Long‐Term Bioprosthetic Valve Durability After Transcatheter Aortic Valve Replacement With Supra‐Annular Self‐Expanding Versus Intra‐Annular Balloon‐Expandable Valves in Patients With a Small Aortic Annulus

• DOI: 10.1002/ccd.31415
• Publication Date: 2025-01-20T14:01:10Z
• Authors: Yutaka Matsuhiro; Isamu Mizote; Daisuke Nakamura; Tomoharu Dohi; Koichi Maeda; Kazuo Shimamura; Ai Kawamura; Kizuku Yamashita; Shumpei Kosugi; Shota Okuno; Hiroki Sugae; Yasuharu Takeda; Yasushi Sakata
• Keywords: Cardiac skeleton

ABSTRACT Background The long‐term valve durability of supra‐annular self‐expanding valves (SEV) and intra‐annular balloon‐expandable (BEV) in patients with small aortic annuli remains unexplored. Aims This study aimed to determine the bioprosthetic SEV versus BEV annuli. Methods retrospective included severe stenosis (AS) an annulus area 430 mm 2 or less who underwent transcatheter replacement using between October 2009 December 2022. Based on Valve Academic Research Consortium's three definitions, endpoints were hemodynamic structural deterioration (SVD) failure (BVF). Inverse probability treatment weighting (IPTW) was used compare two groups adjust for baseline characteristics. Fine‐Gray subdistribution hazard model accounted competing risk death. Results In total, 565 (204 treated 361 BEV) included. median follow‐up duration 3.6 years [2.0 years, 5.7 years], maximum 12.3 years. Hemodynamic SVD BVF frequently identified group than (1.1% vs. 9.1% within 5 0.7% 8.1% respectively). On IPTW adjusted analysis, frequent compared (Hazard Ratio [HR]: 0.16; 95% Confidence Interval [CI]: 0.04–0.56, p = 0.004). also associated a lower (HR: 0.25; CI: 0.08–0.76, 0.015). Conclusions appears be more suitable annulus.