Early experience of implantation of the new CoreValve(®) Evolut(™) in degenerated bioprosthetic aortic valves.

Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in high-risk patients. The PARTNER trial demonstrated equivalent 1-year survival rates between patients randomized to TAVI versus conventional surgery (Leon et al., N Engl J Med 2010;363:1597-1607), with sustained benefit up to 2 years (Makkar et al., NEJM 2012;366:1696-1704). Recently, the ADVANCE registry cited all-cause mortality rates of 4.5%, 12.8%, and 17.9% at 30-days, 6 months, and 1-year following TAVI in 1,015 high-risk patients (Linke, TCT 2012, 2012). In addition, TAVI was demonstrated to be a feasible treatment for severe native valve regurgitation in a series of 31 high-risk patients. The all-cause 30-day mortality rate was 6.4%, with a 30-day major stroke rate of 6.4%. At 1-year, the all-cause mortality rate was 12.5% (Roy et al., J Am Coll Cardiol 2012;60(17S):B264). We report the successful transcatheter implantation of the new CoreValve(®) Evolut(™) in two patients with regurgitant aortic bioprostheses.