Acurate Neo Implantation to Treat Degenerative Regurgitation of Surgical Bioprostheses.

Valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) provides a safe and effective treatment option for failing surgical aortic bioprostheses. Self-expanding supra-annular valves offer optimal haemodynamics for this clinical application. The Acurate Neo transcatheter heart valve (THV) offers further unique advantages with stabilisation arches to assist with alignment, upper crowns to restrain bioprosthetic valve leaflets, rapid final opening coaxial to the left ventricular outflow tract and an open design that optimises future coronary access. We report our procedural technique and experience using the Acurate Neo THV in four VIV-TAVR implantations for patients aged between 70 and 81 yrs. All patients presented with severe symptomatic valvular aortic regurgitation (AR), one of whom was in cardiogenic shock. The patients had malfunctioning surgical bioprostheses (stented n = 3; stentless n = 1) ranging in size from 21 to 25 mm. The Acurate Neo THV was successfully implanted in all patients without any complications, residual AR, coronary compromise or need for permanent pacing. Length of stay was 2 to 7 days. Follow-up to 12 months revealed no adverse events. The Acurate Neo THV is an attractive self-expanding option for patients with AR due to degeneration of a surgical aortic valve bioprosthesis.