Platelet activation is less enhanced in the new balloon expandable Edwards Sapien 3 valve compared to its predecessor model (Edwards Sapien XT)

Suzanne Fateh-Moghadam; Sabrina Voesch; Patrik Htun; Rezo Jorbenadze; Tobias Geisler; Meinrad Gawaz; Wolfgang Bocksch

doi:10.1160/TH15-03-0267

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2016; 115(01): 109-116
DOI: 10.1160/TH15-03-0267

New Technologies, Diagnostic Tools and Drugs

Schattauer GmbH Schattauer

Platelet activation is less enhanced in the new balloon expandable Edwards Sapien 3 valve compared to its predecessor model (Edwards Sapien XT)

Suzanne Fateh-Moghadam

,

Sabrina Voesch

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

,

Patrik Htun

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

,

Rezo Jorbenadze

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

,

Tobias Geisler

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

,

Meinrad Gawaz

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

,

Wolfgang Bocksch

¹Medizinische Klinik III, Kardiologie und Kreislauferkrankungen Universitaetsklinikum Tuebingen, Tuebingen, Germany

› Institutsangaben

Abstract

Summary

Stroke and thromboembolic events after transfemoral aortic valve replacement (TAVR) continue to be a problem. The aim of our study was to compare platelet aggregation (Agg) and platelet activation (PA) observed with two different catheter valves, the ESV-XT and the newer ESV-3 valve in patients (pts) undergoing TAVR on dual antiplatelet therapy (DAPT). A total of 174 patients with severe aortic stenosis and high surgical risk successfully underwent TAVR (60 ESV-XT; 114 ESV-3). Platelet Agg and PA (CD62P expression) were evaluated before and the following three days after TAVR under DAPT. Platelet Agg was inhibited to the same extent in both valve types and there was no significant difference in platelet drop between both valve types between day 0 and day 3 [ESV-XT vs ESV-3: median (25^th-75^th percentile): platelet count (x1000): 55 (42–74) vs 61(42–93), p=0.280]. However, there was an enhanced CD62P expression directly after TAVR with the ESV-XT compared to the ESV-3 [CD62P (MIF): 7.4 (6.8–8.6) vs 6.6 (6–7.9), p=0.014]. Surface expression of platelet CD62P was associated with the occurrence of residual aortic regurgitation (AR) and was significantly higher in patients with residual AR [CD62P (mild AR) vs CD 62P (no or trace AR): 7.9 (7.3–9.1) vs 7.1 (6.4–8.0), p < 0.001)]. PA was significantly enhanced in patients with the ESV-XT compared to the ESV-3 valve and was associated with the amount of residual AR which was significantly reduced by ESV-3. This may have implications for thromboembolic events following TAVR procedure

Keywords

Platelet activation - DAPT - TAVR - Edwards Sapien 3 valve - Edwards Sapien XT - residual aortic regurgitation

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Referenzen

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