# Mid-Term Outcomes After Aortic Valve Replacement in Patients Under 70: A Comparative Study of INSPIRIS RESILIA Versus PERIMOUNT MAGNA EASE Bioprostheses

## TL;DR

This study compares the mid-term outcomes of two aortic valve prostheses in patients under 70 and finds similar safety and performance.

## Contribution

The study provides a direct comparison of mid-term clinical outcomes between two bioprosthetic aortic valves in younger patients.

## Key findings

- All-cause mortality at 3 years was 0% for INSPIRIS and 1.9% for PERIMOUNT.
- Mean transvalvular gradients were similar for both valves at 1 and 3 years.
- INSPIRIS had lower transfusion rates and no structural valve degeneration requiring surgery.

## Abstract

INSPIRIS RESILIA, launched in 2017, is a bioprosthetic aortic valve developed to improve durability and facilitate future valve-in-valve procedures. Despite its advanced design, many surgeons continue to use the PERIMOUNT MAGNA EASE valve, which has long-standing clinical validation. This study aimed to compare mid-term clinical and echocardiographic outcomes in patients under 70 undergoing aortic valve replacement with either prosthesis.

We conducted a retrospective study of patients who underwent surgical aortic valve replacement between January 2018 and May 2023 at the University Hospital of Reims. The primary outcome was all-cause mortality at 1 year following surgical aortic valve replacement. Secondary outcomes included haemodynamic parameters, left ventricular ejection fraction, and major postoperative complications such as reintervention, stroke, pacemaker implantation, mediastinitis, transfusion, and new-onset atrial fibrillation.

A total of 300 patients were included: 52 received the INSPIRIS RESILIA valve and 248 received the PERIMOUNT MAGNA EASE valve. After matching, 52 patients from each group were compared. All-cause mortality at 3 years was 0% in the INSPIRIS group and 1.9% in the PERIMOUNT group. Mean transvalvular gradients were similar at 1 year (11.3 vs 11.2 mmHg) and 3 years (12.9 mmHg for both). Two cases of endocarditis-related reoperation occurred in the INSPIRIS group. No structural valve degeneration requiring surgery was observed. Postoperative aortic regurgitation was trivial or absent. Transfusion rates were lower in the INSPIRIS group (46.1% vs 69.2%, P = .017).

INSPIRIS RESILIA and MAGNA EASE valves offer similar mid-term safety and performance in patients under 70 years of age.

The selection of a bioprosthetic valve for surgical aortic valve replacement (AVR) is increasingly favoured, particularly in younger patients, due to the elimination of long-term anticoagulation and the possibility of future valve-in-valve (ViV) procedures.