Short Term Outcomes of Transcatheter Aortic Valve Implantation with New Generation Devices

Background: The most commonly used valves for transcatheter aortic valve implantation (TAVI) are the Edwards SAPIEN and the Medtronic Corevalve. New generations of both devices are now in use; we aimed to compare short term TAVI outcomes using new vs former generation transcatheter aortic valves.

Methods and Results: From June 2012 to November 2015, 469 consecutive patients with symptomatic severe AS were assigned to transfemoral TAVI using new generation (S3 and EvolutR) (n=144), or former generation (SAPIEN XT and CoreValve) (n=325) devices. Short term outcomes were evaluated using the VARC-2 criteria. No significant differences in baselines characteristics were noted between groups. While modestly higher post-procedural AV gradients were detected in patients implanted with new compared to former devices (mean gradient 12±5 vs 9±3 and peak gradient 22±10 vs 16±6, respectively, p<0.001), no significant differences in the rate of paravalvular leak (0% vs 1.3%, respectively, p=0.35) or overall device failure (5.6% vs 3.7%, respectively, p=0.36) were noted. On multivariate analysis, both types of new generation valves were associated with an increased incidence of new conduction defects requiring more pacemaker implantations, compared to the former valves (OR 1.97, CI 1.3-3, p

Conclusions: Compared with former TAVI devices, new generation valves are associated with a higher rate of conduction defects as well as lower rates of atrial fibrillation, acute kidney injury and 30 days mortality.