Evaluation of clinical outcomes and valve performance of the SAPIEN 3 Ultra Resilia (S3UR) valve over 10 years.
Transcatheter aortic valve replacement (TAVI) has become the gold standard treatment for moderate-to-high risk elderly patients with severe symptomatic aortic stenosis. Based on the results of randomized trials including low risk patients, this treatment has been progressively applied to younger (in the sixties and seventies) patients with a low co-morbidity burden. Life expectancy in this group is expected to extend beyond 5 years from intervention in the vast majority of patients, and beyond 10 years in a high proportion. Thus, the issue of valve durability has become one of the most important aspects in the TAVI field in recent years. To date, the rates of bioprosthetic valve failure at 8-10 years after TAVI have been consistently \<10%, but some studies have shown some degree of valve structural degeneration in close to one third of the patients at 8-year follow-up. This subclinical valve degeneration before the 10-year follow-up landmark would represent the initial step in the process of bioprosthetic valve failure, and further valve degeneration leading to clinical symptoms is likely to occur in a significant proportion of these cases. This prospective registry will evaluate the clinical outcomes and the valve performance of the SAPIEN 3 Ultra RESILIA valve over 10 years.
Study Type
OBSERVATIONAL
Enrollment
500
Elective transfemoral TAVi procedure with S3UR valve.
Heart and Diabetes Center North Rhine-Westphalia
Bad Oeynhausen, North Rhine-Westphalia, Germany
Early Safety
Early safety acc. to VARC-3
Time frame: 1-3 months
Device Success
Device Success acc. to VARC-3
Time frame: 1-3 months
Bioprosthetic Valve Failure
Bioprosthetic valve failure (defined as valve-related mortality OR aortic valve re-operations/re-intervention OR stage 3 hemodynamic valve deterioration (VARC-3))
Time frame: 3-5 years
Bioprosthetic Valve Failure
Bioprosthetic valve failure (defined as valve-related mortality OR aortic valve re-operation/re-intervention OR stage 3 hemodynamic valve deterioration (VARC-3))
Time frame: 9-10 years
Structural Valve Deterioration
Structural Valve Deterioration ≥ stage 2 (VARC-3)
Time frame: 9-10 years
Hemodynamic Valve Performance
* Prosthetic valve regurgitation including paravalvular regurgitation * Mean transvalvular gradient * Max transvalvular gradient * Effective orifice area
Time frame: All follow-ups (1-3 month, 1year, 3-5 year, 6-8 year, 9-10 year)
Bioprosthetic Valve Failure
Bioprosthetic Valve Failure acc. to VARC-3
Time frame: All follow-ups (1-3month, 1year, 3-5 year, 6-8year 9-10 year)
Bioprosthetic Valve Dysfunction
BVD acc. to VARC-3
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Time frame: All follow-ups (1-3month, 1year, 3-5 year, 6-8year, 9-10 year)
Patient reported outcomes
Patient reported outcomes using TASQ questionnaire and EQ-5D questionnaire
Time frame: 1-3month, 1+3year Follow Up compared to BL
Cumulated incidence rate BVD or BVF
Cumulated incidence rate (per 100 patient-years) of bioprosthetic valve dysfunction (stage 2 or 3) OR bioprosthetic valve failure up to 10-year follow-up
Time frame: Up to 10 years
Clinical Events
Clinical events (mortality, stroke, bleeding type 2-4, cardiac rehospitalization, heart failure rehospitalization)
Time frame: All follow-ups (1-3month, 1year, 3-5 year, 6-8year, 9-10 year)
Hemodynamic valve deterioration stage 2 and 3 (VARC-3)
HVD stage 2 and 3 according to VARC-3 Criteria (moderate and severe HVD).
Time frame: All follow-ups (1-3 month, 1year, 3-5 year, 6-8 year, 9-10 year)