ANALYSIS OF CLINICAL AND ECHOCARDIOGRAPHIC OUTCOMES IN PATIENTS UNDER 70 YEARS OF AGE WHO UNDERWENT BIOLOGICAL AORTIC VALVE REPLACEMENT: INSPIRIS RESILIA VS. PERIMOUNT MAGNA EASE

Background: The INSPIRIS-RESILIA-aortic-prosthesis, made from bovine-pericardial- tissue, features an expandable-stent for easier future TAVI and anti-calcification-properties. Mid-term-outcome reports are still insufficient. This study compares midterm, clinical, and echocardiographic performance between patients implanted with the INSPIRIS-valve and those with the CE-Perimount-MAGNA-EASE-valve. Methods: This study is a retrospective-single-centre study. All patients received biological- prostheses, with or without additional procedures, through full-sternotomy, and follow-up included survival, complications, and hospital stay length. The primary outcome was all-cause- mortality one year post-AVR, with secondary-outcomes including gradients, EF, reintervention rates, and postoperative complications. Data were analyzed using descriptive statistics, and PS- matching was used to adjust for baseline differences. Results: We included 300 patients, who were implanted with INSPIRIS (n=52), or ME (n=248) between January 2018 and May 2023. After matching each group included 52 patients. The INSPIRIS-group consisted of younger patients with fewer comorbidities compared to the ME-group, which had higher rates of PAD, preoperative AF, and PTCA. Postoperative- outcomes showed the ME-group had higher transfusion rates (INSPIRIS: 46,1% vs ME: 69,2%, P = 0.017), longer CPB-times (INSPIRIS 93 ± 22, ME 109,51 ± 35,05 P=0,004), and a higher, but not statistically significant, reoperation-rate. Mid-term-results showed no significant difference in survival, SVD, or transvalvular-mean-gradient at 1 year (INSPIRIS 11,3 ± 3,56, ME 11,2 ± 4,1, P=0,9), and 3 years (INSPIRIS 12,9 ± 3,7, ME 12,9 ± 3,6, P=0,7). Conclusion: Surgical-AVR using the INSPIRIS-valve exhibited comparable safety and satisfactory mid-term-outcomes, with hemodynamic performance similar to the ME-valve. This study demonstrates favorable clinical results and good hemodynamics at 3 years.