Key result
Self-expandable valves show no 5-year mortality benefit over balloon-expandable valves in extra-small annulus TAVI.
Why the study?
Mid-term outcomes of TAVI in patients with extra-small aortic annuli are limited and require comprehensive evaluation.
Does the choice between balloon-expandable and self-expandable transcatheter heart valves affect procedural success, hemodynamic performance, and midterm outcomes in patients with an extra-small aortic annulus?
Cohort (n=81)
No
Does the choice between balloon-expandable and self-expandable transcatheter heart valves affect procedural success, hemodynamic performance, and midterm outcomes in patients with an extra-small aortic annulus?
Absolute Event Rate: 13% vs 32%
p-value: p=0.86
Similar mortality does not guide valve selection; leaves open optimal device choice in extra-small annuli.
Objective: Transcatheter aortic valve implantation (TAVI) has become the standard treatment for older or high-risk surgical candidates with severe symptomatic aortic stenosis. However, reports on the mid-term outcomes of TAVI in patients with small annuli are limited. This study aimed to comprehensively evaluate the procedural success, hemodynamic performance, and midterm outcomes of TAVI using balloon-expandable transcatheter heart valves (BEVs) and self-expandable transcatheter heart valves (SEVs) in this population.
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Kitaura et al. (2025) conducted a cohort in Severe symptomatic aortic stenosis with extra-small aortic annulus (n=81). Self-expandable transcatheter heart valves (SEV) vs. Balloon-expandable transcatheter heart valves (BEV) was evaluated on 5-year all-cause mortality (p=0.86). In patients with an extra-small aortic annulus, TAVI with self-expandable valves compared to balloon-expandable valves resulted in comparable 5-year all-cause mortality (13.0% vs 32.0%, p=0.86).
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