Thread by @dr_benoy_n_shah

#EACTS2021

Abstract session on Hot Topics in Transcatheter Therapies

Presentation from Dr Justin Robinson on use of TAVI in patients with very large aortic annuli - Results from the Michigan TAVI Quality Collaborative

#EACTS2021
Methods here: just over 200 patients with aortic annuli in excess of the normal ranges for both the Edwards Sapien and Medtronic Corevalve systems

#EACTS2021

This was not easy to read. Key data here:

Mean STS score ~5%
Device success ~95%
Pacemaker - 6% Sapien 3 vs 11% Corevalve (p<0.05)
In-hosp mortality ~2%

#EACTS2021

Significantly more mild or moderate PVL with Corevalve system at 30days, which was the same as Sapien system by 1 year

Significantly lower mean gradient with Corevalve system at 30days, same as Sapien 3 by 1 year

#EACTS2021

Limitation of this study is reliance on the TVT database - what I was not clear about is why these patients could not have surgery. Anyway, one assumes there was an MDT discussion in each case and surgery was not deemed feasible?

@GilbertTangMD

#EACTS2021

I think that was a point the panel were keen to make, that a single retrospective study could not be used to suggest that TAVI in very large annuli is 'ready for prime time', but that these important results do give some confidence if a patient cannot undergo surgery