The ACURATE neo transcatheter aortic valve system

Abstract

The field of transcatheter aortic valve implantation (TAVI) has seen an exponential expansion in TAVI devices for the treatment of severe symptomatic aortic stenosis. Areas covered: The ACURATE neo (Boston Scientific, MA, USA) is a second-generation self-expanding transcatheter aortic valve system. The valve presents a supra-annular design, and comprises three stabilization arches for axial alignment, an upper-crown for capping the aortic annulus, and a lower-crown that is opened over the native aortic valve for full deployment. This device minimally protrudes into the left ventricular outflow-tract, thereby minimizing the risk of conduction abnormalities. The ACURATE neo can be delivered by transfemoral and transapical approaches with a unique 'top-down' deployment. Information was gathered from published manuscripts obtained using standard databases (MEDLINE) and trial data presented at conferences. Expert commentary: Data from observational series show that TAVI with the ACURATE neo is associated with low rates of all-cause mortality, paravalvular leak, and permanent pacemaker requirement. Randomized data comparing the ACURATE neo valve with contemporary valves and long-term durability data are awaited. Continuing modifications in device and delivery system design are anticipated with a view to further reduction in paravalvular leak.

Keywords: TAVI; TAVR; aortic stenosis; self-expanding; transapical; transfemoral.