Early outcomes of transcatheter aortic valve implantation using the hydra thv self-expanding valve in challenging anatomical scenarios: a three-case series

Objective: To evaluate the feasibility, safety, and early outcomes of transcatheter aortic valve implantation (TAVI) using the Hydra THV self-expanding valve in challenging anatomical scenarios. Methods: This descriptive case series included three patients who underwent TAVI at the Cardiovascular Center, E Hospital. The cohort comprised one valve-in-valve procedure for a degenerated surgical bioprosthesis and two cases of native severe calcific aortic stenosis. All patients underwent comprehensive pre-procedural assessment, including clinical evaluation, electrocardiography, transthoracic echocardiography, and multidetector computed tomography according to a standard TAVI protocol. Hydra THV sizing was based on annular perimeter and the perimeter-derived diameter. Early outcomes were assessed using contemporary standardized TAVI endpoint definitions. Results: All three TAVI procedures were successfully performed via the transfemoral approach. There were no cases of in-hospital mortality, major vascular complications, stroke, or acute coronary obstruction. Following the intervention, transaortic valve gradients were markedly reduced, valve hemodynamics were favorable, and paravalvular regurgitation was no more than mild. The valve-in-valve case involving a small annulus was managed successfully without coronary-related complications. All patients experienced early clinical improvement. Conclusions: In this small case series, TAVI using the Hydra THV self-expanding valve demonstrated favorable early feasibility and safety, even in complex anatomical settings such as valve-in-valve procedures and patients with peripheral arterial disease. Larger studies with extended follow-up are needed to further evaluate long-term valve performance and durability.