Comparison of the sutureless (Perceval S) & The transaortic (Core Valve) implantation (TAVI): Echocardiographic valve haemodynamics and left ventricular mass regression one year follow up

ObjectivesThe aim of this single centre study was to compare early and 1-year echocardiographic outcomes of patients undergoing trans-aortic aortic valve implantation (TAVI-Core Valve) versus patients undergoing sutureless aortic valve replacement (Perceval-AVR) for severe symptomatic aortic valve stenosis.Methods and resultsWe reviewed the echocardiographic hemodynamics of 22 cases of TAVIs (group A) and 14 cases of Perceval-AVRs (group B), performed in our centre from April 2010 to June 2012. Preoperative characteristics of the two groups were comparable. Of the Perceval patients 50% had concomitant CABG. We performed a comparative analysis of the following echocardiographic variables as in Table (1), assessed by two experienced echocardiographer. The comparative analysis were performed pre-discharge and up to 1-year follow up. The echocardiographic data showed that the incidence of paravalvular leak (at least mild) was greater in the TAVI group (31.7% vs 0% P=.005). Valvular incompetence was mild in 5 patients (22%) in group A and 3 patients (21%) in group B. There were no differences in terms of average mean trans-prosthetic gradient (9mmHg vs 13mmHg, P=.59) for (group A) and (group B), respectively. Four patients (19%) in (group A), and one patient (7%) in (group B) shows a reduction in the Ejection Fraction (EF). However, the EF shows significant improvements in (group B) and no improvement in (group A). Furthermore, the septal wall thickness and posterior wall thickness reduction as a marker of left ventricular mass regression were consistent with the changes of the EF between the two groups.ConclusionThis preliminary results shows that the Perceval valve have an equivalent haemodynamic performance to the Core Valve. However, the Perceval S valve have a lower incidence of valvular and paravalvular leak, and this have reflected on the improvements in the left ventricular function and left ventricular mass regression up to 1 year