title: Comparison of procedural and clinical outcomes with Evolut R versus Medtronic CoreValve: a Swiss TAVI registry analysis.
abstract: OBJECTIVE
  Data on procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI) with the new-generation self-expanding Medtronic Evolut R prosthesis in comparison with its predecessor, the Medtronic CoreValve, are scarce. The aim of this study was to assess the safety and efficacy of the Evolut R device compared with the former-generation CoreValve.
  
  
  RESULTS
  In a nationwide, prospective, multicentre cohort study, outcomes of consecutive transfemoral TAVI patients treated with the new-generation Medtronic Evolut R (September 2014 - February 2016) and the Medtronic CoreValve (February 2011 - February 2016) were investigated. Events were reported according to VARC-2 and adjudicated by a clinical events committee. During the study period, 317 and 678 consecutive patients underwent TAVI with the Evolut R and the CoreValve bioprosthesis, respectively. Baseline clinical characteristics between the groups were comparable, although Evolut R patients were lower risk according to the STS score (4.8±3.4% vs. 6.9±5.0%, p<0.001) and logistic EuroSCORE (17.3±13% vs. 20.1±13%, p=0.009). Implantation of the Evolut R was associated with a lower use of predilatation (48.1% vs. 72.4%, p<0.001), a shorter procedure time (67.9±36 min vs. 76.7±42 min, p=0.002), and less contrast dye use during the procedure (155.2±98 ml vs. 208.0±117 ml, p<0.001). Post-procedural mean gradient was comparable (7.4±4.7 mmHg vs. 7.5±5.0 mmHg), as were the 30-day rates of moderate to severe aortic regurgitation (8.5% vs. 10.5%), major vascular (9.8% vs. 10.3%) and life-threatening bleeding complications (5.4% vs. 5.3%), disabling stroke (1.9% vs. 1.6%), all-cause mortality (3.2% vs. 3.4%) as well as permanent pacemaker implantation (22.1% vs. 23.4%).
  
  
  CONCLUSIONS
  Thirty-day clinical outcomes were favourable and comparable between the Evolut R and the CoreValve bioprosthesis.
authors.affiliation: Cardiology Division, University Hospital, Geneva, Switzerland.
authors.forename: Stephane
authors.initials: S
authors.lastname: Noble
authors.forename: Stefan
authors.initials: S
authors.lastname: Stortecky
authors.forename: Dik
authors.initials: D
authors.lastname: Heg
authors.forename: David
authors.initials: D
authors.lastname: Tueller
authors.forename: Raban
authors.initials: R
authors.lastname: Jeger
authors.forename: Stefan
authors.initials: S
authors.lastname: Toggweiler
authors.forename: Enrico
authors.initials: E
authors.lastname: Ferrari
authors.forename: Fabian
authors.initials: F
authors.lastname: Nietlispach
authors.forename: Maurizio
authors.initials: M
authors.lastname: Taramasso
authors.forename: Francesco
authors.initials: F
authors.lastname: Maisano
authors.forename: Jürg
authors.initials: J
authors.lastname: Grünenfelder
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
authors.forename: Christoph
authors.initials: C
authors.lastname: Huber
authors.forename: Thierry
authors.initials: T
authors.lastname: Carrel
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Peter
authors.initials: P
authors.lastname: Wenaweser
authors.forename: Marco
authors.initials: M
authors.lastname: Roffi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001705:Bioprosthesis; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012042:Registries; D065467:Transcatheter Aortic Valve Replacement / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D016896:Treatment Outcome