Valve-in-Valve Implantation Using the ACURATE Neo in Degenerated Aortic Bioprostheses

Holzamer, Andreas; Kim, Won-Keun; Rück, Andreas; Sathananthan, Janarthanan; Keller, Lukas S.; Cosma, Joseph; Bauer, Timm; Nef, Holger; Amat‐Santos, Ignacio J.; Brinkert, Miriam; Hüsser, Oliver; Pellegrini, Costanza; Schöfer, Joachim; Nerla, Roberto; Montorfano, Matteo; Giannini, Francesco; Stella, Pieter R.; Kuwata, Shingo; Hilker, Michael; Castriota, Fausto; Webb, John G.; Nietlispach, Fabiàn; Toggweiler, Stefan

doi:10.1016/j.jcin.2019.07.042

Cited by 21 publications

(19 citation statements)

References 19 publications

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“…[9][10][11] Malpositioning of an ACURATE NEO as a secondary implanted valve after a failing surgical bioprosthesis was reported in 2.4% patients (2/85 patients). 6 In this situation, the upper crown may interfere with the stent posts and leaflets of the degenerated surgical aortic bioprosthesis, which may result in incomplete expansion, if the upper crown is positioned inside the bioprosthesis. This is because the crown is protruding 5 mm from the waist of the stent body.…”

Section: Valve Malpositioningmentioning

confidence: 99%

“…Coronary obstruction was reported in 1 out of 85 patients in a recent report of ACURATE NEO-in-surgical valve implantations (1.2%) 6. CA F I G U R E 3 Aortography after the deployment of the second ACURATE NEO: the two valves, one in the other.…”

mentioning

confidence: 95%

“…Pre‐dilatation is required before valve implantation to allow adequate device expansion. While there is a report from an international multicenter database on valve‐in‐surgical‐valve implantations, 6 there are no reports on ACURATE NEO performance when implanted into another ACURATE NEO. This procedure is not rare; Kim et al 7 reported on 15 valve‐in‐ACURATE NEO implantations in 1000 patients (1.5%) between May 2012 and December 2019.…”

Section: Introductionmentioning

confidence: 99%

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Two‐in‐one: A case report of a touchy TAVI procedure with a new valve

et al. 2021

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Implantation of a second transcatheter heart valve (THV) into a primary THV is a bail-out situation, but may be necessary. An 85-year-old woman was referred with severe symptomatic aortic stenosis (AS). Echocardiography showed a moderately calcified AS. Computed tomography resulted in an average annular diameter of 22.3 mm and an area of 371 mm 2 , leading to M-sized ACURATE NEO implantation. Deployment of the upper valve part was uneventful. During lower valve part deployment, the valve dived into the left ventricle outflow

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Section: Valve Malpositioningmentioning

confidence: 99%

mentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Two‐in‐one: A case report of a touchy TAVI procedure with a new valve

et al. 2021

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“…Several studies have investigated the clinical outcomes up to 1 year after implantation of the ACURATE neo THV for treatment of severe aortic stenosis in elderly patients (Table 1 ) [ 10 – 12 , 13 •, 14 •, 15 , 16 , 17 •, 18 •, 19 , 20 ]. These studies have proposed some strengths and drawbacks of ACURATE neo, which may guide how to optimally tailor the device to the most appropriate anatomy.…”

Section: The Acurate Neo Device For Native Aortic Valve Stenosismentioning

confidence: 99%

“…The international experience of 85 patients using the ACURATE neo THV for the treatment of degenerated surgical aortic bioprostheses was reported from 14 centers in Europe and Canada (Table 1 ) [ 18 •]. Malpositioning of the device was reported in two (2.4%) patients and coronary obstruction in one (1.2%) patient.…”

Section: The Acurate Neo For Degenerated Surgical Aortic Bioprosthesementioning

confidence: 99%

ACURATE neo: How Is This TAVR Valve Doing to Fit into an Increasingly Crowded Field?

2020

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Purpose of Review Critical appraisal of the available evidence on the self-expanding ACURATE neo transcatheter heart valve (THV) for the treatment of aortic valve disease. Recent Findings In an investigator-initiated, multicenter, randomized non-inferiority trial with broad inclusion criteria, ACURATE neo failed to meet non-inferiority compared with SAPIEN 3 with regard to a primary composite safety and efficacy endpoint at 30 days. The difference was driven by higher rates of moderate or severe paravalvular regurgitation and higher rates of acute kidney injury. In turn, registry data suggest that the safety and efficacy profile of the ACURATE neo is comparable to that of other commercially available devices. Randomized evidence indicated favorable hemodynamic results with large effective orifice areas and low residual gradients. Summary The self-expanding ACURATE neo THV is associated with higher rates of residual aortic regurgitation compared to the balloon-expandable SAPIEN 3 THV. The supra-annular design with low residual gradients may be advantageous in patients with small anatomy and mild degree of calcification.

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Computed tomography analysis of coronary ostia location following valve‐in‐valve transcatheter aortic valve replacement with the ACURATE neo valve: Implications for coronary access

Khokhar

Laricchia

Ponticelli

et al. 2021

Cathet Cardio Intervent

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Background: Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) is an emerging alternative to re-do surgery. However, the challenge of coronary access (CA) following ViV-TAVR is a potential limitation as TAVR expands to younger lowerrisk populations.Objectives: Using post-implantation computed tomography (CT) scans to evaluate the geometrical relationship between coronary ostia and valve frame in patients undergoing ViV-TAVR with the ACURATE neo valve.Methods: Post-implant CT scans of 18 out of 20 consecutive patients treated with the ACURATE neo valve were analyzed. Coronary ostia location in relation to the highest plane (HP) (highest point of the ACURATE neo or surgical valve) was determined. Ostia located below the highest plan were further subclassified according to the gap available between the transcatheter heart valve frame and ostium (transcatheter-to-coronary [TTC] distance). The impact implantation depth has on these geometrical relationships was evaluated.Results: A total of 21 out of 36 coronary ostia (58%) were located below the level of the HP with the left coronary artery (36%) more likely to be affected than the right (22%). Further sub-classification of these ostia revealed a large (>6 mm), moderate (4-6 mm), and small (<4 mm) TTC distance in 57% (12/21), 38% (8/21), and in 6%(1/18) of cases, respectively. At an implantation depth <4 mm compared to >4 mm, all ostia were located below the HP with no difference in post-procedural mean gra-

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Valve-in-Valve Implantation Using the ACURATE Neo in Degenerated Aortic Bioprostheses

Cited by 21 publications

References 19 publications

Two‐in‐one: A case report of a touchy TAVI procedure with a new valve

Two‐in‐one: A case report of a touchy TAVI procedure with a new valve

ACURATE neo: How Is This TAVR Valve Doing to Fit into an Increasingly Crowded Field?

Computed tomography analysis of coronary ostia location following valve‐in‐valve transcatheter aortic valve replacement with the ACURATE neo valve: Implications for coronary access

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