Comparing transcatheter aortic valves: time to look beyond simplistic categorisations

As transcatheter aortic valve implantation (TAVI) is increasingly performed in patients with longer life expectancy, focus has shifted towards refining transcatheter aortic valve (TAV) design and optimising device implantation to improve long-term outcomes. The expanding range of commercially available TAVs, including refined device iterations and novel designs, underscores the need to understand the relative performance and long-term durability of different TAV types.

Comparative studies of different valves have conventionally classified devices according to leaflet position as intra-annular or supra-annular and/or by mode of deployment as self-expanding or balloon-expandable.

In this issue of EuroIntervention, Casenghi et al report findings from the HERA-TAVI registry, a retrospective observational study which compared two self-expanding valves – the intra-annular Navitor/Navitor Vision (Abbott) and the supra-annular Evolut FX/Evolut FX+ (Medtronic) – among 892 propensity score-matched pairs of patients.1 Patients were included if they had undergone TAVI for severe native tricuspid aortic stenosis and were at low or intermediate surgical risk.

The study found no difference in the incidence of the composite primary endpoint of all-cause death, disabling stroke, or heart failure hospitalisation at 1 year between Navitor and...