Early and Midterm Outcomes of INSPIRIS RESILIA Versus AVALUS: A Propensity Score Matching Analysis.

Objectives: To compare the early and midterm clinical outcomes of aortic valve replacement (AVR) using the INSPIRIS RESILIA bioprosthesis (IR-B) with AVR using the AVALUS bioprosthesis (AV-B).

Methods: This single-centre retrospective study analysed the perioperative clinical outcomes of 256 consecutive patients who underwent AVR with either IR-B (n=156) or AV-B (n=100) at this institution between 1 August 2018 and 30 June 2023. After propensity score matching, freedom from death, freedom from major adverse cardiovascular events (MACE), and echocardiographic data were compared between the two groups during the follow-up period.

Results: Propensity score matching resulted in the addition of 79 patients to each group. The 1-year survival rates in the propensity score-matched cohort were 93.8% and 94.5% in the IR-B and AV-B groups, respectively, while the 3-year survival rates remained unchanged, with no statistically significant differences between groups (p=0.88). At 3 years postoperatively, freedom from MACE was 93.2% and 92.8% in the IR-B and the AV-B groups, respectively, which was not statistically significant (p=0.90). The mean aortic pressure gradient after AVR remained stable in both the IR-B and AV-B groups (IR-B group, 10.7-11.3 mmHg vs AV-B group, 11.5-12.1 mmHg), and there was no significant difference observed between the two groups during the follow-up period. The absolute change from the baseline left ventricular mass index in both the IR-B and AV-B groups decreased in each group over time (IR-B group, -20.8 to -38.6 g/m² vs AV-B group, -16.6 to -35.5 g/m²). However, these changes were statistically insignificant between the two groups over the 3-year follow-up.

Conclusion: The early and midterm clinical outcomes were comparable between the IR-B and AV-B groups.