Real-world early- to midterm outcomes of aortic valve replacement using novel tissue technology bioprosthesis at a...

The INSPIRIS-RESILIA aortic valve (Edwards Lifesciences) uses a novel tissue-fixation technology to enhance the bioprosthesis's longevity. We sought to report midterm INSPIRIS-RESILIA aortic bioprosthesis performance in a large contemporary cohort at a single institution.

Between January 2013 and July 2024, 9168 patients underwent surgical aortic valve replacement at our center, of which 3758 patients received an INSPIRIS-RESILIA bioprosthesis. Propensity-match analysis between INSPIRIS-RESILIA and PERIMOUNT valves (n = 2480 in each group) was executed. Median follow-up in the INSPIRIS-RESILIA was 2.5 years, and 25% of patients were followed for more than 4.8 years.

In the INSPIRIS-RESILIA aortic valve replacement cohort (n = 3758), concomitant procedures included mitral valve repair or replacement in 20% (n = 741) and thoracic aorta aneurysm repair in 19% (n = 726), whereas 21% were reoperation (n = 781). Postoperative stroke incidence was 1.3% and operative mortality was 1.2%. During the follow-up period, mean gradient across the INSPIRIS-RESILIA bioprosthesis was 12 and 13 mm Hg at 1 year and 4 years, respectively. At 4 years, 97% of patients had none/trace aortic regurgitation, and 1% had moderate or greater aortic regurgitation. There were 69 reinterventions on INSPIRIS-RESILIA bioprosthesis during follow-up, primarily for endocarditis. Compared with the PERIMOUNT bioprosthesis, the INSPIRIS-RESILIA bioprosthesis demonstrated lower likelihood of moderate or greater aortic regurgitation (P < .0001), whereas no significant difference in gradients at 5-years (13.1 vs 13.4 mm Hg) or freedom from reoperation (P > .2) between the 2 bioprostheses in the propensity-matched analysis.

This single-center study of the real-world experience with the INSPIRIS-RESILIA bioprosthesis has demonstrated favorable hemodynamic performance and a low rate of reintervention at early- to midterm follow-up.