Key result
Valve-in-valve implantation of the CoreValve Evolut R significantly reduced the mean transaortic gradient from 37.5 mmHg to 16.3 mmHg in patients with degenerated surgical aortic valves.
Why the study?
Does valve-in-valve implantation of the CoreValve Evolut R improve hemodynamics and survival in high-risk patients with degenerated surgical aortic valves?
Observational (n=26)
No
Does valve-in-valve implantation of the CoreValve Evolut R improve hemodynamics and survival in high-risk patients with degenerated surgical aortic valves?
The CoreValve Evolut R is a feasible and hemodynamically effective option for valve-in-valve transcatheter aortic valve implantation in high-risk patients with degenerated surgical bioprostheses.
Early ViV experience with Evolut R appears feasible; leaves open durability, safety, and comparative effectiveness in larger cohorts.
BACKGROUND: The new CoreValve Evolut R has an improved design to minimize paravalvular leak-age and allows repositioning of the valve. For patients with degenerated bioprosthetic aortic valves, transcatheter aortic valve implantation (TAVI) represents a less invasive option. Herein reported are valve-in-valve (ViV) implantations of this new valve. METHODS: A total of 26 patients (mean age 79.4 ± 6.1 years, 17 males and 9 females) were treated for severe prosthesis stenosis (n = 9), severe regurgitation (n = 8) or severe combination of stenosis and regurgitation (n = 9). All patients underwent transthoracic echocardiography before and after ViV implantation. RESULTS: Valve-in-valve implantation of a CoreValve Evolut R was performed successfully in all pa-tients. The mean transaortic gradient for stenotic valves determined by transthoracic echocardiography was reduced significantly from 37.5 ± 15.3 mmHg in patients with prosthesis stenosis to 16.3 ± 8.2 mmHg (p < 0.001). In all cases with severe prosthesis regurgitation, regurgitation was reduced to none or mild. All-cause mortality after 30 days was 0%. CONCLUSIONS: It was concluded that CoreValve Evolut R is well suited for ViV implantation.
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Schwerg et al. (2018) conducted an observational in Degenerated surgical aortic valves (n=26). CoreValve Evolut R vs. Baseline was evaluated on Mean transaortic gradient (p=<0.001). Valve-in-valve implantation of the CoreValve Evolut R significantly reduced the mean transaortic gradient from 37.5 mmHg to 16.3 mmHg in patients with degenerated surgical aortic valves.
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