• Anh Ngo, Christian Hassager, Thyregod Hans Gustav Hørsted HGH Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark., Lars Søndergaard, Olsen Peter Skov PS Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark., Daniel Steinbrüchel, Peter Bo Hansen, Jesper Kjærgaard, Mathilde Winther-Jensen, and Nikolaj Ihlemann.
• Department of Cardiology, Zealand University Hospital, Roskilde 4000, Denmark.
• Eur Heart J Cardiovasc Imaging. 2018 Jan 1; 19 (1): 39-46.

AimsPatients with severe aortic stenosis (AS) can be considered for treatment with either transcatheter (TAVR) or surgical aortic valve replacement (SAVR). The purpose of this study was to compare left ventricular (LV) remodeling in patients with AS after treatment with TAVR or SAVR.Methods And ResultsThis is an echocardiographic substudy of the NOTION trial, a randomized all-comers trial comparing TAVR with SAVR in patients above 70 years of age. Transthoracic echocardiograms were performed at baseline, 3 and 12 months after TAVR and SAVR. About 232 patients were included in the study, 120 were randomized to TAVR and 112 to SAVR. From baseline to 12 months post-procedure, aortic valve area (AVA) increased in both groups, but with a larger increase in the TAVR group (0.65 ± 0.04 cm2 vs. 1.02 ± 0.05 cm2 for SAVR and TAVR group, P < 0.0001). At 12 months, LV mass regression was more pronounced in the SAVR group as compared with TAVR (17.5% vs. 7.2%, P < 0.001). In the TAVR group at 12 months, end diastolic volume (EDV) increased by 10.2 ± 2.5 ml and, in the SAVR group, EDV decreased by 15.4 ± 2.6 ml with a statistically significant difference between the two groups (P < 0.0001). Paravalvular leakage (PVL) and pacemaker implantations were more common in patients treated with TAVR, which was associated with an increase in EDV (P < 0.01).ConclusionPatients undergoing SAVR had a larger LV mass regression at 1 year compared with patients undergoing TAVR, which may be due to increasing amounts of PVL and pacemakers in the TAVR group.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2017. For permissions, please email: journals.permissions@oup.com.

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