Midterm durability of the ACURATE transcatheter aortic valve implantation system based on VARC-3 definitions

The ACURATE neo (Boston Scientific) system is a transcatheter aortic valve implantation (TAVI) system with limited durability data1. We studied all consecutive patients who underwent TAVI with the first-generation ACURATE neo aortic valve system at Karolinska University Hospital between October 2015 and December 2018. The study endpoints were haemodynamic valve deterioration (HVD; stage 2-3), bioprosthetic valve failure (BVF; stage 1-3), and patient-prosthesis mismatch (PPM), as defined by the Valve Academic Research Consortium (VARC)-3 criteria2. Stage 2 HVD is defined as a mean transvalvular gradient increase of ≥10 mmHg, resulting in a mean gradient ≥20 mmHg, or an increase of ≥1 grade of intraprosthetic aortic regurgitation (AR) resulting in ≥moderate AR. Stage 3 HVD is defined as an increase in the mean transvalvular gradient of ≥20 mmHg, resulting in a mean gradient ≥30 mmHg, or an increase of ≥2 grades of intraprosthetic AR resulting in ≥moderate-to-severe AR. Stage 1 BVF is defined as any bioprosthetic valve dysfunction (BVD) with new-onset or worsening symptoms or irreversible stage 3 HVD. Stage 2 BVF is defined as BVD that required aortic valve...