Original Research

DOI: 10.4244/EIJ-D-23-00996

Performance and outcomes of the SAPIEN 3 Ultra RESILIA transcatheter heart valve in the OCEAN-TAVI registry

Masanori Yamamoto1,2,3, MD; Fumiaki Yashima4, MD; Shinichi Shirai5, MD; Norio Tada6, MD; Toru Naganuma7, MD; Masahiro Yamawaki8, MD; Futoshi Yamanaka9, MD; Kazuki Mizutani10, MD; Masahiko Noguchi11, MD; Hiroshi Ueno12, MD; Kensuke Takagi13, MD; Yohei Ohno14, MD; Masaki Izumo15, MD; Hidetaka Nishina16, MD; Hiroto Suzuyama17, MD; Kazumasa Yamasaki18, MD; Kenji Nishioka19, MD; Daisuke Hachinohe20, MD; Yasushi Fuku21, MD; Toshiaki Otsuka22,23, MD; Masahiko Asami24, MD; Yusuke Watanabe25, MD; Kentaro Hayashida26, MD; on behalf of the OCEAN-TAVI investigators

Abstract

BACKGROUND: Data on the performance of the latest-generation SAPIEN 3 Ultra RESILIA (S3UR) valve in patients who undergo transcatheter aortic valve replacement (TAVR) are scarce.

AIMS: We aimed to assess the clinical outcomes, including valve performance, of the S3UR.

METHODS: Registry data of 618 consecutive patients with S3UR and of a historical pooled cohort of 8,750 patients who had a SAPIEN 3 (S3) valve and underwent TAVR were collected. The clinical outcomes and haemodynamics, including patient-prosthesis mismatch (PPM), were compared between the 2 groups and in a propensity-matched cohort.

RESULTS: The incidence of in-hospital death, vascular complications, and new pacemaker implantation was similar between the S3UR and the S3 groups (allp>0.05). However, both groups showed significant differences in the degrees of paravalvular leakage (PVL) (none-trivial: 87.0% vs 78.5%, mild: 12.5% vs 20.5%, ≥moderate: 0.5% vs 1.1%; p<0.001) and the incidence of PPM (none: 94.3% vs 85.1%, moderate: 5.2% vs 12.8%, severe: 0.5% vs 2.0%; p<0.001). The prevalence of a mean pressure gradient ≥20 mmHg was significantly lower in the S3UR group (1.6% vs 6.2%; p<0.001). Better haemodynamics were observed with the smaller 20 mm and 23 mm S3UR valves. The results were consistent in a matched cohort of patients with S3UR and with S3 (n=618 patients/group).

CONCLUSIONS: The S3UR has equivalent procedural complications to the S3 but with lower rates of PVL and significantly better valve performance. The better valve performance of the S3UR, particularly in smaller valve sizes, overcomes the remaining issue of balloon-expandable valves after TAVR.

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Volume 20 Number 9
May 10, 2024
Volume 20 Number 9
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