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dc.contributor.authorVlastra, W.
dc.contributor.authorChandrasekhar, J.
dc.contributor.authorMuñoz-Garcia, A. J.
dc.contributor.authorTchétché, D.
dc.contributor.authorde Brito, F. S.
dc.contributor.authorBarbanti, M.
dc.contributor.authorKornowski, R.
dc.contributor.authorLatib, A.
dc.contributor.authorD'Onofrio, A.
dc.contributor.authorRibichini, F.
dc.contributor.authorBaan, J.
dc.contributor.authorTijssen, J. G. P.
dc.contributor.authorTrillo Nouche , Ramiro
dc.contributor.authorDumonteil, N.
dc.contributor.authorAbizaid, A.
dc.contributor.authorSartori, S.
dc.contributor.authorD'Errigo, P.
dc.contributor.authorTarantini, G.
dc.contributor.authorLunardi, M.
dc.contributor.authorOrvin, K.
dc.contributor.authorPagnesi, M.
dc.contributor.authorDel Valle, R.
dc.contributor.authorModine, T.
dc.contributor.authorDangas, G.
dc.contributor.authorMehran, R.
dc.contributor.authorPiek, J. J.
dc.contributor.authorDelewi, R.
dc.date.accessioned2021-06-07T12:57:29Z
dc.date.available2021-06-07T12:57:29Z
dc.date.issued2019
dc.identifier.issn0195-668X
dc.identifier.otherhttps://www.ncbi.nlm.nih.gov/pubmed/30590565es
dc.identifier.urihttp://hdl.handle.net/20.500.11940/15006
dc.description.abstractAims: The aim of this study was to compare clinical outcomes of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) with balloon-expandable (BE) valves vs. self-expandable (SE) valves. Transcatheter aortic valve implantation is a minimally invasive and lifesaving treatment in patients with aortic valve stenosis. Even though BE-valves and SE-valves are both commonly used on a large scale, adequately sized trials comparing clinical outcomes in patients with severe aortic valve stenosis treated with BE-valves compared with SE-valves are lacking. Methods and results: In this CENTER-collaboration, data from 10 registries or clinical trials, selected through a systematic search, were pooled and analysed. Propensity score methodology was used to reduce treatment selection bias and potential confounding. The primary endpoints were mortality and stroke at 30 days follow-up in patients treated with BE-valves compared with SE-valves. Secondary endpoints included clinical outcomes, e.g. bleeding during hospital admission. All outcomes were split for early-generation BE-valves compared with early-generation SE-valves and new-generation BE-valves with new-generation SE-valves. The overall patient population (N = 12 381) included 6239 patients undergoing TAVI with BE-valves and 6142 patients with SE-valves. The propensity matched population had a mean age of 81 +/- 7 years and a median STS-PROM score or 6.5% [interquartile range (IQR) 4.0-13.0%]. At 30-day follow-up, the mortality rate was not statistically different in patients undergoing TAVI with BE-valves compared with SE-valves [BE: 5.3% vs. SE: 6.2%, relative risk (RR) 0.9; 95% confidence interval (CI) 0.7-1.0, P = 0.10]. Stroke occurred less frequently in patients treated with BE-valves (BE: 1.9% vs. SE: 2.6%, RR 0.7; 95% CI 0.5-1.0, P = 0.03). Also, patients treated with BE-valves had a three-fold lower risk of requiring pacemaker implantation (BE: 7.8% vs. SE: 20.3%, RR 0.4; 95% CI 0.3-0.4, P < 0.001). In contrast, patients treated with new-generation BE-valves more frequently experienced major and life-threatening bleedings compared with new-generation SE-valves (BE: 4.8% vs. SE: 2.1%, RR 2.3; 95% CI 1.6-3.3, P < 0.001). Conclusion: In this study, which is the largest study to compare valve types in TAVI, we demonstrated that the incidence of stroke and pacemaker implantation was lower in patients undergoing transfemoral TAVI with BE-valves compared with SE-valves. In contrast, patients treated with new-generation BE-valves more often suffered from major or life-threatening bleedings than patients with new-generation SE-valves. Mortality at 30-days was not statistically different in patients treated with BE-valves compared with SE-valves. This study was a propensity-matched analysis generated from observational data, accordingly current outcomes will have to be confirmed in a large scale randomized controlled trial.en
dc.language.isoenges
dc.subject.meshHeart Valve Prosthesis Implantation*
dc.subject.meshAortic Valve Stenosis*
dc.subject.meshHumans*
dc.subject.meshHeart Valve Prosthesis*
dc.subject.meshAortic Valve*
dc.subject.meshRegistries*
dc.subject.meshPropensity Score*
dc.subject.meshConversion to Open Surgery*
dc.subject.meshStroke*
dc.subject.meshAged*
dc.subject.meshPostoperative Complications*
dc.subject.meshProsthesis Design*
dc.titleComparison of balloon-expandable vs. self-expandable valves in patients undergoing transfemoral transcatheter aortic valve implantation: from the CENTER-collaborationen
dc.typeArtigoes
dc.authorsophosVlastra, W.
dc.authorsophosChandrasekhar, J.
dc.authorsophosMuñoz-Garcia, A. J.
dc.authorsophosTchétché, D.
dc.authorsophosde Brito, F. S.
dc.authorsophosBarbanti, M.
dc.authorsophosKornowski, R.
dc.authorsophosLatib, A.
dc.authorsophosD'Onofrio, A.
dc.authorsophosRibichini, F.
dc.authorsophosBaan, J.
dc.authorsophosTijssen, J. G. P.
dc.authorsophosTrillo-Nouche, R.
dc.authorsophosDumonteil, N.
dc.authorsophosAbizaid, A.
dc.authorsophosSartori, S.
dc.authorsophosD'Errigo, P.
dc.authorsophosTarantini, G.
dc.authorsophosLunardi, M.
dc.authorsophosOrvin, K.
dc.authorsophosPagnesi, M.
dc.authorsophosDel Valle, R.
dc.authorsophosModine, T.
dc.authorsophosDangas, G.
dc.authorsophosMehran, R.
dc.authorsophosPiek, J. J.
dc.authorsophosDelewi, R.
dc.identifier.doi10.1093/eurheartj/ehy805
dc.identifier.pmid30590565
dc.identifier.sophos29381
dc.issue.number5es
dc.journal.titleEuropean Heart Journales
dc.organizationÁrea Sanitaria de Santiago de Compostela e Barbanza/Complexo Hospitalario Universitario de Santiago/Cardioloxíaes
dc.organizationServizo Galego de Saúde::Estrutura de Xestión Integrada (EOXI)::EOXI de Santiago de Compostela - Complexo Hospitalario Universitario de Santiago de Compostela:Cardioloxíaes
dc.organizationCHUS
dc.organizationAS Santiagoes
dc.relation.publisherversionhttps://watermark.silverchair.com/ehy805.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAqswggKnBgkqhkiG9w0BBwagggKYMIIClAIBADCCAo0GCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQM5EbPDWYn1a2kXQ-XAgEQgIICXtqbRWGG4qOdrriuEFTxrDf3XmNLLuuqmSZ05fCpj-W59l6LKlD1G0H8SopuUeMme7s-3NDHAAZ69fP5fZQ3zTbu6lrTrmwwDfz7btXOGhbX8d_6uGbHENzDeSJ8oGUqrJCNYyIK2xNGZTlWO8Uk6fEdrCHlSuFbOhfS1qALzoMV7Tc12e2mWzGnGYX4YoFUFstAiizEguXHe3My7obZmfSpnbuYLEkVP2-cBf6IDvqrHhR-Nr4LHPbGSTnAQ17JLz7L0WvVohqsvtdZ5yZOySNEXqB8l8_3rZyVxdtseZb5f6hGQv7UHuYMzdDqsQ8FLDh_pJPZqOSgitzvJwJjbyDtjCQ0I3jpVqmqmnZtP-poQ516yFxq8kWTSJkYHEX5gWR_SrMJAkEkhHGXo3jBI1YRrU3wErdyifR2EZFota5IynpdmQYJvzk_e6RFck38LL3faqqcMsJHlZPR7t3djRQfGGprxsBct0FcYxgOTJbBn2wZ5jRP7qNiR7XTTi_0yfdfqok__lWqnSN9AVG32ELQM8hh1rGiennyXXEwepk4HSjSzxvLj4X0Awo17nHQ7PsZOMfoBNehWmZUIbnBFd4N5VaUvHHPa2nnJ6OyprWaUJ9GK40zUsMjwzmu4sw4dI0exMhubEkims_xKvjCoKECiRqx2Cw3-rauG_DTz98hkAHr1tEZzMhScViKK8vCZmR0l8Cdin2Ojf-VzAknCaYG1l-bvShbUsA0DN2RivRKiMWWSpPdHNEJe31eIf1E4XdKowkE-4TU12cMjaUKVKFUeUzf8V-hQT7ZDqm22Qes
dc.rights.accessRightsembargoedAccesses
dc.subject.decscomplicaciones postoperatorias*
dc.subject.decsprótesis valvulares cardíacas*
dc.subject.decsanciano*
dc.subject.decsconversión a cirugía abierta*
dc.subject.decsdiseño de prótesis*
dc.subject.decsaccidente cerebrovascular*
dc.subject.decspuntuación de propensión*
dc.subject.decshumanos*
dc.subject.decsestenosis de la válvula aórtica*
dc.subject.decsimplantación de prótesis valvulares cardíacas*
dc.subject.decsválvula aórtica*
dc.subject.decssistema de registros*
dc.subject.keywordCHUS
dc.subject.keywordAS Santiago
dc.typefidesArtigo Científico (inclue Orixinal, Orixinal breve, Revisión Sistemática e Meta-análisis)es
dc.typesophosArtículo Originales
dc.volume.number40es


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