Clinical outcomes of the ACURATE neo2 transcatheter heart valve: a prospective, multicenter, observational, post-market surveillance study.


Journal

EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
ISSN: 1969-6213
Titre abrégé: EuroIntervention
Pays: France
ID NLM: 101251040

Informations de publication

Date de publication:
27 Nov 2022
Historique:
pmc-release: 15 05 2024
entrez: 28 11 2022
pubmed: 29 11 2022
medline: 29 11 2022
Statut: aheadofprint

Résumé

The next-generation ACURATE neo2 transcatheter aortic valve was designed for simplified implantation and to mitigate the risk of paravalvular leak (PVL) compared to the earlier device. To collect clinical outcomes and device performance data, including echocardiography and 4-dimensional computed tomography (4D-CT) data, with the ACURATE neo2 transcatheter heart valve in patients with severe aortic stenosis (AS). ACURATE neo2 PMCF is a single-arm, multicentre study of patients with severe AS treated in routine clinical practice. The primary safety endpoint was all-cause mortality at 30-days. The primary imaging endpoint was hypo-attenuated leaflet thickening (HALT), measured by core laboratory-adjudicated 4D-CT at 30 days. Secondary endpoints included VARC safety endpoints, procedural success, and evaluation of valve performance via core laboratory-adjudicated echocardiography. The study enrolled 250 patients at 18 European centres (mean age: 80.8 years; 63.6% female; mean STS score: 2.9±2.0%); 246 (98.4%) were successfully treated with ACURATE neo2. The 30-day rates for mortality and disabling stroke were 0.8% and 0%, respectively. The new permanent pacemaker implantation rate was 6.5%. HALT >50% was present in 9.3% of patients at 30 days. Valve haemodynamics improved from baseline to 30 days (mean aortic valve gradient: from 47.6±14.5 mmHg to 8.6±3.9 mmHg; mean aortic valve area: from 0.7±0.2 cm2 to 1.6±0.4 cm2). At 30 days, PVL was evaluated as none/trace in 79.2% of patients, mild in 18.9%, moderate in 1.9%, and severe in 0%. The study results support the safety and efficacy of TAVI with ACURATE neo2 in patients in routine clinical practice.

Sections du résumé

BACKGROUND BACKGROUND
The next-generation ACURATE neo2 transcatheter aortic valve was designed for simplified implantation and to mitigate the risk of paravalvular leak (PVL) compared to the earlier device.
AIMS OBJECTIVE
To collect clinical outcomes and device performance data, including echocardiography and 4-dimensional computed tomography (4D-CT) data, with the ACURATE neo2 transcatheter heart valve in patients with severe aortic stenosis (AS).
METHODS METHODS
ACURATE neo2 PMCF is a single-arm, multicentre study of patients with severe AS treated in routine clinical practice. The primary safety endpoint was all-cause mortality at 30-days. The primary imaging endpoint was hypo-attenuated leaflet thickening (HALT), measured by core laboratory-adjudicated 4D-CT at 30 days. Secondary endpoints included VARC safety endpoints, procedural success, and evaluation of valve performance via core laboratory-adjudicated echocardiography.
RESULTS RESULTS
The study enrolled 250 patients at 18 European centres (mean age: 80.8 years; 63.6% female; mean STS score: 2.9±2.0%); 246 (98.4%) were successfully treated with ACURATE neo2. The 30-day rates for mortality and disabling stroke were 0.8% and 0%, respectively. The new permanent pacemaker implantation rate was 6.5%. HALT >50% was present in 9.3% of patients at 30 days. Valve haemodynamics improved from baseline to 30 days (mean aortic valve gradient: from 47.6±14.5 mmHg to 8.6±3.9 mmHg; mean aortic valve area: from 0.7±0.2 cm2 to 1.6±0.4 cm2). At 30 days, PVL was evaluated as none/trace in 79.2% of patients, mild in 18.9%, moderate in 1.9%, and severe in 0%.
CONCLUSIONS CONCLUSIONS
The study results support the safety and efficacy of TAVI with ACURATE neo2 in patients in routine clinical practice.

Identifiants

pubmed: 36440588
pii: EIJ-D-22-00914
doi: 10.4244/EIJ-D-22-00914
pmc: PMC10173758
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

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Auteurs

Won-Keun Kim (WK)

Kerckhoff-Klinik GmbH, Bad Nauheim, Germany.

Corrado Tamburino (C)

Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico-San Marco, Catania, Italy.

Helge Möllmann (H)

St.-Johannes-Hospital Dortmund, Dortmund, Germany.

Matteo Montorfano (M)

Interventional Cardiology Unit IRCCS San Raffaele Scientific Institute, Milan, Italy.

Julia Ellert-Gregersen (J)

Department of Cardiology, Odense University Hospital, Odense, Denmark.

Tanja K Rudolph (TK)

Heart and Diabetes Center Northrhine-Westphalia, Bad Oeynhausen, Germany.

Nicolas M Van Mieghem (NM)

Erasmus Medical Center, Rotterdam, the Netherlands.

Michael Hilker (M)

Universitätsklinik Regensburg, Regensburg, Germany.

Ignacio J Amat-Santos (IJ)

Hospital Clínico Universitario de Valladolid, Valladolid, Spain.

Christian Juhl Terkelsen (CJ)

Aarhus University Hospital, Aarhus, Denmark.

Anna Sonia Petronio (AS)

Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.

Pieter R Stella (PR)

University Medical Center Utrecht, Utrecht, Netherlands.

Matthias Götberg (M)

Department of Cardiology, Skane University Hospital, Lund University, Lund, Sweden.

Andreas Rück (A)

Karolinska University Hospital, Stockholm, Sweden.

A Markus Kasel (AM)

Universitätsspital Zürich, Zürich, Switzerland.

Ramiro Trillo (R)

Complejo Hospitalario Universitario de Santiago, Santiago de Compostela. Centro de Investigación Biomedica en Red Enfermedades Cardiovasculares - CIBERCV, Madrid, Spain.

Clare Appleby (C)

Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

Marco Barbanti (M)

Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico-San Marco, Catania, Italy.

Philipp Blanke (P)

Department of Radiology, St Paul's Hospital & University of British Columbia, Vancouver, British Columbia, Canada.

Rodrigo Modolo (R)

Boston Scientific Corporation, Marlborough, MA, USA.

Dominic J Allocco (DJ)

Boston Scientific Corporation, Marlborough, MA, USA.

Lars Sondergaard (L)

The Heart Center, Rigshospitalet, Copenhagen, Demark.

Classifications MeSH