SIX-YEAR RESULTS OF THE NEWEST GENERATION PERICARDIAL VALVES IN PATIENTS YOUNGER THAN 65 YEARS OLD: REAL-WORLD DATA FROM A MULTICENTER REGISTRY

Background and Aim: Structural valve degeneration (SVD) remains the «Achille heel» of biological prostheses and younger age at implantation has been shown to accelerate this process. Current ESC/EACTS guidelines recommend biological prostheses in patients over 65 for aortic valve replacement. This study analyse the six-year results in ≤65 years old patients receiving new generation of bovine pericardial valve Inspiris Resilia prosthesis in the aortic position. Methods: From 2017 to 2023, clinical and echocardiographic data of patients receving IR prosthesis for isolated or combined AVR were prospectively collected at 7 European Cardiac Surgery Centers. 1871 patients were included: 1257 (67.2%) aged ≤65 years, 614 (32.8%) aged >65 years. Primary endopint was six- year freedom from structural valve deterioration «SVD» (staged according to VARC-3 criteria). Secondary endpoints were prosthetic haemodynamics at various time point, freedom from prosthesis explant for SVD, non-SVD issues, infective endocarditis and cardiovascular mortality. Results: Patients ≤65 years receiving INSPIRIS RESILIA valve in aortic position had higher six-year freedom from any stage of structural valve deterioration, comparable to those of > 65 year old patients. Stable prosthetic haemodynamic values were reported over time in both populations. Only 1.5% of valve were explanted, with endocarditis being the primary cause. Only 4 cases underwent reintervention due to severe SVD, and no difference in six-year freedom from explant for SVD was reported between ≤65 and >65 years old patients. Conclusions: This large multicenter registry showed that the INSPIRIS RESILIA valve has good durability in ≤65 years old patients over a six-year follow-up period.