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. 2024 Aug 22:54:101487.
doi: 10.1016/j.ijcha.2024.101487. eCollection 2024 Oct.

Multicenter, propensity-weighted comparison of stented, rapid-deployment and new-generation aortic valves

Augusto D'Onofrio  1   2 , Giorgia Cibin  1 , Chiara Tessari  1 , Giulia Lorenzoni  3 , Giampaolo Luzi  4 , Erica Manzan  4 , Dario Gregori  3 , Gino Gerosa  1 ; INTU-ITA And RES-ITA Investigators
Affiliations

Multicenter, propensity-weighted comparison of stented, rapid-deployment and new-generation aortic valves

Augusto D'Onofrio et al. Int J Cardiol Heart Vasc. .

Abstract

Background: Conventional stented, rapid deployment and new-generation stented valves are now available for surgical aortic valve replacement (SAVR). New-generation devices feature advanced tissue treatment for theoretical prolonged durability and a new stent design able to expand in case of future transcatheter Valve-in-Valve. Aim of this retrospective, multicenter, propensity-weighted study was to compare early clinical and hemodynamic outcomes of these three different bioprostheses.

Methods: We analyzed data of 2589 patients from two national multicenter registries and one Institutional database. Study devices were Magna Ease, Intuity/Intuity Elite and Inspiris Resilia (Edwards Lifesciences, Irvine, CA, USA) and were implanted in 296 (11.4 %), 1688 (65.2 %) and 605 (23.4 %) patients, respectively. A propensity score weighting approach was employed.

Results: In isolated SAVR, aortic cross clamp (ACC) time was shorter for Intuity (Magna Ease: 87, Intuity: 55, Inspiris: 70 min; Magna Ease vs. Intuity: p < 0.001; Inspiris vs. Intuity: p < 0.001). Overall mortality was 2 %, 1.7 % and 0.5 % in Magna Ease, Intuity and Inspiris groups, respectively (Magna Ease vs. Intuity: p = 0.476; Inspiris vs. Intuity: p = 0.395); permanent pace-maker implantation rate was lower for Inspiris (Magna Ease: 6 %, Intuity: 6 %, Inspiris: 2 %; Magna Ease vs. Intuity: p = 0.679; Inspiris vs. Intuity: p < 0.001). Median mean gradients were 13, 10 and 10 mmHg for Magna Ease, Intuity and Inspiris, respectively (Magna Ease vs. Intuity: p < 0.001; Inspiris vs. Intuity: p = 0.13).

Conclusions: All study devices provide excellent early clinical and hemodynamic outcomes. Inspiris shows low rates of permanent pace-maker implantation and its transaortic gradients are similar to rapid-deployment valves and lower than Magna Ease.

Keywords: Aortic valve replacement; Bioprostheses; Rapid-deployment aortic bioprostheses; Stented aortic bioprosthesis.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Augusto D’Onofrio reports a relationship with Edwards that includes: speaking and lecture fees and travel reimbursement. Giorgia Cibin reports a relationship with Edwards Lifesciences Corporation that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Boxplot of mean gradients at discharge of the study devices.
Supplementary Figure 1
Supplementary Figure 1
See this image and copyright information in PMC

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