First experiences with the balloon-expandable Myval® transcatheter aortic valve from Turkey

Transcatheter aortic valve implantation (TAVI), first performed in inoperable patients with severe valvular aortic stenosis (AS), has become a surgical alternative even in low surgical risk patients based on the PARTNER-3 trial (1). TAVI valves can be classified into two categories: self-expandable and balloon-expandable. The experience of the operator and patients’ clinical characteristics, such as aortoiliac-femoral access and distribution of calcium extending to left ventricular outflow tract (LVOT), are important for the choice of the valve. However, post-procedural aortic regurgitation and need for a permanent pacemaker are more commonly observed with selfexpandable valves. Recent trials with the balloon-expandable SAPIEN 3 (Edwards Lifesciences, USA) valve have shown superior clinical results to the surgical aortic replacement and self-expandable valves (2). In our clinics, we prefer balloon-expandable valves because of its superiority, but in select cases which have extensive LVOT calcification and unsuitable peripheral access, the self-expandable Evolut-R (Medtronic, USA) valve is preferred.