Maturation from CoreValve^® to Evolut Pro^®: a clinical overview

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomaterials Science

Background:

• Aortic stenosis necessitates valve replacement, with surgical and transcatheter approaches being curative.
• Transcatheter aortic valve implantation (TAVI) is now a primary treatment for symptomatic severe aortic stenosis in high-risk elderly patients.
• The self-expanding CoreValve bioprosthesis has been a significant development in TAVI.

Purpose of the Study:

• To critically appraise the evolution of the self-expanding CoreValve/Evolut bioprosthesis platforms.
• To highlight the clinical foundation supporting the use of these devices in current practice.

Main Methods:

• Review of consecutive device iterations of the CoreValve/Evolut platforms.
• Appraisal of clinical data and advancements in device design.
• Focus on features such as reduced profile, repositioning capabilities, and material enhancements.

Main Results:

• The CoreValve/Evolut platform has undergone substantial evolution over the past decade.
• Current iterations, like the Evolut PRO, feature a reduced profile, repositioning/retrievable capabilities, and a porcine pericardial wrap.
• These advancements aim to improve procedural outcomes and patient safety in TAVI.

Conclusions:

• The self-expanding CoreValve/Evolut platforms represent a mature and evolving technology in transcatheter aortic valve implantation.
• Continuous device innovation has enhanced the suitability of TAVI for managing severe aortic stenosis in elderly, high-risk populations.
• These platforms provide a strong clinical foundation for their continued use in interventional cardiology practice.