The issue of valve durability has become one of the most important aspects in the TAVR field in recent years since transcatheter aortic valve replacement has been progressively applied to younger patients with a low co-morbidity burden. The SAPIEN 3 Ultra RESILIA valve represents the last generation of the SAPIEN valve system and includes several important iterations (newer leaflet calcium-blocking technology targeting calcium-attracting free aldehydes, dry tissue storage, newer skirt textile design) that should translate into a favorable impact on valve durability at mid- to long- term follow-up
Prospective observational registry including patients with severe aortic stenosis undergoing TAVR with the SAPIEN 3 Ultra RESILIA valve. All patients who will survive the procedure will undergo a clinical and echocardiographic follow-up at 1-3 months (± 15 days), at 1-year (±30 days), 3-5 year (±30 days), 6-8 year (±30 days) and 9-10 year (±30 days) after valve implantation. Transthoracic echocardiography (TTE) exams (baseline, 1-3-month, 1 year, 3-5 years, 6-8 years, and 9-10 years post-procedure) will be evaluated in a Centralized Echocardiographic Core Lab at the Quebec Heart and Lung Institute. The measurements obtained in the Core Lab regarding transvalvular gradient, EOA, PPM and PVL at 1-3 months will determine the primary outcome of the study.
Study Type
OBSERVATIONAL
Enrollment
150
Patients with severe aortic stenosis undergoing transarterial TAVR with the SAPIEN 3 Ultra RESILIA valve.
IUCPQ
Québec, Quebec, Canada
RECRUITINGTransvalvular gradient
Residual (peak and mean) transvalvular gradient
Time frame: 1-3 months
Effective orifice area (EOA)
EOA evaluated by echocardiography imaging
Time frame: 1-3 months
Prosthesis-patient mismatch
Moderate or severe prothesis-patient mismatch (defines as an index aortic valve area 0.85-0.66 cm2/m2 (moderate), ≤0.65 cm2/m2 (severe) for patient with BMI ˂30km/m2 and 0.70-0.56 cm2/m2 (moderate), ≤0.55 cm2/m2 (severe) for patient with BMI ≥30km/m2 and/or moderate-severe aortic regurgitation (AR) (VARC-3 definition).
Time frame: 1-3 months
Paravalvular leaks
Paravalvular leaks evaluated by echocardiography imaging
Time frame: 1-3 months
Transvalvular gradient
Residual (maximal and mean) transvalvular gradient
Time frame: 1-, 3-5-, 6-8-, and 9-10-year follow-up.
Effective orifice area (EOA)
EOA evaluated by echocardiography imaging
Time frame: 1-, 3-5-, 6-8-, and 9-10-year follow-up.
Bioprosthetic valve dysfunction
Bioprosthetic valve dysfunction evaluated by VARC3 criteria
Time frame: 1-, 3-5-, 6-8-, and 9-10-year follow-up.
Paravalvular leaks
Paravalvular leaks evaluated by echocardiography imaging
Time frame: 1-, 3-5-, 6-8-, and 9-10-year follow-up.
Bioprosthetic valve dysfunction
Incidence rate (per 100 patient-years) of bioprosthetic valve dysfunction (stage 2 or 3)
Time frame: yearly
Bioprosthetic valve failure
Incidence rate (per 100 patient-years) of bioprosthetic valve failure
Time frame: yearly
Bioprosthetic valve failure
Bioprosthetic valve failure evaluated by VARC3 criteria
Time frame: 1-, 3-5-, 6-8-, and 9-10-year follow-up.
Clinical events
Individual: mortality, stroke, bleeding type 2-4, cardiac rehospitalization, heart failure rehospitalization
Time frame: 1month and yearly up to 10-year
Valve thrombosis
Number of patients with valve thrombosis
Time frame: 1-3 months and yearly up to 10-year
Valve endocarditis
Number of patients with valve endocarditis
Time frame: 1-3 months and yearly up to 10-year
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