| Title: |
Impact of aortic landing zone geometry on TAVI implantation depth: Comparison between ACURATE neo2 and Portico/Evolut |
| Authors: |
Sturla F.; Pensotti F.; Oliva O. A.; Squillace M.; Poletti E.; Tusa M.; Zannoni J.; Votta E.; Brambilla N.; Testa L.; Bedogni F.; Gorla R. |
| Contributors: |
Sturla, F.; Pensotti, F.; Oliva, O. A.; Squillace, M.; Poletti, E.; Tusa, M.; Zannoni, J.; Votta, E.; Brambilla, N.; Testa, L.; Bedogni, F.; Gorla, R. |
| Publication Year: |
2025 |
| Collection: |
RE.PUBLIC@POLIMI - Research Publications at Politecnico di Milano |
| Subject Terms: |
Aortic Valve Stenosis; Computed Tomography Angiography; Heart Valve Prosthesis Implantation; Transcatheter Aortic Valve Replacement |
| Description: |
Background During transcatheter aortic valve implantation (TAVI), increased aortic angulation can affect the final implantation depth of self-expandable (SE) devices due to the interaction between the high stent frame and the targeted aortic landing zone (LZ). We herein sought to investigate the behaviour of the ACURATE neo2, a SE device with a unique release mechanism, in relation to patient-specific angulation and curvature of the aortic LZ. Methods The mismatch between the intended and the final implantation depth (δH) was compared between patients treated with ACURATE neo2 (Acurate, n=106) and Evolut/Portico (n=101) SE devices. To do so, curvature (κ LZ,tot) and angulation (α LZ,Dist) were calculated based on the three-dimensional aortic LZ centerline available from pre-TAVI CT. Results The Acurate and Evolut/Portico groups showed a negligible difference (p=0.09) for δH averaged between non-coronary (NCC) and left coronary cusp (LCC). However, when splitting both δH NCC and δH LCC values into two subgroups based on κ LZ,tot and α LZ,Dist median values, δH significantly increased on LCC compared with NCC in Evolut/Portico patients with high LZ curvature (κ LZ,tot >0.123/mm, p=0.016) and high LZ distal angulation (α LZ,Dist >28.5°, p=0.012). No statistically significant differences arose within the Acurate group. Conclusions Among SE devices, the ACURATE neo2 was the least affected by the curvature and angulation of the LZ anatomy, leading to a more predictable and symmetrical implantation depth. The clinical impact of this finding on TAVI outcomes in patients with an angulated aortic LZ warrants further investigation in larger studies. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/wos/WOS:001498678400001; volume:12; issue:1; firstpage:1; lastpage:9; numberofpages:9; journal:OPEN HEART; https://hdl.handle.net/11311/1307006 |
| DOI: |
10.1136/openhrt-2025-003181 |
| Availability: |
https://hdl.handle.net/11311/1307006; https://doi.org/10.1136/openhrt-2025-003181 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.6FEAA133 |
| Database: |
BASE |