Abstract 9117: Changes in Left Ventricular Diastolic and Left Atrial Function One Month After Transcatheter and Surgical Aortic Valve Replacement in Severe Aortic Valve Stenosis

Abstract

Background: In the randomized Placement of Aortic Transcatheter Valves (PARTNER) trial, the NYHA functional class was improved at 1 year in both the transcatheter aortic valve replacement (TAVR) and the surgical bioprosthetic aortic valve replacement (SAVR). However, more patients in TAVR than in SAVR had a reduction in symptoms at 30 days. As part of a single center PARTNER trial experience, we compared left ventricular (LV) and left atrial (LA) function in patients after TAVR with those with SAVR for the treatment of severe aortic valve stenosis at one month follow-up. Methods and Results: A total of 83 severe aortic valve stenosis patients with preserved LV systolic function (EF > 40%) and without moderate or severe valvular regurgitation were included in the study: 52 patients underwent TAVR and 31 patients underwent SAVR. Echocardiographic parameters were similar between the two groups. In each group, LVEF and peak early diastolic mitral annular velocity (e') increased significantly at one month follow-up. The ratio of peak S-wave to D-wave from pulmonary vain flow (PVS/PVD) was higher in the TAVR group as compared with the baseline, while there is no significant difference in SAVR group. LV end-diastolic dimension (LVEDD), left atrial area (LAA), the ratio of early transmitral flow velocity (E) to e' (E/e') and LV mass index significantly decreased as compared with baseline in each group (Table 1). There were no significant differences between the two groups in LVEDD, EF, LAA, PVS/PVD, e', E/e' and LV mass index one month after the procedure. At one month follow-up, however, the changes (post minus pre) of LAA, PVS/PVD, e' and E/e' were significantly larger in the TAVR group than the SAVR group (Table2). Conclusion: In patients with severe aortic stenosis, both TAVR and SAVR improved LV systolic and diastolic function and LA function one month after intervention. In particular, the improvement after TAVR appeared to be greater than after SAVR.