Exploring Technical Insights into the Mechanical Adaptation Behavior of the Intuity Elite Aortic Bioprosthesis

Objectives: Rapid-deployment aortic valve replacement (RDAVR) represents an alternative to conventional valves due to the faster and easier implantation. One challenging aspect of these prostheses is their behavior in an oval human annulus. We evaluated the Intuity aortic bioprosthesis by investigating its radial forces in vitro and using computed tomography to evaluate its stent shape after implantation. Methods: N=19 patients received a RDAVR with the Intuity bioprosthesis at our institution between 2018 and 2020. We measured the radial forces of the prosthesis using an RX Machine. Additionally, we measured the degree of deformation after 3D reconstruction of the implanted prostheses. Results: In all three-dimensional reconstructions, the Intuity stent showed no degree of deformation with an ovality of almost 0%, approximating a perfect circle. Intuity's RF was significantly higher than other transcatheter aortic devices and the Perceval prosthesis. Conclusions: The Intuity Elite bioprosthesis demonstrates remarkably high RFs and perfect circularity even in the oval human annulus, which are related to a satisfactory hemodynamic pattern in the aortic root postoperatively. Its high RFs at the annulus may explain the resistance to deformation, ensuring harmonious, natural-like cusp mobility. This may reduce the risk of turbulence-induced fibrosis and increased transvalvular pressure gradients, and may clinically translate into less hemolysis. To validate the possible clinical impact of our findings, additional research with a larger sample size and extended follow-up is essential.