TY - JOUR AU - Gerfer, Stephen; Mauri, Victor; Kuhn, Elmar; Adam, Matti; Eghbalzadeh, Kaveh; Djordjevic, Ilija; Ivanov, Borko; Gaisendrees, Christopher; Frerker, Christian; Schmidt, Tobias; Mader, Navid; Rudolph, Tanja; Baldus, Stephan; Liakopoulos, Oliver; Wahlers, Thorsten TI - Comparison of Self-Expanding RDV Perceval S versus TAVI ACURATE neo/TF SN - 0171-6425 SN - 1439-1902 PY - 2021 JO - Thorac Cardiovasc Surg JF - The Thoracic and Cardiovascular Surgeon LA - EN VL - 69 IS - 05 SP - 420 EP - 427 DA - 2021/03/24 KW - aortic stenosis KW - aortic valve replacement KW - transcatheter aortic valve implantation KW - surgical aortic valve replacement KW - rapid deployment valve KW - Perceval KW - Symetis AB - Background Rapid deployment aortic valve replacement (RDAVR) and transcatheter aortic valve implantation (TAVI) have emerged as increasingly used alternatives to conventional aortic valve replacement to treat patients at higher surgical risk. Therefore, in this single-center study, we retrospectively compared clinical outcomes and hemodynamic performance of two self-expanding biological prostheses, the sutureless and rapid deployment valve (RDV) Perceval-S (PER) and the transcatheter heart valve (THV) ACURATE neo/TF (NEO) in a 1:1 propensity-score-matching (PSM) patient cohort.Methods A total of 332 consecutive patients with symptomatic aortic valve stenosis underwent either singular RDAVR with PER (119) or TAVI with NEO (213) at our institutions between 2012 and 2017. To compare the unequal patient groups, a 1:1 PSM for preoperative data and comorbidities was conducted. Afterward, 59 patient pairs were compared with regard to relevant hemodynamic parameter, relevant paravalvular leak (PVL), permanent postoperative pacemaker (PPM) implantation rate, and clinical postoperative outcomes.Results Postoperative clinical short-term outcomes presented with slightly higher rates for 30-day all-cause mortality (PER = 5.1% vs. NEO = 1.7%, p = 0.619) and major adverse cardiocerebral event in PER due to cerebrovascular events (transient ischemic attack [TIA]-PER = 3.4% vs. TIA-NEO = 1.7%, p = 0.496 and Stroke-PER = 1.7% vs. Stroke-NEO = 0.0%, p = 1). Moreover, we show comparable PPM rates (PER = 10.2% vs. NEO = 8.5%, p = 0.752). However, higher numbers of PVL (mild—PER = 0.0% vs. NEO = 55.9%, p = 0.001; moderate or higher—PER = 0.0% vs. NEO = 6.8%, p = 0.119) after TAVI with NEO were observed.Conclusion Both self-expanding bioprostheses, the RDV-PER and THV-NEO provide a feasible option in elderly and patients with elevated perioperative risk. However, the discussed PER collective showed more postoperative short-term complications with regard to 30-day all-cause mortality and cerebrovascular events, whereas the NEO showed higher rates of PVL. PB - Georg Thieme Verlag KG DO - 10.1055/s-0040-1722692 UR - http://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0040-1722692 ER -