Quantitative angiographic assessment of aortic regurgitation post 11 different types of TAVI devices a multicentre pooled analysis of 2665 valves

Abstract Background Regurgitation following TAVR impacts all-cause mortality. So far, no quantitative comparison of regurgitation by the same core lab has been performed among various commercially available transcatheter heart valves (THV) We aimed to compare angiographic aortic (AR) 11 different types THVs. Method This is a multicentre retrospective corelab pooled analysis aortograms from 2704 consecutive patients treated with THV devices. Analysis was done videodensitometric aortography (LVOT-AR), which an objective, accurate, and reproducible tool for assessment AR TAVR. method relies on time density changes in contrast medium after injection ascending aorta its (and subsequent increase) LVOT. The ratio between areas under two-time curves these regions quantifies absolute percentage. evaluated include ACURATE neo2 (n=120), Lotus (n=546), Myval (n=108), VitaFlow (n=105), Evolut PRO (n=95), SAPIEN 3 (n=397), R (n=295), XT (n=239), neo Venus-A (n=113) CoreValve (n=532). Stratification continuous variable into categorical variables according pre-determined threshold criteria: 1) none/trace (LVOT-AR<6%); 2) mild (6%≤ LVOT-AR ≤17%); 3) moderate or severe (LVOT-AR >17%). Results addition anti PVR sealing features new generations proved be effective reduction incidence significant In first generation neo. Myval, THVs are showing promising results. Although moderate/severe regressed over THVs, still prominent all exhibiting ranging 30% 50% exception valve that had 19% Conclusion lowest severe/moderate percentage improvements options armamentarium. These results should confirmed prospective randomized, head-to-head comparisons Funding Acknowledgement Type funding sources: None.