title: Symetis Acurate Neo transfemoral aortic bioprosthesis - initial Polish experience.
abstract: OBJECTIVE
  Transcatheter aortic valve implantation (TAVI) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high-risk and surgically inoperable patients who suffer from severe symptomatic aortic stenosis. With the second generation of TAVI devices improvements in both handling and performance are highly demanded. This brief clinical communication reports the first Polish experience with the second generation of transfemoral TAVI device--Symetis Acurate Neo.
  
  
  METHODS
  From November 19th 2014 until February 18th 2015 nine (n = 9) patients with severe symptomatic aortic stenosis have been operated on using the Symetis Acurate Neo. Patients were subject to seven-day evaluation and 30-day phone follow-up.
  
  
  RESULTS
  The procedure was safely and successfully performed in all patients. A SMALL (S) valve (21-23 mm equivalent) was used in two patients, MEDIUM valve (M; 23-25 mm equivalent) in five patients, and a LARGE valve (L; 25-26 mm equivalent) in two patients. In three cases post-release balloon dilatation was required. There were no intraoperative complications and no major adverse events (as per VARC classification) during initial hospitalisation, including conduction or rhythm disturbances. In all cases, the mean gradient on the prosthetic valves was 7.8 mm Hg (10.2 mm Hg on the "S" valves). Rapid improvement in patients' functional class was noted. Perivalvular leak was evaluated as "mild" in three cases, "trace" in one, and "not existing" in five.
  
  
  CONCLUSIONS
  This initial experience with the Symetis Acurate Neo demonstrates its good safety profile and excellent haemodynamics. Low radial stress of the valve results in minimal incidence of atrioventricular rhythm disturbances, and a sealing crown for nearly non-existent paravalvular leak.
authors.affiliation: Sląskie Centrum Chorób Serca w Zabrzu. m@sccs.pl.
authors.forename: Michał
authors.initials: M
authors.lastname: Zembala
authors.forename: Michał
authors.initials: M
authors.lastname: Hawranek
authors.forename: Jacek
authors.initials: J
authors.lastname: Wacławski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Niklewski
authors.forename: Paweł
authors.initials: P
authors.lastname: Nadziakiewicz
authors.forename: Rafał
authors.initials: R
authors.lastname: Koba
authors.forename: Roman
authors.initials: R
authors.lastname: Przybylski
authors.forename: Ryszard
authors.initials: R
authors.lastname: Walas
authors.forename: Jan
authors.initials: J
authors.lastname: Głowacki
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jazwiec
authors.forename: Marcin
authors.initials: M
authors.lastname: Garbacz
authors.forename: Mariusz
authors.initials: M
authors.lastname: Gąsior
authors.forename: Marian
authors.initials: M
authors.lastname: Zembala
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D011044:Poland; D016896:Treatment Outcome
keywords: TAVI; aortic stenosis; transcatheter aortic valve implantation