How will the SMART trial results impact our practice and decision making in TAVI?

Sabine Bleiziffer and Didier Tchétché discuss the SMART trial with Flavio Ribichini in this #europcr 2024 roundtable. The trial compares the self-expandable supra-annular EVOLUT platform and the balloon-expandable intra-annular SAPIEN platform in patients with small aortic annulus, prevalent in up to 40% of Europeans, mainly women. At one year, clinical outcomes were identical, but valve haemodynamics differed. They explain the methodology, the choice of BARC 2 over BARC 3, and the implications for clinical practice and transcatheter valve replacement decision-making. They also address the higher incidence of paravalvular leak in the balloon-expandable valve and conclude by discussing annular rupture.

This interview was filmed at EuroPCR 2024: see more videos here.