As transcatheter aortic valve implantation (TAVI) is increasingly used in younger populations with fewer comorbidities, the long-term durability of transcatheter heart valves (THVs) has become a major issue. Each type of THV features distinct expansion mechanisms, stent frame designs, and leaflet configurations that may influence valve haemodynamic performance, leaflet mechanical stress, and long-term valve durability1. However, direct comparisons of durability beyond 5 years between balloon-expandable (BE) and self-expanding (SE) THVs remain scarce and largely indirect1. Nonetheless, current data suggest that SE THV devices with a supra-annular design may be associated with better durability compared to BE THV devices12.
The Myval/Octacor THV (Meril Life Sciences) is a new balloon-expandable valve that has recently demonstrated non-inferiority to both the SAPIEN 3 BE THV (Edwards Lifesciences) and the Evolut SE THV (Medtronic) at 30-day and 1-year follow-up in the head-to-head LANDMARK and COMPARE-TAVI randomised trials345.
In this issue of EuroIntervention, Jain et al6 assessed the 4-year durability of the Myval/Octacor THV. Although this study shares several limitations with previous studies, including (i) the competing risk of death...
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