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DOI: 10.1055/s-0040-1705410
Insights from a Multicenter, Retrospective, Propensity-Matched Register of Next-Generation Self-expanding Devices for Transcatheter Aortic Valve Replacement
Publication History
Publication Date:
13 February 2020 (online)
Objectives: The Acurate NEO and Evolut PRO bioprostheses are two next-generation self-expanding transcatheter heart valves (THV). This study aimed to compare results after transcatheter aortic valve implantation (TAVI) with the Acurate neo (NEO) and Evolut PRO (PRO) devices.
Methods: A total of 1,551 patients (n = 1,263 NEO; n = 288 PRO) were included. The mean age was 82 years, and the mean Society of Thoracic Surgeons score was 5.1%.
Results: After propensity score matching (n = 502), VARC-2 device success (90.6 vs. 91.6%; p = 0.751) and predischarge moderate to severe (II+) paravalvular aortic regurgitation (7.3 vs. 5.7%; p = 0.584) were comparable between the NEO and PRO groups. Moreover, there were no significant differences in any 30-day clinical outcome between matched NEO and PRO pairs, including all-cause mortality (3.2 vs. 1.2%; p = 0.221), stroke (2.4 vs. 2.8%; p = 1.000), new permanent pacemaker implantation (11.0 vs. 12.8%; p = 0.565), and VARC-2 early safety endpoint (10.6 vs. 10.4%; p = 1.000). Logistic regression on the unmatched cohort confirmed a similar risk of VARC-2 device success, paravalvular aortic regurgitation II+, and 30-day clinical outcomes after NEO and PRO implantation.
Conclusion: Transfemoral TAVI with the NEO and PRO bioprostheses was associated with high device success in this multicenter registry. Furthermore, acceptable rates of paravalvular aortic regurgitation II+ and good 30-day clinical outcomes were shown for both groups. After adjusting for potential confounders, short-term outcomes were similar between the devices.