Valvular & structural heart disease
Self-expanding versus balloon-expandable transcatheter heart valves in patients with excessive aortic valve cusp calcification
Authors' conclusion
In patients with excessive leaflet calcification undergoing TAVR, BEV had a higher risk of annular rupture, but a lower risk of paravalvular regurgitation, and a lower risk of permanent pacemaker implantation compared to SEV. Mortality was comparable between SEV and BEV throughout 5 years of follow-up.
Study context
- Population
- Patients with severe aortic stenosis and excessive aortic valve cusp calcification (aortic valve complex calcium volume ≥235 mm³) undergoing transcatheter aortic valve replacement (TAVR), August 2007 to June 2023patients with excessive cusp calcification undergoing TAVR, 271 matched pairs
- Participants
- 1,345 patients
- Exposure
- self-expanding (SEV) and balloon-expandable (BEV) prostheses in patients with excess cusp calcification undergoing TAVR
- SEVn = 271
- BEVn = 271
Methodological details1:1 propensity-matched analysis, consecutive patients
- 1:1 propensity-matched analysis
- Consecutive patients
Main finding
As reported in the abstract
Procedural success
Procedural success achieved in >85% of patients with no difference between groups
>85%
Observational data: associations, not effects.
Further findings
Transprosthetic gradient
Mild or greater paravalvular regurgitation
- Transprosthetic gradient: lower with SEV, P < .001
- Mild or greater paravalvular regurgitation: higher with SEV, P = .008
Mortality · 5 years
- No statistically significant difference in mortality between groups (45.1% vs 50.2%)
- P = 0.173
Safety
Annular rupture
New permanent pacemaker implantation
- Annular rupture: more frequent with BEV, P = .030
- New permanent pacemaker implantation: higher with SEV, P = .001
Original publication
Self-expanding versus balloon-expandable transcatheter heart valves in patients with excessive aortic valve cusp calcification. Am Heart J. Published 18 September 2025. doi:10.
Summarised from the published abstract; every number is checked against it