Medtronic plc has received U.S. Food and Drug Administration (FDA) approval for the expanded Redo-TAVR indication of its Evolut transcatheter aortic valve replacement (TAVR) system, marking a significant advancement in treatment options for patients with failing transcatheter heart valves. The approval allows for the implantation of a new Evolut transcatheter aortic valve (TAV) inside any failed previously implanted TAV and follows CE Mark approval for Evolut PRO+, FX and FX+ systems in Europe.
Clinical Indication and Patient Population
The Redo-TAVR procedure is indicated for patients experiencing failure of any TAV, including but not limited to severe aortic stenosis, who are at high-risk for open-heart surgery. The approval covers the Evolut PRO+, FX, and FX+ systems and extends to patients with failing TAVI valves from any manufacturer, providing physicians with broader treatment options than previously available.
"FDA approval for Redo-TAVR with the Evolut system marks a significant milestone in patient care, empowering physicians across the United States to offer a critical treatment option for patients with failing transcatheter heart valves who are at high surgical risk," said Dr. Michael Caskey, MD, attending cardiothoracic surgeon at Abrazo Arizona Heart Hospital in Phoenix. "This advancement also benefits patients considering a new TAVR procedure today, giving patients options for future intervention and has the potential to profoundly improve their long-term outcomes and quality of life."
Disease Background and Clinical Need
Severe aortic stenosis occurs when the aortic valve leaflets become stiff and thickened and have difficulty opening and closing, making the heart work harder to pump blood to the rest of the body. This condition often reduces a patient's quality of life and limits their daily activities. If left untreated, patients with symptomatic severe aortic stenosis can die from heart failure in as little as two years.
RESTORE Study Launch
In addition to the FDA approval, Medtronic has launched the RESTORE study to evaluate the outcomes of Redo transcatheter aortic valve replacement (TAVR) in patients experiencing symptomatic bioprosthetic valve failure. This pivotal study will enroll 225 participants and follow them for up to five years, focusing on both immediate and long-term clinical outcomes. The study aims to assess 30-day procedural success rates, one-year freedom from mortality and stroke, and additional measures of safety, technical success, and quality of life.
Market Impact and Competitive Landscape
The broader indication means that physicians planning redo TAVI cases now have more choices than the Sapien valves from Edwards Lifesciences, which also are approved for valve-in-valve procedures. This expansion provides Medtronic with a competitive advantage in the growing redo-TAVR market segment.
"The Redo-TAVR indication marks an important milestone for our Evolut TAVR systems, reinforcing our commitment to provide physicians with patient-specific solutions today, and for the future of TAVR," said Jorie Soskin, vice president and general manager of the Structural Heart business within the Cardiovascular Portfolio at Medtronic. "With a broader indication than other available options, this expansion, together with the launch of our RESTORE study build on our differentiated design and unparalleled evidence to advance solutions and elevate care options for heart teams and patients worldwide."
Current Indications
In native (non-prosthetic) aortic valves, Evolut TAVR systems are currently indicated for implantation in symptomatic severe aortic stenosis patients across all risk categories (extreme, high, intermediate, and low) in more than 120 countries worldwide, including the European Union and the United States.
