Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Objectives: Little is known about valve hemodynamic performance during the Evolut and Neo deployment course. We aimed to evaluate transvalvular mean and peak-to-peak gradients over several intraprocedural timepoints during TAVR with Evolut PRO+ (Medtronic) and Neo (Boston Scientific) systems.
Methods: This was single-center pilot sub-study from the SavvyWire EFficacy and SafEty in Transcatheter Aortic Valve Implantation Procedures (SAFE-TAVI) trial. Participants received either the Evolut PRO+ or Neo for native valve severe aortic stenosis and the SavvyWire (OpSens Medical) was used for device delivery, pacing, and continuous left ventricular and aortic pressure measurements. For the Evolut, evaluation was done for baseline, two-thirds of valve deployment (still recapturable), 90% of valve deployment (no longer recapturable), and post-deployment hemodynamics. For the Neo, analysis was done at baseline, after the first step (top-crown deployment), and at final status.
Results: Nineteen patients were included (Evolut = 15; Neo = 4). There were no statistically significant changes in peak-to-peak gradients (44 mm Hg [IQR:33-69] vs 43 mm Hg [IQR:26-62], P = .41) between baseline and two-thirds of valve deployment in the Evolut patients. There was a significant decrease in mean (40 mm Hg [IQR:32-54] vs 14 mm Hg [IQR:10-18], P less than .001) and peak-to-peak (43 mmHg [IQRS:26-62] vs 9 mm Hg [IQR:8-13], P less than .001) transvalvular gradients between two-thirds and 90% of valve deployment for Evolut. Neo patients exhibited a decrease in transvalvular gradients after top-crown deployment (42.5 mm Hg baseline vs 13 mm Hg).
Conclusions: Transvalvular gradients did not vary between the point of "no-recapture" compared to baseline values in patients receiving the Evolut, whereas a significant reduction in transvalvular gradients was observed when the valve was deployed at 90% and fully deployed. The Neo valve was slightly obstructive after the first step of deployment.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.25270/jic/23.00286 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Transfemoral TAVR in a Quadricuspid Aortic Valve With Pure Regurgitation: Overcoming Anatomical and Technical Barriers.
JACC Case Rep
September 2025
Division of Cardiology, Department of Medicine, University of Florida Health, Jacksonville, Florida, USA. Electronic address:
We present a case of successful transfemoral transcatheter aortic valve replacement for a rare quadricuspid aortic valve with pure aortic regurgitation. Procedural challenges included identifying the annular plane, determining the appropriate deployment view, annular sizing, the absence of annular calcium, and the lack of a dedicated transcatheter device for pure aortic regurgitation.
View Article and Find Full Text PDFUniform Safety and Excellent Performance of Pressure-Regulated Deployment of Transcatheter Aortic Valves.
Struct Heart
September 2025
University of Sydney, School of Medicine and Health, Sydney, NSW, Australia.
•Pressure-regulated deployment (PRD) results in consistent and excellent transcatheter aortic valve (TAV) performance.•PRD produces superior valve hemodynamics in patients with small aortic annuli.•PRD mitigates the risk of annular injury even among patients at high anatomic risk.
View Article and Find Full Text PDFInvasive and Echocardiographic Mean Transvalvular Pressure Gradients of Different Transcatheter Aortic Valve Prostheses.
J Clin Med
August 2025
Clinic for Cardiac Surgery, Heart and Diabetes Center NRW, 32545 Bad Oeynhausen, Germany.
This study aimed to assess the effectiveness and clinical relevance of intraprocedural invasive measurements-specifically intraprocedural mean pressure gradients (IC MPGs) and diastolic delta (DD)-in comparison with echocardiography for evaluating transcatheter heart valve (THV) performance across different prosthesis types. Particular attention was paid to comparing outcomes between balloon-expandable (BE) and self-expandable (SE) valves, with further stratification by aortic annulus size. A retrospective analysis was performed on 926 patients who underwent transcatheter aortic valve replacements (TAVRs) between 2012 and 2021.
View Article and Find Full Text PDFMolecular Mechanisms of Cardiac Adaptation After Device Deployment.
J Cardiovasc Dev Dis
July 2025
Division of Cardiology, Annunziata Hospital, 87100 Cosenza, Italy.
Cardiac devices have transformed the management of heart failure, ventricular arrhythmias, ischemic cardiomyopathy, and valvular heart disease. Technologies such as cardiac resynchronization therapy (CRT), conduction system pacing, left ventricular assist devices (LVADs), and implantable cardioverter-defibrillators have contributed to abated global cardiovascular risk through action onto pathophysiological processes such as mechanical unloading, electrical resynchronization, or hemodynamic optimization, respectively. While their clinical benefits are well established, their long-term molecular and structural effects on the myocardium remain under investigation.
View Article and Find Full Text PDFCharacterizing the Acute Changes in Pulmonary Capillary Wedge Pressure Associated With Transcatheter Pulmonary Valve Replacement.
Catheter Cardiovasc Interv
August 2025
University of Colorado School of Medicine, Colorado, USA.
Background: After transcatheter pulmonary valve replacement (TPVR), changes in left ventricular loading conditions can result in increased pulmonary capillary wedge pressure (PCWP). Recognizing this effect may allow better understanding of the physiologic response of the left ventricle (LV) as well as early identification and treatment of procedural complications.
Aims: Our aim was to describe the hemodynamic changes in LV filling pressures after TPVR measured by a PCWP before and after valve deployment.