Key result
J-Valve TAVI shows ~43% hemodynamic SVD in aortic stenosis but none in pure aortic regurgitation.
Why the study?
The long-term structural valve deterioration after TAVI using J-Valve in patients with aortic stenosis or pure aortic regurgitation was not well characterized.
RCT (n=18)
No
TAVI using J-Valve shows stable long-term hemodynamics and 100% 4-year survival, though moderate-to-severe hemodynamic structural valve deterioration occurred in over 40% of patients with aortic stenosis.
Alerts to possible hemodynamic SVD risk after J-Valve TAVI in AS; leaves open durability questions in larger prospective studies.
PURPOSE: Our study aimed to investigate the structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI) using J-Valve. METHODS: In all, 14 patients with aortic stenosis (AS) and 4 patients with pure aortic regurgitation (PAR) were available in the study. Four-year follow-up was performed in all patients, and the clinical data and echocardiographic findings were recorded and analyzed. RESULTS: All patients survived at the 4-year follow-up. There was no evidence of morphological SVD or prosthetic valve thrombosis in enrolled patients. None of the hemodynamic SVD occurred in patients with PAR. Mean gradients decreased from 61.93 ± 15.42 mm Hg (pre-TAVI) to 19.64 ± 9.16 mm Hg (discharge) in patients with AS (p <0.001); subsequently, a slight increase was observed in the mean trans-aortic gradient throughout follow-up (p = 0.967). Overall, in patients with AS, six individuals suffered moderate (3/14, 21.4%) or severe (3/14, 21.4%) hemodynamic SVD at 4-year follow-up. CONCLUSIONS: The limited number of cases provides a preliminary indication of the long-term efficacy of TAVI using J-Valve in patients with PAR. In patients with AS, although the higher rate of SVD was observed, the overall transcatheter heart valve (THV) hemodynamics remained stable over time after prosthetic valve implantation and the long-term durability of J-Valve was convincing.
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Li et al. (2020) conducted an RCT in Severe aortic stenosis (AS) and pure aortic regurgitation (PAR) (n=18). Transcatheter aortic valve implantation (TAVI) using J-Valve was evaluated on Hemodynamic structural valve deterioration (SVD) at 4 years. At 4-year follow-up after TAVI using J-Valve, no morphological structural valve deterioration occurred, while hemodynamic structural valve deterioration was observed in 42.9% of patients with aortic stenosis and 0% of patients with pure aortic regurgitation.
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