| Title: |
Long-Term Follow-Up After Direct-Flow Transcatheter Aortic Valve Implantation: A Single Center Experience |
| Authors: |
Prunea, D. M.; Geissler, R.; Achim, A.; Stark, C.; Kanoun Schnur, S. S.; Strobl, B.; Bugger, H.; Luha, O.; Zirngast, B.; Schmidt, A.; Zirlik, A.; Toth, G. G. |
| Contributors: |
Cardiology; Kanoun-Schnur, Sadeek |
| Publisher Information: |
Wiley |
| Publication Year: |
2026 |
| Collection: |
RD&E Research Repository (Royal Devon and Exeter NHS Foundation Trust) |
| Subject Terms: |
Humans; Male; Female; Heart Valve Prosthesis; Time Factors; Aged; 80 and over; Transcatheter Aortic Valve Replacement/adverse effects/instrumentation/mortality; Aortic Valve Stenosis/physiopathology/diagnostic imaging/surgery/mortality; Treatment Outcome; Prosthesis Design; Registries; Aortic Valve/physiopathology/diagnostic imaging/surgery; Risk Factors; Retrospective Studies; Prosthesis Failure; Hemodynamics; Recovery of Function; Risk Assessment; Direct Flow; aortic stenosis; transcatheter aortic valve implantation; valve degeneration; valve‐in‐valve |
| Description: |
AIMS: Valve degeneration after DirectFlow implantation poses a challenge for valve-in-valve procedures due to its fragile polymeric structure and embolization risk. This study analyzes long-term follow-up of patients who underwent TAVI with DF to understand valve degeneration tendencies. METHODS: In this single-center registry, we included all patients who underwent DF implantation in our center. Clinical characteristics and echocardiographic parameters were assessed at baseline and during the latest follow-up. Long-term overall survival was analyzed. Outcome data was compared with a matched cohort of patients who underwent TAVI with other commercial devices during the same period. RESULTS: From 2014 to 2017, 67 patients with significant aortic stenosis were treated with DF; 36 (54%) were male, mean age 83 ± 7 years. Left ventricular ejection fraction was 50 ± 13% with a mean gradient of 46 ± 15 mmHg. Post-procedural echocardiography showed a mean gradient of 16 ± 8 mmHg, markedly higher than the reference group (8 ± 3 mmHg; p < 0.01). This residual gradient showed no progression during follow-up at 20 [9; 39] months (16 ± 9 mmHg; p = 0.52). Overall survival was comparable between DF and the reference group at 12 months (6% vs. 4%, HR 1.37, 95% CI 0.31-6.02) and maximal follow-up of 39 ± 25 months (31% vs. 25%, HR 1.44, 95% CI 0.76-2.73). CONCLUSIONS: According to this single center experience, DF devices resulted in higher residual gradients; however, no signs of faster degeneration or worse long-term outcomes were observed compared to other devices. ; Creative Commons Attribution License CC-BY 4.0. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://pmc.ncbi.nlm.nih.gov/articles/pmid/40454775/; Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions; PMC12336784; https://hdl.handle.net/11287/623657 |
| DOI: |
10.1002/ccd.31647 |
| Availability: |
https://hdl.handle.net/11287/623657; https://doi.org/10.1002/ccd.31647 |
| Rights: |
© 2025 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. |
| Accession Number: |
edsbas.247A5F58 |
| Database: |
BASE |