Paravalvular Aortic Regurgitation Severity Assessed by Quantitative Aortography: ACURATE 2 versus ACURATE Transcatheter Aortic Valve Implantation.

The new-generation ACURATE 2 system was commercially released in September 2020. In this study, we sought to compare the aortic regurgitation (AR) severity of the ACURATE 2 versus the ACURATE transcatheter heart valve, using quantitative videodensitometric angiography (qAR). This is a retrospective, Corelab analysis of final post-transcatheter aortic valve implantation (TAVI) aortograms of patients treated with the ACURATE 2 and ACURATE systems. The ACURATE 2 cohort comprised consecutive patients treated between September 2020 and January 2021 at two centers. The ACURATE cohort included consecutive patients treated before September 2020. Our primary objective was to compare AR severity on qAR following TAVI with ACURATE 2 and ACURATE . Out of 401 aortograms, 228 (56.9%) were analyzable, with 120 in the ACURATE 2 cohort, and 108 in the ACURATE cohort. The mean AR fraction was 4.4 ± 4.8% in the 2 cohort, and 9.9 ± 8.2% in the cohort ( < 0.001). Furthermore, moderate or severe AR (qAR > 17%) was detected in 2 aortograms (1.7%) in the 2 cohort and 15 aortograms (13.9%) in the cohort ( < 0.001). Quantitative aortography shows a lower rate of moderate or severe paravalvular AR in what is the first European experience of the new-generation, self-expanding ACURATE 2 when compared to the first-generation ACURATE . Moreover, aortographic data need to be correlated and compared to Core Laboratory-adjudicated 30-day echocardiographic data.