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June 3, 2026Catheterization and Cardiovascular Interventions0 citationsOpen Access

Clinical and Echocardiographic Outcomes After Implantation of the ALLEGRA Transcatheter Valve Using the Fully Repositionable IMPERIA Delivery System: One‐Year Results of the EMPIRE I Study

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JBJosé Antonio BazBRBen RenCBChristof Burgdorf

Key Result

Implantation of the ALLEGRA transcatheter valve using the IMPERIA delivery system resulted in 10.8% all-cause mortality and 5.9% bioprosthetic valve dysfunction at 1 year in native aortic stenosis.

Key Points

  • To evaluate the safety and efficacy of the IMPERIA delivery system for implantation of the ALLEGRA valve in patients with severe aortic stenosis.
  • Pre-market, prospective, multi-center, single-arm study at 11 centers in 3 European countries.
  • Utilized VARC-3 definitions for clinical endpoints and echocardiographic parameters.
  • Included patients with severe native aortic stenosis and those with degenerated surgical bioprosthesis.
  • 5.9% incidence of bioprosthetic valve dysfunction in the native population at 1 year.
  • Cardiovascular mortality was 6.8% in the native population and 0% in valve-in-valve patients.
  • Overall mortality was 10.8% (95% CI 6.4%-17.8%) in native aortic stenosis patients at 1 year.

Structured PICO

Does the ALLEGRA transcatheter aortic valve implanted using the IMPERIA delivery system provide safe and effective outcomes at 1 year in patients with severe native aortic stenosis or degenerated surgical bioprosthesis?

P
Population
137 patients with severe native aortic stenosis or a degenerated surgical bioprosthesis followed for 1 year.
I
Intervention
ALLEGRA transcatheter aortic valve implanted using the fully repositionable IMPERIA delivery system
O
Outcome
Clinical and echocardiographic outcomes at 1 year defined by VARC-3 criteriacomposite

The ALLEGRA transcatheter aortic valve using the IMPERIA delivery system demonstrated excellent 1-year safety and hemodynamic performance in patients with severe native aortic stenosis or degenerated surgical bioprostheses.

Abstract

BACKGROUND: The EMPIRE I study assessed the early (30 days) safety and efficacy of a new fully repositionable delivery system (IMPERIA) for the commercially available ALLEGRA transcatheter aortic valve in patients with either severe native aortic stenosis or a degenerated surgical bioprosthesis. AIM: To report the final 1-year results of the EMPIRE I study. METHODS: EMPIRE I is a pre-market, prospective, multi-center, single-arm study conducted at 11 centers in 3 European countries. There were independent data safety and clinical events committees and an independent echocardiographic core laboratory. In this analysis, VARC-3 definitions of all clinical endpoints and echocardiographic parameters were employed. RESULTS: The study recruited 121 patients with severe native aortic stenosis and 16 with degenerated surgical bioprosthesis. At 1 year, the incidence of bioprosthetic valve dysfunction in the native population was 5.9%. No patients developed structural valve deterioration or endocarditis, and there were no patients with haemodynamic valve deterioration or bioprosthetic valve failure. In the valve-in-valve sub-group, 2/14 (14.3%) patients had moderate patient prosthesis mismatch at 30 days with no evidence of new bioprosthetic valve dysfunction at 1 year. In the native population, new permanent pacemaker implantation was 14.3% at 30 days and remained unchanged at 1 year. Cardiovascular mortality was 6.8% in the native population and 0% in the valve-in-valve patients. At 1-year, all-cause mortality was 10.8% (95% CI 6.4%-17.8%) in the native aortic stenosis population and 0% in the valve-in-valve patients. CONCLUSION: After 1 year of follow-up, the results of the EMPIRE 1 study show excellent haemodynamic performance, a low rate of bioprosthetic valve dysfunction, and no bioprosthetic valve failure in patients treated with the ALLEGRATM trans-catheter aortic valve implanted using the new IMPERIATM fully repositionable delivery system.

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Cite This Study

Baz et al. (2026) studied Severe native aortic stenosis or degenerated surgical bioprosthesis (n=137). ALLEGRA transcatheter aortic valve using IMPERIA delivery system was evaluated on All-cause mortality in the native aortic stenosis population (95% CI 6.4-17.8). Implantation of the ALLEGRA transcatheter valve using the IMPERIA delivery system resulted in 10.8% all-cause mortality and 5.9% bioprosthetic valve dysfunction at 1 year in native aortic stenosis.

synapsesocial.com/papers/6a1fc730dee9eb8c0dce803ehttps://doi.org/10.1002/ccd.70675
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