DIKUL - logo
E-viri
Celotno besedilo
Recenzirano
  • Comparison of the self-expa...
    Kalogeras, Konstantinos; Ruparelia, Neil; Kabir, Tito; Jabbour, Richard; Naganuma, Toru; Vavuranakis, Manolis; Nakamura, Sunao; Wang, Brian; Sen, Sayan; Hadjiloizou, Nearchos; Malik, Iqbal S.; Mikhail, Ghada; Dalby, Miles; Panoulas, Vasileios

    International journal of cardiology, 07/2020, Letnik: 310
    Journal Article

    The Evolut PRO self-expanding transcatheter aortic valve has been designed to feature an outer pericardial wrap that aims to reduce paravalvular regurgitation (PVR) rates. Medium-term clinical outcomes, compared to its predecessor Evolut R, in a real-world setting, have not been investigated. The aim of the present study was to compare the two valves with regards to peri-procedural complications, early outcomes and mid-term survival. Consecutive patients, undergoing TAVI with either the Evolut PRO or Evolut R device, from the multicenter ATLAS registry were retrospectively studied. Outcomes studied included periprocedural complications, PVR at discharge, need for new pacemaker implantation and Kaplan-Meier estimated 1-year all-cause mortality. Analysis included 673 patients (498 treated with Evolut R and 175 treated with Evolut PRO). At least moderate PVR was numerically lower amongst patients treated with Evolut PRO (7.4% vs 3.8% for Evolut R and Evolut PRO respectively, p = .108). Rates of new permanent pacemaker (PPM) implantation (21.1% vs. 11.9%, p = .023), and bail-out valve-in-valve (2.4% vs. 0%, p = .049) were significantly lower amongst the Evolut PRO group. No differences were demonstrated regarding bleeding, stroke or acute kidney injury. One-year Kaplan-Meier estimated survival was similar between groups (93% for Evolut R vs. 91.2% for Evolut PRO, plog-rank = 0.806). The Evolut PRO self-expanding valve demonstrates similar mid-term survival rates and numerically, yet not significant, lower incidence of PVR compared to its predecessor. Interestingly this new generation valve is associated with a significantly reduced rate for new PPM implantation. Future studies are required to confirm this finding. •Last generation Evolut PRO features an outer pericardial wrap aiming to reduced PVR•It demonstrates similar mid-term survival rates compared to its predecessor.•Last generation device demonstrates, yet not significant, lower incidence of PVR.•Significantly reduced rate of new PPM implantation has been recorded.