The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Interventions for valvular disease and heart failure

Transcatheter aortic valve implantation with the Portico and Evolut R bioprostheses in patients with elliptic aortic annulus

EuroIntervention 2020;15:e1588-e1591. DOI: 10.4244/EIJ-D-19-00115

1. Department of Clinical and Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy; 2. Department of Electrical, Computer, and Biomedical Engineering, University of Pavia, Pavia, Italy; 3. Department of Civil Engineering and Architecture, University of Pavia, Pavia, Italy


Among anatomical factors affecting transcatheter aortic valve implantation (TAVI) success, aortic annulus shape plays a relevant role: an elliptic geometry may lead to gaps between the aortic root and the prosthesis, which is designed to expand circularly, resulting in paravalvular leak (PVL). In this context, the impact of different self-expanding (SE) devices is currently unknown.

The aim of the study was to compare PVL and device success rates of the Portico and Evolut R in patients with an elliptic aortic annulus and to test by computational simulations their behaviour by increasing eccentricity.


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