Transcatheter Aortic Valve Implantation: Abbott Portico
The Portico (St. Jude Medical) valve (Fig. 24.1a) is a self-expanding transcatheter aortic prosthesis that was clinically evaluated in the Portico CE trial. In this prospective, multicenter study, safety, and performance of the Portico system (23 and 25 mm valves delivered through 18 Fr transfemoral resheathable delivery system) were tested on 100 patients with severe symptomatic aortic stenosis, 50 for each valve size. The results through 12 months showed that the Portico system produces clinically significant and sustained improvements in patient outcomes. Additionally, this study establishes an excellent safety profile at 30 days with the Portico system in terms of mortality, permanent pacemaker rate, moderate/severe paravalvular leak (PVL), major stroke rate, and major vascular complications. The good hemodynamic results were sustained up to 12 months, with the mean aortic gradient constantly stable at about 9.9 mmHg and valve area at 1.6 cm2. The functional NYHA class remained improved and remained stable at follow-up .
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