Department of Cardiology Karolinska University Hospital Stockholm Sweden.
Department of Cardiology and Cardiac Surgery Kerckhoff Heart and Lung Centre Bad Nauheim Germany.
J Am Heart Assoc. 2023 Aug;12(15):e029464. doi: 10.1161/JAHA.122.029464. Epub 2023 Jul 25.
Background ACURATE is a transcatheter aortic valve implantation system consisting of a self-expanding bioprosthetic valve with supra-annular leaflet position and featuring innovations to facilitate placement accuracy and reduce paravalvular regurgitation. Methods and Results The goal of the Early neo2 (Early neo2 Registry of the ACURATE neo2 TAVI Prosthesis) was to gather real-life data on safety and efficacy in a European transcatheter aortic valve implantation population treated with ACURATE . Data were collected from 554 consecutive patients treated with ACURATE at 12 European sites (mean age, 82 years; 66% women; mean European System for Cardiac Operative Risk Evaluation II, 4.5%±3.8%) between September 2020 and March 2021. The composite primary end point was the occurrence of any of the following: postoperative (in-hospital) paravalvular regurgitation grade ≥2, in-hospital acute kidney injury stage 3, postoperative pacemaker implantation, 30-day death, and 30-day stroke. The primary end point occurred in 12.6% of patients. The 30-day rates for all-cause death and all stroke were 1.3% and 2.7%, respectively, and 1.5% of patients exhibited stage 3 acute kidney injury. A total of 34 patients (6.2%) received a postoperative permanent pacemaker. Per core laboratory-adjudicated echocardiographic analysis, mean postoperative aortic valve gradient was 7.6±3.3 mm Hg, and 2.8% of patients exhibited paravalvular regurgitation grade ≥2. Conclusions In this report of postmarket use of the ACURATE valve in a real-world transcatheter aortic valve implantation population, patients exhibited favorable postoperative hemodynamics and clinical outcomes and a low rate of postoperative pacemaker implantation.
ACURATE 是一种经导管主动脉瓣植入系统,由一个具有瓣上叶位置的自膨式生物假体瓣膜组成,具有创新设计,以提高植入的准确性并减少瓣周漏。
早期 neo2(ACURATE neo2 经导管主动脉瓣置换术的早期 neo2 注册研究)的目的是收集在接受 ACURATE 治疗的欧洲经导管主动脉瓣置换术人群中的安全性和疗效的真实数据。该研究在 2020 年 9 月至 2021 年 3 月期间,从欧洲 12 个中心的 554 例连续接受 ACURATE 治疗的患者中收集数据(平均年龄 82 岁;66%为女性;平均欧洲心脏手术风险评估系统 II 评分 4.5%±3.8%)。复合主要终点是以下任何一项的发生:术后(住院期间)瓣周漏分级≥2 级、住院期间急性肾损伤 3 期、术后起搏器植入、30 天死亡和 30 天卒中等。主要终点发生在 12.6%的患者中。30 天全因死亡率和全因卒中等发生率分别为 1.3%和 2.7%,3 级急性肾损伤发生率为 1.5%。共有 34 例(6.2%)患者接受了术后永久性起搏器植入。根据核心实验室裁定的超声心动图分析,平均术后主动脉瓣跨瓣压差为 7.6±3.3mmHg,2.8%的患者存在瓣周漏分级≥2 级。
在本报告中,在真实世界的经导管主动脉瓣置换术人群中使用 ACURATE 瓣膜后,患者术后血流动力学和临床结局良好,术后起搏器植入率较低。