Portico at 1 Year

Portico valve is a self-expanding percutaneous aortic valve prosthesis consisting of a Nitinol cage and leaflets made of bovine pericardium.Potential advantages of its design include large stent cell sizes and a relatively shorter height with minimal flaring, designed to prevent deep placement in the left ventricular outflow tract and lower pacemaker rates.In this issue of Circulation: Cardiovascular Interventions, Linke et al 1 present 1-year outcomes from the Portico prospective, multicenter registry (ClinicalTrials.gov,NCT01493284).A total of 222 patients with severe aortic stenosis and a mean age of 83 years (74% women) were enrolled in Europe and Australia, with the primary end point of all-cause 30-day mortality.Inclusion and exclusion criteria, as well as study design, are similar to previous intermediate and high-risk transcatheter aortic valve replacement (TAVR) trials, with an Society of Thoracic Surgery (STS) risk 2 requirement of ≥4.Patients with a lower STS risk score but deemed inoperable or high risk by the heart team were also included.A high proportion, one third, of valves required recapture and repositioning during the procedure.The implanted valves included an equal distribution of all 4 available sizes.