Single-centre experience with next-generation devices for transapical aortic valve implantation

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Transcatheter aortic valve implantation (TAVI) is a key treatment for high-risk aortic stenosis patients.
• First-generation transcatheter heart valves (THVs) have limitations, including paravalvular regurgitation.
• Next-generation THVs aim to improve TAVI outcomes.

Purpose of the Study:

• To evaluate the short-term clinical outcomes of transapical TAVI using next-generation THVs.
• To assess the safety and efficacy of these novel devices in a consecutive patient cohort.

Main Methods:

• A total of 200 high-risk patients underwent transapical TAVI with next-generation THVs (Engager, JenaValve, Symetis Acurate).
• Data were collected at baseline, during the procedure, and at follow-up, analyzed per Valve Academic Research Consortium standards.
• Median follow-up duration was 219 days.

Main Results:

• Successful implantation was achieved in 96.5% of cases.
• Significant improvements in valve function (effective orifice area, transvalvular gradients) were observed.
• Low rates of relevant paravalvular regurgitation (none/trace in 70.3%) and acceptable rates of complications were reported. 30-day survival was 91.5%.

Conclusions:

• Next-generation transapical THVs demonstrate favorable short-term hemodynamic and clinical outcomes in a real-world setting.
• The incidence of significant paravalvular regurgitation was low.
• Further long-term studies are necessary to confirm the durability of these devices.