From the Evolut Pro to the Evolut FX self-expanding transcatheter aortic valve replacement systems: current status and future perspectives

ABSTRACT

Introduction

Since the initial experience with the CoreValve (Medtronic, Minneapolis, Minnesota), there have been continuous iterations of this valve system in order to improve procedural success and reduce periprocedural complications. The Evolut Pro, Pro+, and FX are the latest generations of this transcatheter heart valve (THV).

Areas covered

This review paper aims to analyze the main characteristics and clinical evidence about the Evolut Pro THV and summarize the main iterations of the newer generation Evolut FX valve system.

Expert opinion

The Evolut Pro system has been associated with good clinical outcomes and excellent valve hemodynamic performance including reduced rates of paravalvular leaks. Technical enhancements to improve valve positioning, orientation, and vascular access have been implemented in the newer generation Evolut FX system.

KEYWORDS:

• TAVR
• Corevalve
• Evolut R
• Evolut Pro
• Evolut FX

Article highlights

• Evolut Pro/Pro+ devices are associated with fewer significant paravalvular leaks and bleedings compared to the former Evolut R transcatheter heart valve.

• Current evidence indicates good procedural and short-term results of the Evolut Pro device, but further studies are needed to better assess mid and long-term outcomes.

• The recently approved Evolut Fx delivery catheter will display three main refinements: a redesigned tip to improve vascular access, gold markers to enhance positioning and commissural alignment, and increased stability to improve valve deployment.

Acknowledgments

Dr. Rodés-Cabau holds the Research Chair “Fondation Famille Jacques Larivière” for the Development of Structural Heart Disease Interventions

Dr. Panagides has received a research grant from the “Mediterranean Academic Research and Studies in Cardiology” association (MARS Cardio).

Dr. Mesnier has received a research grant from the “Fédération Française de Cardiologie.”

We would like to thank their contribution.

Dr. Nuche has received a research grant from the “Fundación Alfonso Martin Escudero” (Madrid Spain)

Declaration of interest

Dr. Rodes-Cabau has received institutional research grants from and is a consultant for Edwards Lifesciences, Medtronic, and Boston Scientific. Dr. Panagides has received institutional research grants from Medtronic, Boston Scientific and Microport. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewers disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.