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Transcatheter Aortic Valve IMPLANTATION (TAVI)

Designed to be durable

The Medtronic Evolut™ platform is designed for valve durability, because the best reintervention is the one that never needs to happen.

Elderly African American man and woman wearing blue shirts and backpacks while hiking

Durability starts with design

With its supra-annular, self-expanding valve frame, Evolut™ TAVI is built on the original CoreValve™ platform which, has consistently shown strong EOAs and low gradients over time.

How did we design for durability?

Medtronic Evolut Pro transcatheter aortic valve in the native anatomy

More height.

By decoupling the native annular plane where the sealing occurs, from the working portion of the prosthetic leaflets, you can facilitate circularity and maximize leaflet coaptation.

More surface.

Taller leaflet mounting allows for a greater distance between the commissure and the edge of the leaflet, distributing stress over a greater distance.

More room.

The tall valve keeps the working portion above and unconstrained by the native annulus (supra-annular), allowing for a large effective orifice area (EOA).

Supra-annular design benefits

Large EOAs mean less restriction of blood through the valve.

Less restriction leads to low gradients (mean systolic gradient).

Large EOAs have been correlated to less patient-prosthesis mismatch (PPM).

Less PPM and low gradients after aortic valve implantation have been linked to:

  • Better survival1,2
  • Less heart failure rehospitalization2,3
  • Better valve durability4,5
Top-down view of a Medtronic transcatheter aortic valve in the with a large blue effective orifice area (EOA)

The data make the case

CoreValve™ and Evolut™ TAVI systems are the only platform to demonstrate a durability benefit over SAVR at five years.*6

Structural valve deterioration out to 5 years

Chart showing structural valve deterioration at five years between surgery and CoreValve Evolut TAVR/TAVI

* In pooled analysis of intermediate and high-risk patients. Devices used: CoreValve 88.5%/Evolut R 11.5%.
† Structural valve deterioration (SVD) was defined as an increase in mean gradient ≥ 10 mm Hg over five years with a mean gradient ≥ 20 mm Hg at last echo OR new onset/increase of central AR of ≥ moderate in severity.

TAVI risks may include, but are not limited to, death, stroke, damage to the arteries, bleeding, and need for permanent pacemaker.

Related pages

Explore our other procedural guidance and outcomes you can expect from the Evolut platform.
Evolut transcatheter aortic valve with catheter accessing the coronary

Post-TAVI coronary access

Review the guidance
Evolut transcatheter aortic valve being deployed using the cusp overlap technique shown within a circular outline

Cusp overlap technique

Explore the technique
Top-down view of the Evolut transcatheter aortic valve within a circular outline

Comprehensive clinical evidence

Explore the data

References

1

Playford D, Stewart S, Celermajer D, et al. Poor Survival with Impaired Valvular Hemodynamics After Aortic Valve Replacement: The National Echo Database Australia Study. J Am Soc Echocardiogr. 2020;33(9):1077–1086.e1.

2

Herrmann HC, Daneshvar SA, Fonarow GC, et al. Prosthesis-Patient Mismatch in Patients Undergoing Transcatheter Aortic Valve Replacement: From the STS/ACC TVT Registry. J Am Coll Cardiol. 2018;72(22):2701–2711.

3

Anand V, Ali MA, Naser J, et al. Incidence, Mechanisms, and Predictors of Mean Systolic Gradients ≥20 mm Hg after Transcatheter Aortic Valve Implantation. Am J Cardiol. 2020;125(6):941–947.

4

O’Hair D. Presented at American College of Cardiology 70th Annual Scientific Session & Expo. May 2021.

5

Søndergaard L, Ihlemann N, Capodanno D, et al. Durability of Transcatheter and Surgical Bioprosthetic Aortic Valves in Patients at Lower Surgical Risk. J Am Coll Cardiol. 2019;73(5):546–553.

6

Reardon M. 5-Year Incidence, Timing and Predictors of Structural Valve Deterioration of Transcatheter and Surgical Aortic Bioprostheses: Insights from the CoreValve US Pivotal and SURTAVI Trials. Presented at ACC 2022. Updated data on file.