CONGRESS ABSTRACT

Background and Aim: Transcatheter aortic valve replacement (TAVR) represents the ideal alternative for aortic valve disease in elderly patients. The Navitor valve, a third generation self- expanding valve system from the Portico series, has been designed to minimize TAVR complications, enhancing procedural success and patient outcomes. This study aimed to evaluate the outcome of patients with at least 12 months follow-up, undergone TAVR using Navitor valve at our center .   Methods: From September 2021 to August 2023, seventeen patients (median age 85,7±3,7 y.o, range 76-90, 17,6% male, median calcium score 1800 [1350-2350]) with severe aortic valve disease underwent transcatheter treatment. A dedicated structural valve team has been established for patient selection, treatment and strict follow-up.  Results: A complete anatomic evaluation was performed in all patients, using CT scan (perimetral annulus 72,8 [68,3-77,8], annulus area 3,6 [3,3-4,1], maximum annulus size 26 [23,5-28], STJ 27 [26-30]). Pre-dilation was performed in 15 patients, using Osypka balloon. Size of implanted valve was generally high (median 27 [25-27]). In-hospital mortality was observed in 1 patient. Other adverse events included: 1 vascular complication (pseudoaneurysm), 2 permanent pacemaker implantations. No clinical significant paravalvular leak (PVL), pericardial effusion or stroke occurred over a median length of stay of 3 days. At 1year, no signs of structural valve degeneration were observed, with a mean gradient of 6,5 (6-9) mmHg, peak gradient of 11 (10-16) mmHg, valve area of 1,7 (1,6-1,9) cmq and no decline in LVEF. A total of 5 mild PVL were observed without clinical implications. No late clinical events occurred. Conclusions: TAVR with Navitor valve provides excellent short term results and good hemodynamic performace over the first year after implant. The acceptable rate of PVL and PMK implantation even in patients with larger aortic annulus size might represent an interesting finding to be investigated in larger studies.