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A patient-specific algorithm to achieve commissural alignment with Acurate Neo: The sextant technique
Federico De Marco1, Matteo Casenghi1,2, Pietro Spagnolo1
1Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Summary
A new CT-scan algorithm ensures safe and effective coronary clearance and commissural alignment during Acurate Neo transcatheter aortic valve replacement (TAVR). This patient-specific approach achieved excellent results in a proof-of-concept study.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Medical Device Technology
Background:
- Transcatheter aortic valve replacement (TAVR) is a key treatment for aortic stenosis.
- Accurate device placement is crucial to prevent complications like coronary artery obstruction.
Purpose of the Study:
- To evaluate a CT-scan based, patient-specific algorithm for optimizing coronary clearance and commissural alignment with the Acurate Neo device during TAVR.
Main Methods:
- A prospective study enrolled 45 patients undergoing TAVR with the Acurate Neo transcatheter heart valve (THV).
- A pre-procedural CT scan was used to calculate optimal rotational deployment for commissural alignment.
- Post-TAVR CT scans assessed coronary clearance and THV alignment.
Main Results:
- The device success rate was 100%.
- Coronary clearance was achieved in 98% of patients, with no severe coronary artery overlap.
- 93% of patients had ideal or mild THV misalignment, and 100% had successful post-TAVR coronary artery engagement.
Conclusions:
- The CT-scan based patient-specific algorithm is safe and effective for TAVR with the Acurate Neo.
- This method successfully maximizes coronary clearance and achieves good commissural alignment, preventing complications.
