Why the study?
Bioprosthetic valves are increasingly used in younger patients undergoing AVR, but clinical and valve-related outcomes comparing the next-generation INSPIRIS Resilia bioprosthesis with its predecessor have not been established up to six years.
Does the INSPIRIS Resilia valve improve valve-related outcomes compared to the Perimount Magna Ease valve in patients undergoing aortic valve replacement?
Cohort (n=2,053)
No
Does the INSPIRIS Resilia valve improve valve-related outcomes compared to the Perimount Magna Ease valve in patients undergoing aortic valve replacement?
Answers are grounded in this paper and cite their sources.
The next-generation INSPIRIS Resilia valve shows comparable mid-term clinical and hemodynamic outcomes to its predecessor, with prosthetic endocarditis rather than structural degeneration driving mid-term reinterventions.
Background: Current ESC/EACTS guidelines recommend bioprosthetic valves for aortic valve replacement (AVR) in patients > 65 years, yet their use is increasing among younger individuals. The INSPIRIS Resilia (IR) valve, a next-generation bioprosthesis, was designed to improve durability and reduce structural valve degeneration (SVD). This study compares clinical and valve-related outcomes up to six years in patients undergoing AVR with either the IR or its predecessor, the Perimount Magna Ease (PME) valve. Methods: Between January 2017 and December 2023, 2053 patients underwent isolated or combined AVR at a single institution (1602 PME; 451 IR). Propensity-score matching identified 224 patient pairs with comparable baseline characteristics. Outcomes were assessed over follow-up extending up to six years, focusing on cardiovascular and valve-related adverse events. Transvalvular gradients were also assessed at follow-up. Results: After matching, mean age was 64.2 ± 7.7 years in both groups. Freedom from cardiovascular mortality at six years was similar between PME and IR (96.6% vs. 98.2%; p = 0.34), as were rates of stroke, rehospitalization, prosthetic valve endocarditis, and reintervention. A total of 12 PME (5.4%) and six IR valves (2.5%) were explanted during follow-up (p = 0.15), with prosthetic endocarditis representing the leading cause of reintervention. Only one case of severe SVD was observed in both groups. Conclusions: In patients undergoing AVR with comparable baseline risk profiles, IR and PME valves demonstrated similar clinical, valve-related, and hemodynamic outcomes up to six years of follow-up. Prosthetic valve endocarditis represented the leading cause of valve failure, whereas structural valve deterioration remained rare. Longer follow-up and a greater number of valve-related events will be necessary to determine whether differences in bioprosthetic valve degeneration emerge over time.
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Francica et al. (2026) conducted a cohort in Aortic valve disease requiring replacement (n=2,053). INSPIRIS Resilia (IR) valve vs. Perimount Magna Ease (PME) valve was evaluated on Prosthetic valve reintervention (SHR 0.69, 95% CI 0.25-1.91, p=0.47).
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