Valvular & structural heart diseaseRandomised controlled trial
Prosthesis-patient mismatch with intra-annular self-expanding valves: an analysis of the PORTICO IDE trial
- prospective, multicentre, international, premarket randomised controlled trial
- independent core laboratory evaluation
Authors' conclusion
Haemodynamic performance was similar for the intra-annular Portico and supra-annular Evolut. Portico haemodynamics outperformed the balloon-expandable SAPIEN 3 for PPM and mean gradient in both small and large aortic annuli.
Study context
- Population
- Patients with severe aortic stenosis (AS) at high or extreme surgical risk, treated with Portico, Evolut or SAPIEN 3 transcatheter aortic valves (TAVs), in small (diameter ≤23 mm) and large (diameter >23 mm) aortic annulipatients with severe AS at high or extreme surgical risk · Portico 362 · Evolut 109 · SAPIEN 3 204
- Participants
- 675 patients
- Comparison
- Portico compared to Evolut and SAPIEN 3 TAVs
- Porticon = 362
- Evolutn = 109
- SAPIEN 3n = 204
Primary result
As reported in the abstract
EOA, severe PPM and MG in small aortic annuli, Portico vs Evolut · 30 days
| Outcome | Portico | Evolut | SAPIEN 3 |
|---|---|---|---|
| EOA | 1.65 cm² | 1.78 cm² | Not reported in the abstract |
| PPM | 3.3% | 3.0% | Not reported in the abstract |
| MG | 8.5 mmHg | 6.9 mmHg | Not reported in the abstract |
Further findings
| Outcome | Portico | Evolut | SAPIEN 3 |
|---|---|---|---|
| MG, EOA and PPM in large aortic annuli, Portico vs Evolut | |||
| MG | 8.3 mmHg | 7.4 mmHg | Not reported in the abstract |
| EOA | 1.93 cm² | 2.02 cm² | Not reported in the abstract |
| PPM | 5.4% | 3.2% | Not reported in the abstract |
| MG, EOA and PPM in small aortic annuli, Portico vs SAPIEN 3 | |||
| MG | 8.5 mmHg | Not reported in the abstract | 13.7 mmHg |
| EOA | 1.65 cm² | Not reported in the abstract | 1.40 cm² |
| PPM | 3.3% | Not reported in the abstract | 26.3% |
| MG, EOA and PPM in large aortic annuli, Portico vs SAPIEN 3 | |||
| MG | 8.3 mmHg | Not reported in the abstract | 10.9 mmHg |
| EOA | 1.93 cm² | Not reported in the abstract | 1.67 cm² |
| PPM | 5.4% | Not reported in the abstract | 10.9% |
| Structural valve deterioration in patients with small aortic annuli · 5 years | 2.2% | Not reported in the abstract | 13.9% |
- MG, effective orifice area (EOA) and prosthesis-patient mismatch (PPM) in large aortic annuli, Portico vs Evolut: MG p=0.069
- MG, EOA and PPM in large aortic annuli, Portico vs Evolut: EOA p=0.18
- MG, EOA and PPM in large aortic annuli, Portico vs Evolut: PPM p=0.83
- MG, EOA and PPM in small aortic annuli, Portico vs SAPIEN 3: MG p<0.0001
- MG, EOA and PPM in small aortic annuli, Portico vs SAPIEN 3: EOA p<0.0001
- MG, EOA and PPM in small aortic annuli, Portico vs SAPIEN 3: PPM p<0.0001
- MG, EOA and PPM in large aortic annuli, Portico vs SAPIEN 3: MG p<0.0001
- MG, EOA and PPM in large aortic annuli, Portico vs SAPIEN 3: EOA p<0.0001
- MG, EOA and PPM in large aortic annuli, Portico vs SAPIEN 3: PPM p=0.0014
- Structural valve deterioration in patients with small aortic annuli: p=0.03
MG, EOA and PPM in large aortic annuli, Portico vs Evolut
- No significant differences
MG, EOA and PPM in small aortic annuli, Portico vs SAPIEN 3
- Portico was superior to SAPIEN 3
MG, EOA and PPM in large aortic annuli, Portico vs SAPIEN 3
- Portico was superior to SAPIEN 3
Structural valve deterioration in patients with small aortic annuli · 5 years
- significantly lower in patients treated with Portico
Original publication
Prosthesis-patient mismatch with intra-annular self-expanding valves: an analysis of the PORTICO IDE trial. EuroIntervention. Published 6 July 2026. doi:10.4244/eij-d-26-00158
Summarised from the published abstract; every number is checked against it