Despite promising results following transcatheter aortic valve implantation (TAVI), several relevant challenges still remain. To overcome these issues, new generation devices have been developed. The purpose of the present study was to determine whether TAVI with the new self-expanding repositionable Evolut R offers potential benefits compared to the preceding CoreValve, using propensity matching.
Between June 2007 and November 2015, 2,148 consecutive patients undergoing TAVI either CoreValve (n=1,846) or Evolut R (n=302) were prospectively included in the Italian TAVI ClinicalService® project. For the purpose of our analysis 211 patients treated with the Evolut R were matched to 211 patients treated with the CoreValve. An independent core laboratory reviewed all angiographic procedural data and an independent clinical events committee adjudicated all events.
In a matched comparison of high surgical risk patients undergoing TAVI, the use of Evolut R was associated with a significant survival benefit at 1year compared with the CoreValve. This was driven by lower incidence of periprocedural complications and higher rates of correct anatomic positioning.
- Giannini C, De Carlo M, Tamburino C, Ettori F, Latib AM, Bedogni F, Bruschi G, Presbitero P, Poli A, Fabbiocchi F, Violini R, Trani C, Giudice P, Barbanti M, Adamo M, Colombo P, Benincasa S, Agnifili M, Petronio AS. Transcathether aortic valve implantation with the new repositionable self-expandable Evolut R versus CoreValve system: A case-matched comparison. Int J Cardiol 2017 May 29. pii: S0167-5273(16)34005-0. doi: 10.1016/j.ijcard.2017.05.095. [Epub ahead of print] Go to PubMed