Background
Transcatheter aortic valve implantation (TAVI) is an established therapy for the treatment
of aortic valve disease in appropriately selected patients. Previous studies using
the self-expanding Portico transcatheter heart valve (THV), (Abbott Structural Heart,
St Paul, MN, USA) have demonstrated the technical feasibility of this system albeit
in the hands of relatively inexperienced Portico users. The objective of this study
was to assess the real-world safety and efficacy of the Portico THV (with and without
the FlexNav delivery system, Abbott Structural Heart) at the 30-day timepoint in an
Australian cohort.
Methods and Results
This study was a retrospective real-world cohort analysis of 269 consecutive patients
with severe aortic valve disease who underwent TAVI at multiple centres within Australia
between February 2015 and April 2021. Of the 269 patients, 51.7% were female, mean
Society of Thoracic Surgeons (STS) score was 5.2 (±6.8) and 98.5% had successful implantations.
Thirty (30)-day post-implantation all-cause mortality was observed in one (0.4%) patient,
major vascular complications in two (0.7%) patients, more-than-mild paravalvular leak
in six (2.2%) patients and requirement for new permanent pacemaker implantation in
27 (10.2%) patients. Haemodynamic parameters at 30 days included mean effective orifice
area (EOA) of 2.3 (±0.9) cm2 and mean aortic valve gradient (AVG) of 9.6 (±6.2) mmHg.
Conclusion
This analysis of the Portico THV in a real-world setting suggested that the system
is associated with satisfactory safety and efficacy parameters. Previously published
datasets may not have found similar findings owing to lower operator experience with
the Portico THV system.
Keywords
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Article info
Publication history
Published online: November 04, 2022
Accepted:
September 20,
2022
Received in revised form:
July 10,
2022
Received:
March 23,
2022
Identification
Copyright
© 2022 Published by Elsevier B.V. on behalf of Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
