Bunc Matjaž, Verček Gregor, Vitez Luka, Holc Primož, Steblovnik Klemen, Šušteršič Miha
Department of Cardiology, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia.
Institute of Pathological Physiology, Faculty of Medicine, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia.
Medicina (Kaunas). 2025 Aug 6;61(8):1419. doi: 10.3390/medicina61081419.
: Transcatheter heart valve (THV) selection is challenging as self-expanding valves (SEVs) are associated with lower post-procedural mean aortic gradients, while balloon-expandable valves (BEVs) have lower rates of paravalvular leak (PVL) and permanent pacemaker implantation (PPI). We aimed to compare the 30-day and 1-year outcomes following Myval BEV (Meril Life Sciences, Vapi, Gujarat, India) and intra-annular Portico SEV (Abbott, St. Paul, MN, USA) implantation. : We retrospectively analyzed the data from the all-comer TAVI registry of the University Medical Centre Ljubljana, Slovenia, from October 2017 to August 2023. Safety and efficacy outcomes following Myval BEV and Portico SEV implantation were compared overall and after propensity score matching. : Of the total 1152 THVs implanted, 97 patients (8%) received a Myval BEV and 47 (4%) a Portico SEV. After propensity score matching, there were no significant differences between the two patient cohorts regarding 30-day (Myval 0.0% vs. Portico 2.9%, = 1.000) and 1-year mortality (Myval 0.0% vs. Portico 5.9%, = 0.492). Likewise, the rates of new PPI, device failure (mean aortic gradient and more than mild PVL), and periprocedural in-hospital complications were comparable between the two groups. : In this retrospective analysis of two intra-annular THVs, the Myval BEV was associated with comparable short- and mid-term outcomes as the Portico SEV.
经导管心脏瓣膜(THV)的选择具有挑战性,因为自膨胀瓣膜(SEV)与术后较低的平均主动脉梯度相关,而球囊扩张瓣膜(BEV)的瓣周漏(PVL)和永久起搏器植入(PPI)发生率较低。我们旨在比较Myval BEV(印度古吉拉特邦瓦皮市梅里尔生命科学公司)和瓣环内Portico SEV(美国明尼苏达州圣保罗市雅培公司)植入术后30天和1年的结局。
我们回顾性分析了斯洛文尼亚卢布尔雅那大学医学中心2017年10月至2023年8月所有患者的经导管主动脉瓣置换术(TAVI)注册数据。总体上以及在倾向评分匹配后,比较了Myval BEV和Portico SEV植入后的安全性和有效性结局。
在总共植入的1152个THV中,97例患者(8%)接受了Myval BEV,47例患者(4%)接受了Portico SEV。倾向评分匹配后,两个患者队列在30天死亡率(Myval为0.0%,Portico为2.9%,P = 1.000)和1年死亡率(Myval为0.0%,Portico为5.9%,P = 0.492)方面没有显著差异。同样,两组之间新的PPI发生率、器械故障(平均主动脉梯度和中重度以上PVL)以及围手术期住院并发症发生率相当。
在这项对两种瓣环内THV的回顾性分析中,Myval BEV与Portico SEV的短期和中期结局相当。