Long-Term Follow-Up of Transcatheter Aortic Valve Implantation With Portico Versus Evolut Devices

Nicola Corcione, Giuseppe Biondi-Zoccai, Paolo Ferraro, Alberto Morello, Sirio Conte, Michele Cimmino, Carlo Vigna, Giacomo Frati, Giovanni De Persio, Luca Altamura, Fabrizio Tomai, Andrea Berni, Mauro Cassese, Martino Pepe, Arturo Giordano

Research output: Contribution to journalArticlepeer-review

Abstract

New-generation devices such as Evolut and Portico have provided favorable results in patients who underwent transcatheter aortic valve implantation (TAVI) for aortic stenosis, but their comparative effectiveness remains debated, despite its relevance when envisioning TAVI in low-risk patients. We evaluated the safety and efficacy of 2 leading TAVI devices (Evolut and Portico) used by the same team of experienced TAVI operators, focusing on long-term outcomes, including major adverse events (i.e., the composite of death, stroke, myocardial infarction, major vascular complication, or major bleeding). Unadjusted and propensity score-adjusted analyses were carried out. A total of 233 patients were included, 119 (51.1%) receiving Evolut and 114 (49%) Portico. Baseline and procedural data showed significant between-device differences, including functional class, surgical risk, chronic obstructive pulmonary disease, renal function, transesophageal guidance, device size, postdilation, and procedural time (all p <0.05). Yet, acute and in-hospital outcomes were not significantly different (all p >0.05). Follow-up status was ascertained in 228 (98%) patients after 15.0 ± 7.6 months. Unadjusted analysis showed similar rates of major adverse events, as well as the individual risk of death, stroke, myocardial infarction, major vascular complication, major bleeding, and pacemaker implantation (all p >0.05). Even at propensity score-adjusted analysis outcomes were not significantly different with Evolut and Portico (all p >0.05). In conclusion, Evolut and Portico devices yield similarly favorable results at long-term follow-up when used by experienced TAVI operators.

Original languageEnglish
Pages (from-to)1209-1215
Number of pages7
JournalThe American Journal of Cardiology
Volume125
Issue number8
DOIs
Publication statusPublished - Apr 15 2020

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