arms were compared: cohort A patients (high-risk) treated by either TAVR (n=149) or surgical aortic valve replacement (SAVR, n=138); and cohort B patients (considered inoperable) treated by either TAVR (n=72) or medical therapy only (MedTx, n=95). Results: In the total group of patients included in the PARTNER trial who underwent TAVR, those having no COPD (n=1096) and non-O2-dep COPD (n=627) had better 1-year survival than did O2-dep COPD patients (n=215). (Table) O2-dep COPD patients who underwent TAVR and survived for 1 year had relatively low rates of high functional class (NYHA class I/II): 79.2% of cohort A patients; 52.4% of cohort B. There were no differences in baseline characteristics between the TAVR and control groups in the different subgroups evaluated. In cohort A patients, 1-year outcomes did not differ significantly between TAVR and SAVR. In cohort B patients, TAVR, compared to MedTx, improved 1-year survival free of hospitalization but not 1-year survival. (Table) Conclusions: Patients with severe COPD and severe AS are at higher risk for worse clinical outcome and lower survival. In COPD patients, TAVR had better outcome than did medical therapy but showed no benefit over SAVR. All TAVR patients COPD patients (TAVR vs. control) No COPD n1096 non-O2dep COPD n627 O2 dep COPD n215 p Value TAVR n149 SAVR n138 p Value TAVR n72 MedTx n95 p Value 1-year survival (%) 85.0 84.1 76.9 0.02 75.0 73.1 0.60 62.5 47.8 0.12 1-year survival free from hospitalization (%) 79.2 78.3 69.7 0.01 65.5 63.0 0.57 51.4 30.1 0.03 TCT-95 Outcomes of Transcatheter vs. Surgical Aortic Valve Replacement in Women: Insights from the Randomized PARTNER Trial Mathew Williams 1 , Susheel Kodali 2 , Karin Humphries 3 , Vuyisile Nkomo 4 , Lars Svensson 5 , Neil Weissman 6 , David Cohen 7 , Vinod Thourani 8 , Michael Mack 9 , E Murat Tuzcu 10 , Irene Hueter 11 , Maria Alu 12 , Ajay Kirtane 13 , Martin Leon 14 1 Columbia University, New York, USA, 2 Columbia, New York, USA, 3 Providence Health System, Vancouver, British Columbia, 4 Mayo Clinic, Rochester, MN, 5 Cleveland Clinic, Cleveland, USA, 6 MedStar Washington Hosp Center, Washington, USA, 7 Saint Luke’s Mid America Heart Institute, Kansas City, USA, 8 Emory University, Atlanta, GA, 9 Baylor Healthcare System, Plano, USA, 10 Cleveland Clinic, Cleveland, OH, 11 Cardiovascular Research Foundation, New York, NY, 12 Columbia University Medical Center, New York, NY, 13 Columbia University / Cardiovascular Research Foundation, New York, NY, 14 Cardiovascular Research Foundation, New York, USA Background: The PARTNER Trial demonstrated that transcatheter aortic valve replace- ment (TAVR) in high surgical risk patients with aortic stenosis was non-inferior to surgical AVR. Whether there are gender-specific differences in the application of TAVR to this high-risk population are unknown. Methods: Patients enrolled in the high-surgical risk cohort of the PARTNER Trial (Cohort A) were included in this analysis (n=697). Gender-specific differences in baseline characteristics and outcomes at 2 years of follow-up were compared by randomized treatment assignment. Results: Despite greater age (84.9 vs. 83.4, p0.01), and slightly higher median STS scores (11.1 vs. 11.0, p=0.03), women (n=298) had a lower prevalence of important comorbidities, including diabetes (35.6% vs. 45.6%, p0.01), smoking history (33.2% vs. 60.7%, p0.001), coronary artery disease (64.4% vs. 83.7%, p0.001), prior CABG (19.8% vs. 60.4%, p0.001), peripheral vascular disease (36.4% vs. 46.9%, p0.01), and chronic kidney disease (11.7% vs. 23.9%, p0.001). There were no differences in outcomes at 30 days between TAVR and surgery in women; among TAVR patients, there were similar rates of both mortality (4.1% vs. 3.0%, p=0.58) and stroke (5.5% vs. 4.0%, p=0.52) in women compared to men. Compared to surgery, women undergoing TAVR had better one (18.5% vs. 29.5%, p=0.02) and 2-year (28.6% vs. 38.6%, p=0.05) survival, whereas, among men, there was no difference at either one (28.5% vs. 25.2%, p=0.67) or 2 years (37.5% vs. 32.1%, p=0.43). Compared to surgery, women undergoing TAVR had higher stroke rates at 1 year (7.1% vs. 0.7%, p0.01); this difference was not seen in men (5.3% vs. 5.0%, p=0.90). There was a significant treatment-gender interaction for mortality and stroke at 1 but not 2 years, with no significant interactions for other outcomes. Conclusions: Gender-specific differences in outcomes (beyond 30 days) were observed among randomized patients in PARTNER suggesting TAVR may be the preferred therapy among women. Further investigation is required to determine whether this benefit can be attributed specifically to gender, or whether other factors may be involved. TCT-96 Influence Of Gender On Clinical Outcomes Following Transcatheter Aortic Valve Implantation: Results From The UK TAVI Registry On Behalf Of The UK TAVI Steering Group And The National Institute For Cardiovascular Outcomes Research Rasha Al-Lamee 1 , Christopher Broyd 2 , Jessica Parker 3 , Justin Davies 2 , Jamil Mayet 2 , Nilesh Sutaria 3 , Ben Ariff 3 , Beth Unsworth 2 , John Cousins 3 , Colin Bicknell 3 , Jon Anderson 3 , Iqbal Malik 3 , Andrew Chukwuemeka 3 , Neil Moat 4 , Peter Ludman 5 , Darrel Francis 2 , Ghada Mikhail 3 1 Imperial College NHS Trust, London, 2 Imperial College, London, 3 Imperial College NHS Trust, London, 4 Royal Brompton Hospital, London, 5 University Hospital, Birmingham Background: Female sex is associated with adverse outcomes following conventional aortic valve replacement. We investigate gender differences following transcatheter aortic valve implantation (TAVI) in the UK’s National Institute for Cardiovascular Outcomes Research (NICOR) TAVI Registry. Methods: Retrospective analysis of 1627 patients enrolled in a UK multicentre registry from January 2007 to December 2010. TAVI was conducted via transfemoral, transapical, subclavian/transaxillary and transaortic access routes with implantation of Medtronic CoreValve ReValving System®, Edwards SAPIENTM and SAPIEN XTTM devices. Results: TAVI was performed in 756 (46.5%) females and 871 (53.5%) males aged 82.66.8 years and 80.87.6 years respectively. Females had a higher peak aortic gradient (84.428.6mmHg v 76.624.5mmHg; p0.001) and smaller aortic annulus diameter (21.12.8mm v 23.03.1mm; p0.001). Men had greater prevalence of type II diabetes (23.9% v 19.2%; p=0.021), poor left ventricular systolic function (11.9% v 5.5%; p0.001), three vessel coronary artery disease (19.4% v 9.2%; p0.001), left main stem disease (8.0% v 3.2%; p0.001), previous myocardial infarction (29.5% v 13.0%; p0.005), peripheral vascular disease (32.4% v 23.3%; p0.001) and higher logistic EuroSCORE (21.814.2% v 21.013.4%; p=0.046). Kaplan-Meier mortality at 30 days was 6.3% (95% CI 4.3% to 7.9%) in women and 7.4% (5.6% to 9.2%) in men. At 6 months, 14.1% (11.5% to 16.7%) and 16.6% (14.0% to 16.6%) respectively. At 1 year 21.9% (18.7% to 25.1%) and 22.4% (19.4% to 25.4%) respectively. There was no difference in mortality: p=0.331 by log-rank test; hazard ratio for women 0.911 (0.754 to 1.100). There was no difference in device success rate (96.6% in women v 96.4% in men; p=0.889) or cerebro- vascular event rate at 30 days (3.8% v 3.7%; p=0.962). However, women had significantly more major vascular complications than men (7.5% v 4.2%; p=0.004). Conclusions: Despite a higher risk profile in males there was no difference in mortality, procedural success or cerebrovascular event rate between genders. However, women had almost twice the rate of major vascular complications compared with men. Transcatheter Aortic Valve Replacement II D240-241 Tuesday, October 23, 2012, 10:30 AM–12:30 PM Abstract nos: 97-104 TCT-97 Three-dimensional Echocardiographic Measurements of the Aortic Annulus Predict Paravavular Regurgitation following Transcatheter Aortic Valve Replacement Rebecca Hahn 1 , Jean-Michel Paradis 1 , Benoit Daneault 1 , Susheel Kodali 1 , Elana Koss 1 , Isaac George 1 , Martin Leon 2 , Mathew Williams 1 1 Columbia University, New York, NY, 2 Cardiovascular Research Foundation, New York, NY Background: Background Paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR) is associated with adverse outcomes. Studies evaluating the utility of three-dimensional echo (3DE) are limited. We performed a retrospective analysis using 3DE-derived annular measurements and evaluated their ability to predict PVR. Methods: 58 TAVR patients were evaluated: 35 patients who receive a post-dilatation for paravalvular regurgitation (PD) and 23 who did not (NoPD). Intra-procedural trans- esophageal echocardiography was performed with both two-dimensional (2DE) and 3DE imaging. PVR areas seen on a short axis view were measured immediately following deployment. Pre-TAVR annular dimensions included the sagittal 2DE annular diameter and 3DE measurements of: minimal diameter, maximal diameter, mean diameter, average diameter and area. A cover index was calculated using these diameters. An area cover index was also calculated using nominal areas of the THV and the 3DE. Results: PD patients were more often male (p=0.01) and had larger BSA (1.83 0.24 vs. 1.67 0.23 m2, p=0.013) and a higher annular eccentricity index (13.6 5.1 vs. 8.01 5.3, p=0.001). Following TAVR, PD patients had larger PVR areas immediately following deployment (40.3 17.1 vs. 15.4 14.2mm2, p0.0001). These patients had a lower cover index irrespective of the annular diameter used (Table). All measurements TUESDAY, OCTOBER 23, 10:30 AM–12:30 PM www.jacc.tctabstracts2012.com B30 JACC Vol 60/17/Suppl B | October 22–26, 2012 | TCT Abstracts/ORAL/Transcatheter Aortic Valve Replacement II ORALS Downloaded From: http://173.193.11.214/ on 03/04/2013