Outcomes and Hemodynamic Performances of Transcatheter Aortic Valve Replacement With Two Generations of Self-expanding Transcatheter Aortic Valves

The aim of this study was to investigate the hemodynamic and clinical performance of the Evolut R compared with its direct predecessor, CoreValve, in Taiwanese population. This study included all consecutive patients who underwent TAVR with either the CoreValve or Evolut R between March 2013 to December 2020. Thirty-day Valve Academic Research Consortium-2 (VARC-2)-defined outcomes and hemodynamic performances were investigated. There were no significant differences in baseline demographic characteristics between patients receiving CoreValve (n= 117) or Evolut R (n=117). Aortic valve-in-valve procedures for failed surgical bioprosthesis and procedures under conscious sedation were performed significantly more often with Evolut R. Pre-dilatation was performed significantly more often and contrast media volume was significantly higher with CoreValve. Stroke (0% vs 4.3%, p = 0.024) and the need for emergent conversion to open surgery (0% vs 5.1%, P = 0.012) were significantly lower in Evolut R than CoreValve recipients. Evolut R significantly reduce 30-day composite safety endpoint (4.3% vs 15.4%, p = 0.004). In conclusion, advancements in transcatheter valve technologies have resulted in improved outcomes for patients undergoing TAVR with self-expanding valves. With new-generation Evolut R, device success was high and significantly reduced 30-day composite safety endpoint after TAVR compared with CoreValve.