Comparative 30-day echocardiographic outcomes of Myval vs. Sapien and Evolut THVs: insights from LANDMARK trial

作者：Osama Soliman, Elfatih A. Hasabo, Niels van Royen, Ignacio J. Amat‐Santos, Martin Hudec, Matjaž Bunc, Alexander Ijsselmuiden, Peep Laanmets, Daniel Unić, Béla Merkely, Renicus S. Hermanides, Mohamed Mouden, Vlasis Ninios, Marcin Protasiewicz, Benno J. Rensing, Pedro Martín, Fausto Feres, Manuel Almeida, Éric Van Belle, Axel Linke, Alfonso Ielasi, Matteo Montorfano, Mark Webster, Konstantinos Toutouzas, Emmanuel Teíger, Francesco Bedogni, Michiel Voskuil, Dolores Mesa, Oskar Angerås, Won‐Keun Kim, Jürgen Rothe, Ivica Kristić, Vicente Peral Disdier, Ben J L Van den Branden, Ashok Thakkar, Udita Chandra, Dina Neiroukh, Cagri Ayhan, Mahmoud Y Nosir, Magdi Yacoub, Sanaa A. Ali, Mohammad Al‐Tamimi, Hesham Elzomor, Patrick W. Serruys, Andreas Baumbach · 发表于：European Heart Journal - Cardiovascular Imaging · 年份：2025 · DOI：10.1093/ehjci/jeaf245 · 被引用次数：2 · 研究领域：Cardiac Valve Diseases and Treatments、Cardiovascular Function and Risk Factors、Congenital Heart Disease Studies

AIMS: Several factors, including device design, annulus size, and sizing strategies, influence transcatheter heart valve (THV) haemodynamic outcomes in patients with aortic stenosis (AS). This sub-study evaluates early (30-day) echocardiographic outcomes of the Myval, Sapien, and Evolut THV series, focusing on haemodynamic performance and valve durability. METHODS AND RESULTS: The LANDMARK trial is a prospective, randomised, multicentre, open-label, non-inferiority trial comparing 384 patients implanted with Myval THV series to 384 receiving Sapien and Evolut THV series. Haemodynamic assessments followed Valve Academic Research Consortium-3 recommendations. At 30-day, haemodynamic device success rates were 85.9%, 77.8, and 85.4% for Myval, Sapien, and Evolut THV series, respectively (PMyval-Sapien = 0.03 and PMyval-Evolut = 0.98). Significant improvements in peak aortic flow velocity, pressure gradients, effective orifice area (EOA), Doppler velocity index (DVI), and cardiac indices were observed across all groups, except for unchanged left ventricular ejection fraction. Moderate prosthesis-patient mismatch (PPM) was less frequent with Myval THV series(11.3%) vs. Sapien THV series(21.8%), but higher than Evolut THV series (5.3%) (PMyval-Sapien = 0.0024, PMyval-Evolut = 0.0396), while severe PPM showed no significant differences (4.2% vs. 6.3% vs. 1.8%; PMyval-Sapien = 0.394, PMyval-Evolut = 0.2438). Rates of ≥ moderate paravalvular leak (PVL) were lower in Myval (3.5%), and S...