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Transcatheter Aortic Valve Replacement With Evolut Platform for Failed Surgical Valves Stratified by Heart Team Risk Assessment

Abstract:

Background: Transcatheter aortic valve replacement (TAVR) to treat deteriorated surgical bioprostheses (TAV-in-SAV) has been increasing. However, the Food and Drug Administration approval is limited to high-risk patients with data obtained from older generation valves. This study aimed to assess real-world outcomes of TAV-in-SAV using next generation supra-annular, self-expanding transcatheter valves by Heart Team risk stratification. Methods: Transfemoral patients undergoing TAV-in-SAV procedures using Evolut R, Evolut PRO and Evolut PRO+ valves (Medtronic, MN) from the STS/ACC TVT Registry between July 2015 and March 2021 were evaluated. One-year outcomes included procedures through March 2020. Patients were grouped based on Heart Team surgical stratification: Extreme/high (ER/HR), intermediate (IR) and low (LR) risk groups. Site reported 30-day and 1-year clinical outcomes and …