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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003ETranscatheter aortic valve implantation (TAVI) is a viable treatment option for high-risk surgical patients with severe symptomatic aortic stenosis (AS). The SAPIEN XT\u2122 (SXT) and CoreValve\u00ae with AccuTrak\u2122 delivery system (MCVAT) are new generation devices currently available in Europe for transfemoral TAVI. To date, no prospective comparisons between these 2 devices have been undertaken. The objectives of this study were to assess the overall clinical outcomes of TAVI and to compare the SXT versus MCVAT devices in a nonrandomized registry population.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EValvular Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EImaging Modalities\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECardiology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003ETranscatheter aortic valve implantation (TAVI) is a viable treatment option for high-risk surgical patients with severe symptomatic aortic stenosis (AS). The SAPIEN XT\u2122 (SXT) and CoreValve\u00ae with AccuTrak\u2122 delivery system (MCVAT) are new generation devices currently available in Europe for transfemoral TAVI. To date, no prospective comparisons between these 2 devices have been undertaken. The objectives of this study, presented by Alaide Chieffo, MD, San Raffaele Scientific Institute, Milan, Italy, were to assess the overall clinical outcomes of TAVI and to compare the SXT versus MCVAT devices in a nonrandomized registry population.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPatients enrolled in the Milan Registry (n=400) were evaluated with echocardiography to assess severity of AS, annulus size, and left ventricular ejection fraction (LVEF) and multislice computed tomography scan with echocardiogram-gating and contrast injection to evaluate the coronary arteries, annulus size, aorta, and the iliac and femoral arteries. The registry included patients treated with TAVI using either the SXT (n=144) or MCVAT (n=119) devices. Transfemoral access was the route of choice unless contraindicated.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe overall mean age was 79.4\u00b17.4 years. The 30-day event rates in the overall population (n=400) using the Valve Academic Research Consortium definition were as follows: all-cause mortality (4.7%), cardiovascular (CV) mortality (3.6%), myocardial infarction (MI; 1.3%), stroke (1.0%), life-threatening bleeding (22.7%), major vascular complications (13.5%), and acute kidney injury (AKI) stage 3 (9.6%). The success rate for device delivery was 92.5%.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EAnalysis according to valve type showed important differences in baseline characteristic between patients receiving the SXT (n=132) versus the MCVAT (n=89), including the percentage of males (41.7% vs 58.4%; p=0.014), LVEF (54.5\u00b111.3 vs 48.0\u00b115.5; p\u0026lt;0.001), history of cerebrovascular disease (12.9% vs 3.4%; p=0.017), previous coronary artery bypass graft surgery (12.9% vs 26.1%; p=0.013), Society of Thoracic Surgeons score (7.4\u00b16.5 vs 9.9\u00b110.2; p=0.030), and aortic annulus diameter (23.3\u00b11.8 vs 24.4\u00b12.0; p\u0026lt;0.001). There was no significant difference between the 2 device groups in the rates of all-cause mortality, CV mortality, MI, stroke, life-threatening bleeding, AKI stage 3, major vascular complications, combined safety endpoint, combined efficacy endpoint, and moderate to severe prosthetic aortic regurgitation.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThere were, however, significant differences between the SXT and MCVAT groups in the rates of valve embolization (0% vs 9.0%; p\u0026lt;0.001), need for 2 valves (1.5% vs 7.9%; p=0.021), conduction disturbances and arrhythmia (16.9% vs 36.0%; p=0.001), permanent pacemaker implantation (5.4% vs 32.6%; p\u0026lt;0.001), and device success (97.0% vs 89.9%; p=0.028; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E), favoring the patients treated with an SXT valve.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/12764\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/12764\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/12764\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ESafety and Efficacy Outcomes.\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-9\u0022\u003EProf. Chieffo concluded that TAVI is a viable option for patients at high risk for surgical aortic valve replacement in her center using both the SXT and MCVAT via a range of access routes.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2012 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/12\/8\/10.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzna41\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzna41\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}