Intra- versus supra-annular self-expanding transcatheter heart valves in small aortic annuli

doi:10.4244/eij-d-24-00966

Valvular & structural heart disease

Intra- versus supra-annular self-expanding transcatheter heart valves in small aortic annuli

EuroInterventionPublished 7 Jul 2025retrospective

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Authors' conclusion

The latest-generation IA-SEV and SA-SEV demonstrated similar clinical results except for a few echocardiographic findings after TAVI in patients with SAA.

Study context

Population: Patients with a small aortic annulus (SAA), defined as an annulus area ≤430 mm², who underwent transcatheter aortic valve implantation (TAVI) with a latest-generation intra-annular or supra-annular self-expanding valvePropensity score-matched (PSM) cohort n=219 patients/group · IA-SEV 518 · SA-SEV 401
Participants: 919 patients

Exposure: Differences in valve design on postprocedural results were investigated between the two groups and in the propensity score-matched (PSM) cohort.
IA-SEVn = 518
SA-SEVn = 401

Methodological detailspropensity score-matched (PSM) cohort

Propensity score-matched (PSM) cohort

Main finding

As reported in the abstract

Postprocedural effective orifice area (EOA), indexed EOA and mPG (overall cohort) · postprocedural

Similar between the two groups

allp>0.05

Observational data: associations, not effects.

Further findings

mPG (PSM cohort) · postprocedural · higher with IA-SEVs

P = 0.049

IA-SEV8.74 ± 5.01 mmHg

SA-SEV7.84 ± 4.43 mmHg

Severe prosthesis-patient mismatch (PSM cohort)

P = 0.405

IA-SEV1.9%

SA-SEV0.9%

Paravalvular leakage ≥mild (PSM cohort)

P = 0.084

IA-SEV34.1%

SA-SEV42.2%

Technical success, device success at discharge (overall cohort)

Technical success

IA-SEV95.9%

SA-SEV95.8%

Device success at discharge

IA-SEV91.3%

SA-SEV87.8%

Mean pressure gradient (mPG) (PSM cohort): after PSM (n=219 patients/group)
Technical success, device success at discharge (overall cohort): allp>0.05
Technical success, device success at discharge (overall cohort): These results were not changed in the PSM cohort (allp>0.05).

Safety

In-hospital death (overall cohort)

IA-SEV1.4%

SA-SEV0.5%

In-hospital death (overall cohort): allp>0.05
In-hospital death (overall cohort): not changed in the PSM cohort (allp>0.05)

Original publication

Intra- versus supra-annular self-expanding transcatheter heart valves in small aortic annuli. EuroIntervention. Published 7 July 2025. doi:10.4244/eij-d-24-00966

Read the original article ↗PubMed

Summarised from the published abstract; every number is checked against it