Objectives

The aim of this study was to compare two self-expanding transcatheter heart valves (THV), the ACURATE neo and the PORTICO, with regard to in-hospital and 30-days outcome, as well as early device failure.

Background

During the last years, several THV became commercially available. These prostheses differ regarding several technical and functional aspects and little comparative data on the different THV is available. 

Methods
In two centers, 1610 patients with severe native aortic valve stenosis treated either with PORTICO or Acurate neo were included in this analysis. To reduce selection bias, 1-to-1 propensity matching was performed to identify one patient treated with PORTICO (n = 360) for each patient treated with ACURATE neo (n = 360).

Results
In-hospital complications were comparable between both THV (PORTICO vs. ACURATE), including stroke (4.2 % vs. 2.5%; p = 0.29), major vascular complications (5.1% vs. 7.7 %; p = 0.36), or life-threatening bleeding (0.9% vs. 2.3%; p = 0.45). Rates of VARC-2 defined device failure were comparable (7.2% vs. 6.9%; p = 1.0) including elevated gradients (1.1% vs. 2.3 %; p = 0.38) and more-than-mild paravalvular leakage (3.4% vs. 4.0%; p = 0.82). Only the rate of permanent pacemaker implantation (PPI) was significantly higher with PORTICO (18.4% vs. 9.3%; p=0.001). 

Conclusion
In this two-center propensity-matched comparison, short-term clinical and hemodynamic outcomes were comparable between PORTICO and ACURATE neo prostheses. However, the use of PORTICO was associated with a significantly higher rate of PPI.