Outcomes of Acurate Neo 2 Sapien 3 and Evolut Pro/Pro+ in Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with severe symptomatic aortic stenosis (AS). Comparative data on the efficacy and safety of newer transcatheter heart valve (THV) devices is still evolving. We aim to compare clinical and hemodynamic outcomes of the Symetis ACURATE Neo-2® versus the Medtronic Evolut Pro/Pro^+® and the Edwards Sapien-3® THVs, from a large cohort of patients undergoing TAVR. In this all-comer, single center trial, patients with severe symptomatic AS undergoing TAVR and treated with either ACURATE Neo-2 (N = 240), Evolut Pro/Pro+ (N = 324) or Sapien-3 (N = 485) THVs were included. Baseline clinical, demographic and follow-up data were collected. Patients (N = 1049) (female 48.6%) mean age 80.1 ± 7.7 years. ACURATE Neo-2 patients were predominantly female (81%) in comparison to Evolut Pro/Pro+ (59%) and Sapien-3 (26%). Need for post-TAVR permanent pacemaker implantation (PPI) was lower in the ACURATE Neo-2 group in comparison to the Evolut Pro/Pro+ and similar to the Sapien-3 group. Rates of ≥ moderate paravalvular leak (PVL) were similar between ACURATE Neo-2 and Evolut Pro/Pro+, but higher in comparison to Sapien-3. In sight of our center's clinical approach to choosing various THV's according to patient characteristics, The ACURATE Neo-2 constitutes a reliable and suitable tool for the treatment of patients with severe symptomatic AS undergoing TAVR. Even in the wake of the ACURATE Neo-2's withdrawal, our study offers valuable contributions to ongoing discourse in the field of TAVR, emphasizing the necessity for continuous research and innovation to improve patient care and device efficacy.