Early Hemodynamic Outcomes in Self-Expandable Valves: Comparison of ACURATE Neo Versus ACURATE Neo2

Background: Comparisons of hemodynamic results between ACURATE Neo and ACURATE Neo 2, which have up-dated outer sealing skirts, are limited. This retrospective study aimed to demonstrate the differences in hemody-namic outcomes between the two transcatheter heart valves (THVs).Methods: We included 449 patients who underwent transfemoral transcatheter aortic valve replacement (TAVR) with either ACURATE Neo2 (n = 100) or ACURATE Neo (n = 348) between January 2016 and November 2021. The primary endpoint was the incidence of moderate or severe paravalvular leakage (PVL). The mean aortic pres-sure gradient (APG), peak aortic velocity (AV), and early clinical outcomes were assessed as secondary outcomes.Results: In the propensity-score matching comparison (94 pairs), there were no significant differences in the in-cidence of moderate or severe PVL (4.3 % in Neo2 group vs. 8.5 % in Neo group, p = 0.233), and peak AV and mean APG were significantly higher in Neo2 group (Peak AV: 2.1 +/- 0.4 vs. 1.9 +/- 0.5 m/s, p = 0.003; mean APG: 10.6 +/- 4.8 vs. 9.0 +/- 6.1 mmHg, p = 0.045). In the multivariate logistic regression analysis, the THV type (ACURATE Neo2) was not an independent predictor of moderate or severe PVL.Conclusion: The incidence of moderate or severe PVL did not significantly differ between TAVR with ACURATE Neo2 and ACURATE Neo; however, it was numerically lower in ACURATE Neo2. In contrast, the Neo2 group had a higher residual mean APG and peak AV. A larger study with long-term follow-up is warranted to assess the clinical relevance of these findings.(c) 2022 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).