Aims Stent-frame morphology of the newer-generation, balloon-expandable transcatheter heart valve (THV), the SAPIEN 3 (S3), after transcatheter aortic valve implantation (TAVI) is unknown.We evaluated the THV stent-frame morphology post TAVI of the S3 using multi-slice computed tomography (MSCT) compared with the prior-generation THV, SAPIEN XT (S-XT). Methods and results A total of 94 consecutive participants of RESOLVE registry (NCT02318342) had MSCT after balloon-expandable TAVI (S3 39 and S-XT 55). The morphology of the THV stent-frame was evaluated for expansion area and eccentricity at the THV-inflow, native annulus, mid-THV and THV-outflow levels. Mean %-expansion area for the S3 and the S-XT was 100.9+5.7 and 96.1+5.5%, respectively (P , 0.001). In the S3 group, the THV-inflow level had the largest value of %-expansion area, which decreased from THV-inflow to mid-THV level (105.2+6.4 to 96.5+5.9%, P , 0.001). However, in the S-XT group, %-expansion area increased from THV-inflow level to mid-THV level (93.2+6.2 to 95.1+6.1%, P 0.0058). On nominal delivery balloon volume, the S3 in 88.5% of cases had overexpansion at the THV-inflow level. The observed degree of THV oversizing of the S3 was significantly lower than the S-XT (6.3+8.6 vs. 11.8+8.5%, P 0.0027). Nonetheless, the incidence of post-procedural paravalvular aortic regurgitation (PVR) ? mild following the S3 TAVI was also significantly lower than the S-XT TAVI (17.9 vs. 43.6%, P 0.014). Conclusion The newer-generation, balloon-expandable device, the S3, has a flared inflow morphology, whereas the prior-generation device, the S-XT, has relatively constrained inflow morphology post TAVI. This may contribute to a lesser degree of PVR with the S3.
- SAPIEN 3
- SAPIEN XT
- Transcatheter heart valve expansion