Balloon-Expandable vs Self-Expandable Valves: Does the CHOICE Matter?

Procedural outcomes at 30 days after transcatheter aortic valve replacement favored the BE device, but longer and larger trials are needed to assess clinical outcomes.

Both the balloon-expandable (BE) Sapien XT and the self-expandable (SE) CoreValve transcatheter heart valves are approved for use in the U.S. and Europe. In this German, five-center, open-label, randomized trial, 241 patients with severe aortic stenosis and at least intermediate surgical risk underwent transcatheter aortic valve replacement with one of the two devices. The primary endpoint was device success, a procedural composite endpoint described by the Valve Academic Research Consortium.

The device success rate was higher with the BE than with the SE device (96% vs. 76%; P<0.001), primarily because of less-frequent moderate or severe aortic regurgitation (4% vs. 18%; P<0.001) and need for a second valve (0.8% vs. 5.8%; P=0.03). No signi…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)