Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2025
Comparison of Latest Generation Intra- and Supra-Annular Self-Expanding Transcatheter Heart Valves for Aortic Valve-in-Valve Procedures.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Stötzel Antonia Katharina, Bhadra Oliver D, Waldschmidt Lara, Demal Till J, Grundmann David, Voigtländer Lisa, Blankenberg Stefan, Reichenspurner Hermann, Schofer Niklas, Schaefer Andreas
Аннотация
BACKGROUND: Valve-in-valve (ViV) procedures are an established therapy. Self-expanding (SE) supra-annular transcatheter heart valves (THV) achieve superior hemodynamics compared to balloon-expandable (BE) intra-annular THV, but influence of stent design versus valve position remains unclear.
AIMS: This study compares SE intra- and supra-annular THV for aortic ViV procedures to further elucidate this topic.
METHODS: From 05/2022 to 11/2023, 10 patients underwent ViV procedures with the SE intra-annular Navitor valve. A control group of 22 patients treated with the SE supra-annular Evolut R/PRO valve during the same period was retrieved from our database. Data were retrospectively analyzed according to updated valve academic research consortium (VARC) 3 definitions. A subgroup analysis matched patients for true internal diameter (ID) and body mass index (BMI).
RESULTS: Postprocedural transvalvular gradients were similar between groups. No differences in rates of significant paravalvular leakage (PVL) were seen (p = 0.131). No all-cause mortality occurred in either group. Device success (study group, Navitor: 70 [7] vs. control group, Evolut: 90.1 [20]; p = 0.293), early safety (90 [9] vs. 86.4 [19]; p = 1.000), permanent pacemaker implantation (PPI) (0 [0] vs. 9.1 [2]; p = 1.000), and stroke (0 [0] vs. 4.5 [1]; p = 1.000) were similar between groups. Procedure time was shorter for the study group (65.8 ± 27.9 min vs. 145.7 ± 51.3 min; p < 0.001). After matching for True ID and BMI these results persisted.
CONCLUSION: Intra- and supra-annular THV showed similar clinical and hemodynamic outcomes in aortic ViV procedures. These findings highlight the applicability of SE intra-annular THV for aortic ViV procedures.
AIMS: This study compares SE intra- and supra-annular THV for aortic ViV procedures to further elucidate this topic.
METHODS: From 05/2022 to 11/2023, 10 patients underwent ViV procedures with the SE intra-annular Navitor valve. A control group of 22 patients treated with the SE supra-annular Evolut R/PRO valve during the same period was retrieved from our database. Data were retrospectively analyzed according to updated valve academic research consortium (VARC) 3 definitions. A subgroup analysis matched patients for true internal diameter (ID) and body mass index (BMI).
RESULTS: Postprocedural transvalvular gradients were similar between groups. No differences in rates of significant paravalvular leakage (PVL) were seen (p = 0.131). No all-cause mortality occurred in either group. Device success (study group, Navitor: 70 [7] vs. control group, Evolut: 90.1 [20]; p = 0.293), early safety (90 [9] vs. 86.4 [19]; p = 1.000), permanent pacemaker implantation (PPI) (0 [0] vs. 9.1 [2]; p = 1.000), and stroke (0 [0] vs. 4.5 [1]; p = 1.000) were similar between groups. Procedure time was shorter for the study group (65.8 ± 27.9 min vs. 145.7 ± 51.3 min; p < 0.001). After matching for True ID and BMI these results persisted.
CONCLUSION: Intra- and supra-annular THV showed similar clinical and hemodynamic outcomes in aortic ViV procedures. These findings highlight the applicability of SE intra-annular THV for aortic ViV procedures.