ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology
Comparison of Evolut-R 34 mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors [Anatol J Cardiol]
Anatol J Cardiol. 2024; 28(2): 109-117 | DOI: 10.14744/AnatolJCardiol.2023.3563

Comparison of Evolut-R 34 mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors

Raif Kılıç1, Tuncay Güzel2, Adem Aktan3, Muhammed Demir4, Serhat Günlü5, Bayram Arslan6, Faruk Ertaş4
1Department of Cardiology, Çermik State Hospital, Diyarbakır, Türkiye
2Department of Cardiology, Health Science University, Gazi Yaşargil Training and Research Hospital, Diyarbakır, Türkiye
3Department of Cardiology, Mardin Training and Research Hospital, Mardin, Türkiye
4Department of Cardiology, Dicle University Faculty of Medicine, Diyarbakır, Türkiye
5Department of Cardiology, Mardin Artuklu University Faculty of Medicine, Mardin, Türkiye
6Department of Cardiology, Ergani State Hospital, Diyarbakır, Türkiye

Objective: The main purpose of this study was to evaluate and compare the in-hospital, 1-month and 1-year post-procedure outcomes of patients treated with Evolut-R 34 mm and Evolut-R 23/26/29 mm devices. Additionally, the study aimed to identify factors that could predict the occurrence of ≥ mild paravalvular leaks (PVL).

Methods: Between April 2015 and May 2022, 269 consecutive patients who underwent transcatheter aortic valve implantation (TAVI) with Evolut-R 34 mm (n = 66, 24.5%) and Evolut-R 23/26/29 mm (n = 203, 75.5%) devices in a single center were retrospectively analyzed.

Results: Patients in the Evolut-R 34 mm group had a lower female sex ratio (16.7% vs. 66.5%, P <.001, respectively), ejection fraction (50.7 ± 10.1% vs. 54.5 ± 9.3%, P =.016, respectively), and mean aortic gradient (7.4 ± 3.3 vs. 9.2 ± 5.0, P =.026, respectively) compared to the Evolut-R 23/26/29 mm group. The groups did not exhibit any statistically significant distinctions with regard to technical success, the need for a permanent pacemaker, occurrences of stroke, major vascular complications, PVL, major adverse cardiovascular and cerebrovascular events, or mortality. Peak velocity was confirmed as a significant predictor of ≥mild PVL in both patient groups in the receiver operating characteristic curve analysis. In logistic regression analysis; In patients with Evolut-R 34 mm valve, pre-TAVI aortic valve peak velocity (odds ratio (OR) = 23.202; P =.019) and calcium volume 800 Hounsfield Units (mm3) (OR = 1.017; P <.001) were independent predictors of ≥mild PVL.

Conclusion: The Evolut-R 34 mm valve has shown comparable in-hospital results with smaller valve sizes. Pre-TAVI aortic valve peak velocity and calcium volume predicted ≥ mild PVL in Evolut-R 34 mm patients.

Keywords: Transcatheter aortic valve implantation, paravalvular leak, Evolut-R 34 mm, peak velocity

Raif Kılıç, Tuncay Güzel, Adem Aktan, Muhammed Demir, Serhat Günlü, Bayram Arslan, Faruk Ertaş. Comparison of Evolut-R 34 mm Valve and Smaller Evolut-R Valves in Patients Undergoing Transcatheter Aortic Valve Implantation and Determination of Mild Paravalvular Leak Predictors. Anatol J Cardiol. 2024; 28(2): 109-117

Corresponding Author: Raif Kılıç, Türkiye
Manuscript Language: English


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