EuroPCR 2017: Impressive results for a next generation TAVR / TAVI device

Reported from EuroPCR 2017, Paris

There was excitement in the room when Dr Tchétché presented the 30-day results of the next generation Centera TAVR / TAVI system (Edwards Lifescience) in high surgical risk severe aortic stenosis patients. Although this was a relatively small (n=203), non-randomised study, the early-stage results were impressive. The key headline figures were a 1% rate of death from all cause mortality (interestingly this very low event rate even fooled the investigators, equaling just 0.16 of their predicted mortality), a 2.5% disabling stroke rate and a 4.9% new pacemaker rate with the next generation TAVR system. The low rate of pacemaker insertion was particularly impressive considering the Centera is a self-expanding device that was post dilated in one third of cases.

From a device specifics point of view, simplified preparation of the valve, a 14 F delivery system and a motorised deployment system marked attractive innovations that may streamline TAVR in realworld clinical use.

Although some in the room were already keen to put the S3 workhorse ‘out to pasture’, we must bear in mind the limitations of any non-randomised study design to provide us a truly unbiased opinion. Furthermore, we do not yet have any data on valve durability, although there were no signals for concern. In conclusion, this study marks an important development in the field of TAVR / TAVI and adds to the strong start made by the next generation TAVR / TAVI systems. 

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