Which Transcatheter Valve Is Best for Treatment of a Failing Small Surgical Aortic Valve?

A small randomized trial suggests an initial hemodynamic advantage for self-expanding over balloon-expandable valves.

Although transcatheter aortic valve replacement (TAVR) was originally developed for treatment of the native aortic valve, it is also performed for treatment of failing surgical aortic valves (valve-in-valve TAVR). However, high residual transvalvular gradients and patient-prosthesis mismatch are concerns in this setting, as both have been associated with increased long-term mortality. Observational studies suggest that self-expanding supra-annular valves (SEVs) may offer an advantage over balloon-expandable valves (BEVs) in such patients; however, no head-to-head comparisons have been performed.

To address this issue, investigators evaluated hemodynamics based on echocardiography in 98 patients with failing small surgical aortic bioprosthese…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)