Trans-Catheter Aortic Valve Implantation using the ACURATE Neo Valve – Single Center Experience with Mid-Term Follow Up - The 65th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 24-25 April 2018

Meir Tabi Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Yaron Almagor Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Jonathan Balkin Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Rami Jubeh Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel David Rosenmann Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Rivka Farkash Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Carmit Ben Ami Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel Rafael Wolff Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel

Background: Trans-catheter aortic valve implantation (TAVI) has profoundly transformed the treatment of elderly patients presenting with symptomatic severe aortic stenosis. The most common TAVI devices used in Israel are the Sapien (Edwards) and Evolute (Medtronic) valves. The ACCURATE Neo (Boston Scientific / SYMETIS) valve is a relatively new self-expendable valve with 2 year experience in Israel (primarily in our center).

Objective: To investigate the 30 day and one year outcome of patients treated with trans-femoral TAVI using the ACURATE Neo valve in Shaare Zedek Medical center.

Methods: the ACURATE Neo was used in 42 patients between 01/2016-12/2017. The mean age of the patients was 82.5 +/- 6.35 years (range 62-93 years) and the mean valve area 0.69 +/- 0.18 cm2 (range 0.3-0.9 cm2); 50% were women

Results: The procedural success rate was 100%. All cases were done through trans-femoral approach. Peak and mean aortic valve gradients dropped significantly following the procedure (71+/- 30 and 41+/-19 vs 15+/-7 and 10+/-5 mmHg, P<0.0005). Total 30 day and one year mortality rates were both 7.1% (three patients). Only one patient (2.4%) underwent permanent pacemaker implantation after the TAVI procedure. The rate of stroke was 2.4% (one patient). Four patients (9.5%) had vascular complications, of whom one (2.5%) was defined as major vascular complication (according to the VARC definitions).

Conclusions: The 30 day and one year clinical outcomes of the first 42 ACURATE Neo consecutive TAVI patients in our center were favorable, with a mid-term mortality rate of 7.1% and low rates of stroke (2.4%) as well as major vascular complications (2.5%).