0345: Thirty-day outcomes of transcatheter aortic valve implantation with the latest generation Edwards SAPIEN 3 prosthesis via the transiliofemoral approach

Abstract

Few data is available concerning the latest generation Edwards SAPIEN 3- S3 in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). To evaluate periprocedural and 30-day clinical outcomes of TAVI using the Edwards SAPIEN 3 prosthesis) via transiliofemoral approach. Between September 2014 and March 2015, consecutive high-risk or non-operable patients with severe aortic stenosis had TAVI using Edwards SAPIEN 3 prosthesis in Institut Mutualiste Montsouris. Valve Academic Research Consortium endpoints were used. Of 142 patients who underwent TAVI using Edwards SAPIEN prosthesis, 66 were treated with SAPIEN 3 via transfemoral access (mean age 84±7.1 years; 70% female). About 65% and 48% of patients had, respectively, severe peripheral artery diseases and calcified iliofemorale arteries. Multi-detector computed tomography estimated an aortic annular diameter of 25,07±2mm. Mean logistic EuroSCORE was 15,8±10,8. The device success rate was 98.5%. No failure of valve deployment had occurred and no patient had more than mild paravalvular aortic regurgitation. Mean transaortic gradient decreased from 46, 0±12,33mmHg to 8,2±3,37mmHg (p<0,001), at 30 days follow up, there were no myocardial infarction. The major bleedings rate was 1.5%, and 6% of patients required transfusion. The major vascular complications were 6%, mortality and stroke were of 3%, and the rate for a new pacemaker was 10,6. In our study, TAVI with Edwards SAPIEN 3 was associated with a high rate of device success and low rate of paravalvular aortic regurgitations and major bleedings.