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May 1, 2023Open Access

Evolut R TAVR linked to ~72% lower 30-day composite safety risk vs CoreValve.

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Why the study?

The superiority of the new-generation self-expanding Evolut R compared with the first-generation CoreValve regarding outcomes after TAVR was unclear.

Does the new-generation Evolut R valve improve 30-day safety outcomes compared to the first-generation CoreValve in patients undergoing TAVR?

Population

Consecutive patients undergoing TAVR with CoreValve or Evolut R in a Taiwanese population

Comparison

Evolut R vs CoreValve

Design

Observational cohort study

Follow-up

30-day

Key result

Transcatheter aortic valve replacement with the new-generation Evolut R significantly reduced the 30-day composite safety endpoint compared with CoreValve (4.3% vs. 15.4%, p=0.004).

Authors

CKChia-Cheng KuoHCHsiao‐Huang ChangHLHsin‐Bang Leu

Discussion

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Overview

May improve 30-day TAVR safety in cohorts; leaves open confirmation in randomized trials.

Study Design

Type

Cohort (n=234)

Structured PICO

Does the new-generation Evolut R valve improve 30-day safety outcomes compared to the first-generation CoreValve in patients undergoing TAVR?

P
Population
234 consecutive patients undergoing transcatheter aortic valve replacement (TAVR) in a Taiwanese population
I
Intervention
Transcatheter aortic valve replacement with the new-generation self-expanding Evolut R valve
C
Comparator
Transcatheter aortic valve replacement with the first-generation self-expanding CoreValve
O
Outcome
30-day Valve Academic Research Consortium-2 (VARC-2)-defined composite safety endpointsafety

Main Result

Absolute Event Rate: 4.3% vs 15.4%

p-value: p=0.004

The newer-generation Evolut R self-expanding valve significantly reduces 30-day composite safety endpoints, including stroke and the need for emergent surgery, compared to the older CoreValve in TAVR patients.

Cite This Study

Kuo et al. (2023) conducted a cohort in Aortic stenosis requiring TAVR (n=234). Evolut R vs. CoreValve was evaluated on 30-day composite safety endpoint (p=0.004). Transcatheter aortic valve replacement with the new-generation Evolut R significantly reduced the 30-day composite safety endpoint compared with CoreValve (4.3% vs. 15.4%, p=0.004).

synapsesocial.com/papers/6a0f55d45725bbd5cc5facd8https://doi.org/10.6515/acs.202305_39(3).20221109a
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Outcomes and Hemodynamic Performances of Transcatheter Aortic Valve Replacement With Two Generations of Self-expanding Transcatheter Aortic Valves2021
  2. 2Early and Mid-Term Outcomes of Transcatheter Aortic Valve Replacement Using the New Generation Self-Expanding Corevalve Evolut R Device2018 · 2 citations
  3. 3Improvements of Procedural Results With a New‐Generation Self‐Expanding Transfemoral Aortic Valve Prosthesis in Comparison to the Old‐Generation Device2016 · 57 citations
  4. 4Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis2017 · 56 citations
  5. 5Early Real-World Experience with CoreValve Evolut PRO and R Systems for Transcatheter Aortic Valve Replacement2019 · 19 citations