title: Successful percutaneous implantation of symetis ACURATE neo transcatheter aortic bioprosthesis for the treatment of pure aortic regurgitation.
abstract: Transcatheter aortic valve implantation (TAVI) was initially developed for the treatment of calcific aortic stenosis. In the recent years, however, TAVI has been used to treat selected patients with pure, severe AR. We report successful transfemoral implantation of a Symetis ACURATE neo bioprosthesis in a severely symptomatic, 87-year-old woman with pure AR and major comorbidities. We decided to use the ACURATE neo bioprosthesis for some of its features appeared to us as potentially useful in the setting of pure AR: the stabilization arches ensure perfect coaxial alignment and extreme stability of the device during deployment, and the "waist" and the skirt were considered useful to obtain a good seal in the absence of significant valvular and annular calcifications. Finally, we decided to use a self-expanding valve to minimize the trauma to the aortic annulus. The procedure was successful and the patient was discharged home on postoperative day 3. At the 3-month control echocardiography, there was no residual AR, and the mean transprosthetic gradient was 3 mm Hg. The current case demonstrates that percutaneous TAVI with the ACURATE neo bioprosthesis may be used to treat pure, isolated AR in selected patients. The device has several interesting features that could make it advantageous in this setting. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Operative Unit of Cardiac Surgery, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, Massa, Italy.
authors.forename: Alfredo Giuseppe
authors.initials: AG
authors.lastname: Cerillo
authors.affiliation: Department of Cardiology, Cardiovascular Center Bad Neustadt, Bad Neustadt an Der Saale, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Griese
authors.affiliation: Operative Unit of Cardiology, Fondazione Toscana G. Monasterio, G. Pasquinucci Heart Hospital, Massa, Italy.
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
mesh_terms: D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000295:instrumentation*; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006801:Humans; D011474:Prosthesis Design; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: aortic valve disease; interventional devices/innovation; percutaneous intervention; percutaneous valve therapy; structural heart disease intervention; transcatheter valve implantation