compared to its predecessor model (Edwards Sapien XT)

Suzanne Fateh-Moghadam
,
Sabrina Voesch
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
,
Patrik Htun
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
,
Rezo Jorbenadze
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
,
Tobias Geisler
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
,
Meinrad Gawaz
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
,
Wolfgang Bocksch
1   Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany
› Author Affiliations
Further Information

Publication History

Received: 29 March 2015

Accepted after major revision: 10 July 2015

Publication Date:
22 November 2017 (online)

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Summary

Stroke and thromboembolic events after transfemoral aortic valve replacement (TAVR) continue to be a problem. The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) observed with two different catheter valves, the ESV-XT and the newer ESV-3 valve in patients (pts) undergoing TAVR on dual antiplatelet therapy (DAPT). A total of 174 patients with severe aortic stenosis and high surgical risk successfully underwent TAVR (60 ESV-XT; 114 ESV-3). Platelet Agg and PA (CD62P expression) were evaluated before and the following three days after TAVR under DAPT. Platelet Agg was inhibited to the same extent in both valve types and there was no significant difference in platelet drop between both valve types between day 0 and day 3 [ESV-XT vs ESV-3: median (25th-75th percentile): platelet count (x1000): 55 (42–74) vs 61(42–93), p=0.280]. However, there was an enhanced CD62P expression directly after TAVR with the ESV-XT compared to the ESV-3 [CD62P (MIF): 7.4 (6.8–8.6) vs 6.6 (6–7.9), p=0.014]. Surface expression of platelet CD62P was associated with the occurrence of residual aortic regurgitation (AR) and was significantly higher in patients with residual AR [CD62P (mild AR) vs CD 62P (no or trace AR): 7.9 (7.3–9.1) vs 7.1 (6.4–8.0), p < 0.001)]. PA was significantly enhanced in patients with the ESV-XT compared to the ESV-3 valve and was associated with the amount of residual AR which was significantly reduced by ESV-3. This may have implications for thromboembolic events following TAVR procedure

Keywords

Platelet activation - DAPT - TAVR - Edwards Sapien 3 valve - Edwards Sapien XT - residual aortic regurgitation

 

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