Self-Expanding Supraannular Valve vs. Balloon-Expandable Valve in TAVR for Small Aortic Annulus

At 1 year, clinical outcomes were similar and supraannular valve recipients had a significantly lower risk of bioprosthetic-valve dysfunction.

In patients undergoing transcatheter aortic-valve replacement (TAVR) for symptomatic, severe aortic-valve stenosis, observational studies have suggested that use of a self-expanding supraannular valve may provide lower residual gradients compared with a balloon-expandable intraannular valve. This advantage might be especially beneficial in patients with a small aortic annulus, who have increased risk for impaired valve hemodynamics, but data are lacking in this population.

In an industry-funded trial (NCT04722250), roughly 740 patients (87% women; mean age, 80 years) with symptomatic severe aortic stenosis and an aortic-valve annulus area ≤430 mm² were randomized to TAVR with a self-expanding valve (Evolut platform) or a balloon-expandable v…

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)