Durability of bioprosthetic aortic valve replacement in patients under the age of 60 years - 1-year follow-up from the prospective INDURE registry.

Meuris, Bart; Roussel, Jean-Christian; Borger, Michael A; Siepe, Matthias; Stefano, Pierluigi; Laufer, Günther; Langanay, Thierry; Theron, Alexis; Grabenwöger, Martin; Binder, Konrad; Demers, Philippe; Pessotto, Renzo; van Leeuwen, Wouter; Bourguignon, Thierry; Canovas, Sergio; Mariscalco, Giovanni; Coscioni, Enrico; Dagenais, Francois; Wendler, Olaf; Polvani, Gianluca; ... (2023). Durability of bioprosthetic aortic valve replacement in patients under the age of 60 years - 1-year follow-up from the prospective INDURE registry. Interdisciplinary cardiovascular and thoracic surgery, 37(4) Oxford University Press 10.1093/icvts/ivad115

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OBJECTIVES

We report 1-year safety and clinical outcomes in patients <60 years undergoing bioprosthetic surgical aortic valve intervention.

METHODS

The INSPIRIS RESILIA Durability Registry (INDURE) is a prospective, multicentre registry to assess clinical outcomes of patients <60 years. Patients with planned SAVR with or without concomitant replacement of the ascending aorta and/or coronary bypass surgery were included. Time-related valve safety, haemodynamic performance, and quality of life (QoL) at 1 year were assessed.

RESULTS

421 patients were documented with a mean age of 53.5 years, 76.5% being male, and 27.2% in NYHA class III/IV. Outcomes within 30 days included cardiovascular-related mortality (0.7%), time-related valve safety (VARC-2; 5.8%), thromboembolic events (1.7%), valve-related life-threatening bleeding (VARC-2; 4.3%), and permanent pacemaker implantation (3.8%). QoL was significantly increased at 6 months and sustained at 1 year. Freedom from all-cause mortality at 1 year was 98.3% (95%CI 97.1;99.6) and 81.8% were NYHA I vs. 21.9% at baseline. No patient developed structural valve deterioration Stage 3 (VARC-3). Mean aortic pressure gradient was 12.6 mmHg at 1 year and effective orifice area was 1.9 cm2.

CONCLUSIONS

The 1-year data from the INSPIRIS RESILIA valve demonstrate good safety and excellent haemodynamic performance as well as an early QoL improvement.

CLINICALTRIALS NUMBER

NCT03666741.

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