Transcatheter polytetrafluoroethylene leaflet valve prosthesis for structural heart desease treatment

Aim: to evaluate immediate and long-term outcomes of transcatheter heart valve replacement using a polytetrafluoroethylene leaflets prosthesis.

Materials and methods: this single-center retrospective study included 521 patients following implantation of the MedLAB-CT prosthesis: 503 with aortic valve (AVR) replacement, 8 in pulmonary artery (PA) position, and single cases of mitral (MV) and tricuspid (TV) valve replacements. The maximum clinical follow-up extended to 9 years. The cohort predominantly comprised high surgical risk patients (mean EuroSCORE II: 8.7%) of advanced age, with TAVI recipients having a mean age of 74.8 years."8.7%) and elderly, the average age in the TAVI group was 74.8 years.

Results: for transcatheter aortic valve implantation (TAVI), the mean gradient was 6.7±2.1 mm Hg with a peak gradient of 11.2±5.1 mmHg. Freedom from reintervention and cumulative survival rates at 9 years were calculated using the Kaplan-Meier method, with the following results: freedom from reoperation 99% and survival rate 68%. In cases of transcatheter pulmonary, tricuspid, and mitral valve replacements, all patients showed clinical improvement with reduction of heart failure symptoms to NYHA functional class I-II.

Conclusion: the immediate and mid-term outcomes of MedLab-CT valve implantation in the aortic position were comparable to those of established international transcatheter systems, both in clinical outcomes and in hemodynamic parameters. All MedLab-CT implantations in PA position included in this study resulted in good immediate clinical and hemodynamic results, that were comparable to similar interventions using other systems. MedLab-CT implantation in the mitral valve position using the «valve-in-ring» technique and in the tricuspid position using the «valve-in-valve» technique showed good immediate results, consistent with global data. However, as is the case worldwide, the problem of transcatheter replacement of native atrioventricular valves remains unresolved.

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