Transcatheter Aortic Valve Implantation with the Portico Valve: 2-Year Outcomes of a Multicenter, Real-World Registry

Matthaios Didagelos; Vlasis Ninios; Charalampos Kakderis; Lampros Lakkas; Antonios Kouparanis; Dimitrios Nikas; Katerina K Naka; Aidonis Rammos; Thomas Zegkos; Vasileios Kamperidis; Ilias Ninios; Sotirios Evangelou; Dimitrios G Tsalikakis; Lampros Michalis; Antonios Ziakas

doi:10.3390/life13081785

Transcatheter Aortic Valve Implantation with the Portico Valve: 2-Year Outcomes of a Multicenter, Real-World Registry

Life (Basel). 2023 Aug 21;13(8):1785. doi: 10.3390/life13081785.

Authors

Affiliations

¹ 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece.
² 2nd Cardiology Department, Interbalkan Medical Center, 55535 Thessaloniki, Greece.
³ 2nd Cardiology Department, University Hospital of Ioannina, 45500 Ioannina, Greece.
⁴ Department of Informatics and Telecommunications Engineering, University of Western Macedonia, 50100 Kozani, Greece.

Abstract

Introduction: The self-expanding, resheathable, repositionable transcatheter aortic heart valve Portico is being used successfully for transcatheter aortic valve implantation procedures (TAVI) in patients with severe aortic stenosis. The aim of this study was to evaluate outcomes at 2 years after TAVI with the Portico valve.

Methods: Multicenter registry of clinical, echocardiographic and survival data from consecutive patients treated with the Portico TAVI system (Abbott, Chicago, IL, USA) in three cath labs in Northern Greece and Epirus during 2017-2020. The primary end point was all-cause mortality at 24 months. Secondary end points included procedural outcomes (efficacy and safety) and echocardiographic measurements.

Results: A total of 90 patients (81 ± 6 years, 50% females, mean age 81 ± 6 years) were included in the registry. The indication for implantation was severe, symptomatic aortic stenosis (NYHA III, IV) in eighty-two (91.1%) and degeneration of a prosthetic aortic valve in eight (8.9%) patients. All patients were categorized as high surgical risk (mean Logistic Euroscore 25.9 ± 10, Euroscore II 7.7 ± 4.4 and STS score 10.8 ± 8.9). The procedure was performed transfemorally in all patients, under general anesthesia in 95.6%, under TOE guidance in 21.1%, with native valve predilatation in 46.7%, and the "resheath" option was used in 31.1% of the cases. The implantation was successful in 97.8% and there was a need for a second valve in 2.2% of the cases. Complications included permanent pacemaker implantation (16.7%), access cite complications (15.6%), arrythmias (23.3%), paravalvular leak (moderate 7.8%, severe 1.1%), acute kidney injury (7.8%), no strokes and one death during the procedure. Aortic valve peak velocity, peak and mean pressure gradients, were significantly reduced after the procedure. All-cause mortality at 1, 12 and 24 months was 4.4%, 6.7% and 7.8%, respectively.

Conclusions: TAVI with the Portico system comprises an effective and safe solution for the management of severe, symptomatic aortic stenosis in high-risk surgical patients.

Keywords: Portico; TAVI; aortic stenosis; valvular disease.

Grants and funding

This research received no external funding.