Outcomes of transcatheter aortic valve implantation using evolut self-expanding valves at Cardiovascular Center – E Hospital

Abstract

Objectives: To evaluate the procedural outcomes, safety, and clinical efficacy of Transcatheter Aortic Valve Implantation (TAVI) using the Evolut self-expanding valve system in patients with severe aortic stenosis at E Hospital.

Methods: A descriptive, longitudinal study was conducted on 21 patients undergoing TAVI from December 2019 to December 2025.

Results: The mean age was 72.2 ± 8.3 years; males accounted for 52.4%. Complex characteristics included bicuspid aortic valves (33.3%), degenerated bioprosthetic valves (Valve-in-Valve) (19.0%), and concomitant coronary artery disease requiring Chimney stenting (23.8%). The mean EuroSCORE II was 5.2 ± 1.8%, and the STS Score was 4.1 ± 1.5%. Regarding hemodynamics, the effective orifice area (EOA) increased from 0.65 ± 0.15 cm² to 1.85 ± 0.45 cm²; the mean pressure gradient decreased from 55 ± 12 mmHg to 8.5 ± 3.2 mmHg. The procedural volume increased over time, peaking with 9 cases in 2025. In-hospital mortality was 9.5% (2 cases); both occurred in the early phase (2020 and 2023) associated with highly complex anatomy. Moderate paravalvular leak was observed in 1 case (4.8%), and there were no cases of conduction disorders requiring a permanent pacemaker (0%). No major complications were recorded in the 2024–2025 period. At the 6-month follow-up, left ventricular ejection fraction (EF) improved from 57.38 ± 12.1% to 60.15 ± 9.8%.

Conclusion: TAVI using Evolut self-expanding valves is a feasible and effective procedure at E Hospital. Despite initial challenges related to the learning curve, the current protocol has been standardized with high safety outcomes. The role of the Heart Team in patient selection and thorough anatomical assessment is the key factor in improving treatment outcomes.