Comparative study of post-procedural Doppler velocity index (DVI) and long-term prognosis in self-expandable and balloon-expandable transcatheter aortic valve replacement

Abstract Background Little is known about the relationship between post-procedural Doppler velocity index (DVI) and long-term clinical outcomes following transcatheter aortic valve replacement (TAVR). This study aimed to evaluate the association between post-procedural DVI and five-year outcomes for both self-expandable and balloon-expandable transcatheter aortic valves. Methods In this study, we compared outcomes based on post-procedural Doppler velocity index (DVI) in patients who underwent either self-expandable (n=457) or balloon-expandable (n=455) TAVR between June 2015 and September 2023. Patients were divided into two discharge DVI groups (≤0.5 vs. >0.5). The relationship between discharge DVI and five-year all-cause mortality was analyzed using Kaplan-Meier analysis. Results Among 912 patients who underwent follow-up echocardiography within 30 days post-TAVR, 38.4% had a DVI ≤0.5, with 29.3% in the self-expandable group and 47.5% in the balloon-expandable group. Discharge DVI ≤0.5 was not associated with increased five-year all-cause mortality in either the self-expandable (67.7% vs. 59.6%, p=0.621) or balloon-expandable (69.9% vs. 70%, p=0.703) valve groups. Kaplan-Meier analysis showed no significant differences in five-year all-cause mortality between the DVI groups across both valve types: Evolut high DVI, Evolut low DVI, Sapien high DVI, and Sapien low DVI groups (59.4% vs. 68.1% vs. 70.2% vs. 69.8%, p=0.18, Figure 1). Overall, DVI ≤0.5 was not associated with adverse outcomes following TAVR (69% vs. 65.1%, p=0.708). Conclusions DVI ≤0.5 was not predictive of adverse outcomes following TAVR with either the balloon-expandable or self-expandable valve.