Haemodynamic performance and clinical outcomes of transcatheter aortic valve replacement with the self-expanding ACURATE neo2
EuroIntervention
; 18(10)Mar. 2022. graf, tab
Article
in English
| CONASS, Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1378039
Responsible library:
BR79.1
ABSTRACT
BACKGROUND:
Transcatheter aortic valve replacement (TAVR) with the ACURATE neo device has been associated with a non-negligible incidence of paravalvular aortic regurgitation (AR). The new-generation ACURATE neo2 has been designed to mitigate this limitation.AIMS:
The aim of the study was to compare TAVR with the ACURATE neo and neo2 devices.METHODS:
The NEOPRO and NEOPRO-2 registries retrospectively included patients undergoing transfemoral TAVR with self-expanding valves at 24 and 20 centres, respectively. Patients receiving the ACURATE neo and neo2 devices (from January 2012 to December 2021) were included in this study. Predischarge and 30-day VARC-3 defined outcomes were evaluated. The primary endpoint was predischarge moderate or severe paravalvular AR. Subgroup analyses per degree of aortic valve calcification were performed.RESULTS:
A total of 2,026 patients (neo 1,263, neo2 763) were included. Predischarge moderate or severe paravalvular AR was less frequent for the neo2 group (2% vs 5%; p<0.001), resulting in higher VARC-3 intended valve performance (96% vs 90%; p<0.001). Furthermore, more patients receiving the neo2 had none/trace paravalvular AR (59% vs 38%; p<0.001). The reduction in paravalvular AR with neo2 was mainly observed with heavy aortic valve calcification. New pacemaker implantation and VARC-3 technical and device success rates were similar between the 2 groups; there were more frequent vascular and bleeding complications for the neo device. Similar 1-year survival was detected after TAVR (neo2 90% vs neo 87%; p=0.14).CONCLUSIONS:
TAVR with the ACURATE neo2 device was associated with a lower prevalence of moderate or severe paravalvular AR and more patients with none/trace paravalvular AR. This difference was particularly evident with heavy aortic valve calcification.
Full text:
Available
Collection:
National databases
/
Brazil
Database:
CONASS
/
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Aortic Valve Insufficiency
/
Transcatheter Aortic Valve Replacement
Type of study:
Risk factors
Language:
English
Journal:
EuroIntervention
Year:
2022
Document type:
Article
Institution/Affiliation country:
ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia/IT
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Cardio Center, Humanitas Research Hospital/IT
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Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute/IT
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Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute/ES
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Cardiology, King's College Hospital/GB
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Centre for Heart Valve Innovation, St. Paul's and Vancouver General Hospital/CA
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Clinical and Interventional Cardiology Unit, Istituto Clinico Sant' Ambrogio/IT
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Contilia Heart and Vascular Centre, Elisabeth-Krankenhaus Essen/DE
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Department for Percutaneous Treatment of Structural Heart Disease, Albertinen Heart Center/DE
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Department of Cardiology and Cardiac Surgery, Kerckhoff Heart and Lung Center/DE