Early experience with the Evolut FX self-expanding valve vs. Evolut PRO+ for patients with aortic stenosis undergoing TAVR

• Published in: Cardiovascular revascularization medicine Vol. 56; pp. 1 - 6
• Main Authors: Merdler, Ilan, Case, Brian, Bhogal, Sukhdeep, Reddy, Pavan K., Sawant, Vaishnavi, Zhang, Cheng, Ali, Syed, Ben-Dor, Itsik, Satler, Lowell F., Rogers, Toby, Waksman, Ron
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2023
• Subjects: Aortic stenosis; Self-expanding valve; Transcatheter aortic valve replacement; Transcatheter heart valve; Aortic stenosis; THV; PVL; Transcatheter heart valve; VARC-3; PPM; Transcatheter aortic valve replacement; Self-expanding valve; TAVR
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2023.06.003

The Evolut FX system is the most recent generation of self-expandable transcatheter heart valve (THV) technology. This study aims to report the early experience and outcomes associated with this system.
Our analysis included 200 consecutive patients who underwent transcatheter aortic valve replacement at our center from 2022 to 2023. The first cohort comprised the last 100 patients who received the Evolut PRO+ THV, while the second cohort included the first 100 patients who received the Evolut FX THV. The primary endpoints of the study were defined according to the Valve Academic Research Consortium-3 (VARC-3) criteria, which included technical success (at exit from procedure), device success (at discharge or at 30 days), and early safety (at 30 days).
The study groups demonstrated no significant differences in baseline characteristics, including co-morbidities, pre-procedural imaging, and echocardiography. VARC-3 technical success rate was 99 % for both valves. The VARC-3 device success rate for the Evolut FX was 92 % compared to 97 % for the Evolut PRO+ (p = 0.12), and VARC-3 early safety rate was 80.1 % for the Evolut PRO+ vs. 81.5 % for the Evolut FX (p = 0.82). The in-hospital permanent pacemaker implantation rate for the Evolut FX was 12 % compared to 9 % for the Evolut PRO+ (p = 0.21). There were no differences in clinical outcomes, such as mortality or stroke, between the two groups.
The Evolut FX THV performed well when used for patients with severe aortic stenosis, demonstrating high success with low complication rates when compared to an earlier generation of self-expanding THV.
•The Evolut FX system is among the newest generation of self-expandable THVs.•We compared clinical outcomes of patients receiving Evolut FX vs. Evolut PRO+.•Evolut FX showed excellent VARC-3 clinical outcomes vs. Evolut PRO+.•FX showed similarly low complication rates but longer procedure times vs. PRO+.