The efficacy of transcatheter treatment of aortic valve stenosis based on the type of implanted valve
DOI:
https://doi.org/10.52692/1857-0011.2025.1-81.01Keywords:
aortic stenosis, transcatheter aortic valve implantation, balloon-expandable valve , self-expanding valveAbstract
Introduction. Aortic stenosis is the most common valvular disease among elderly patients and carries a poor prognosis if left untreated. Transcatheter aortic valve implantation (TAVI) has emerged as an effective alternative to surgical valve replacement, particularly in high and intermediate-risk patients. The type of valve implanted may significantly influence postoperative outcomes. Aim of study. To assess the efficacy and safety of TAVI based on the type of prosthesis used: self-expanding (SEV) versus balloon-expandable (BEV). Materials and Methods. A prospective study was conducted on 114 patients over 70 years old with severe aortic stenosis who underwent TAVI: Abbott valve (n=44), Medtronic (n=40), Edwards (n=30). Valve performance and safety were evaluated according to Valve Academic Research Consortium-3 (VARC-3) criteria. Results. No significant differences were observed between groups regarding age, BMI, sex, or comorbidities. Edwards valves showed the highest post-TAVI mean pressure gradients (16.2 ± 6.7 mmHg), followed by Abbott (12.4 ± 6 mmHg) and Medtronic (10.1 ± 3.5 mmHg, p<0.001). Vmax was significantly higher in the Edwards group at all follow ups (p<0.01), indicating greater residual stenosis risk. Left ventricular function was similar across groups. Paravalvular regurgitation was more frequent with Edwards (p<0.001 vs. Abbott, p=0.008 vs. Medtronic). High-grade AV block and permanent pacemaker implantation were more frequent in the SEV group. Mortality and rehospitalization rates were similar between groups. Conclusions. TAVI proved to be an effective and safe treatment for severe aortic stenosis in elderly patients. The type of prosthesis influences hemodynamic performance and complication profile, highlighting the need for individualized valve selection based on patient characteristics.
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