Final 3‐year clinical outcomes following transcatheter aortic valve implantation with a supra‐annular self‐expanding repositionable valve in a real‐world setting: Results from the multicenter FORWARD study

• Published in: Catheterization and cardiovascular interventions 2022-01, Vol.99 (1), p.171-178
• Main Authors: Van Mieghem, Nicolas M., Windecker, Stephan, Manoharan, Ganesh, Bosmans, Johan, Bleiziffer, Sabine, Modine, Thomas, Linke, Axel, Scholtz, Werner, Tchétché, Didier, Finkelstein, Ariel, Ito, Saki, Eisenberg, Ruth, Grube, Eberhard
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Aortic stenosis; Aortic valve; Aortic Valve - diagnostic imaging; Aortic Valve - surgery; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - surgery; Clinical medicine; Endocarditis; Female; Heart Valve Prosthesis; Humans; Mortality; Pacemakers; Patients; Prospective Studies; Prosthesis Design; Regurgitation; Risk Factors; safety outcomes; self‐expanding; supra‐annular; Thrombosis; Time Factors; transcatheter aortic valve implantation; transcatheter aortic valve replacement; Transcatheter Aortic Valve Replacement - adverse effects; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.29889

Objectives The Evolut R FORWARD study confirmed safety and effectivenesss of the Evolut R THV in routine clinical practice out to 1 year. Herein, we report the final 3‐year clinical follow up of the FORWARD study. Background Transcatheter aortic valve replacement (TAVR) is a proven alternative to surgery in elderly patients with symptomatic severe aortic stenosis. Long‐term clinical outcome data with the Evolut R platform are scarce. Methods FORWARD is a prospective multicenter observational study that evaluated the Evolut R system in routine clinical practice at 53 centres. Eligible patients had symptomatic native aortic valve stenosis or failed surgical aortic bioprosthesis and elevated operative risk per Heart‐Team assessment. TAVR was attempted in 1039 patients. Results Mean age was 81.8 ± 6.2 years, 64.9% were women, STS score was 5.5 ± 4.5% and 34.2% were frail. Rates of all‐cause mortality and disabling stroke were 24.8% and 4.8% at 3 years. Early need for a new pacemaker implantation after TAVR (all‐cause mortality: with new PPI; 21.0% vs. without; 22.8%, p = 0.55) and the presence of > trace paravalvular regurgitation (all‐cause mortality: no or trace; 22.0% vs. ≥ mild; 25.5%, p = 0.29) did not affect survival. Between 1 and 3 years incidence rates of valve related intervention, endocarditis and clinically relevant valve thrombosis were low. Conclusions The Evolut R valve maintained a favorable safety profile through 3 years in routine clinical practice. Rates of transcatheter heart valve‐related adverse events were low.