Comparison of Clinical Outcomes of Myval vs. Acurate Neo Valves in TAVR: A Single-Center Experience

Background and Objectives: Transcatheter aortic valve replacement (TAVR) has become an established treatment for severe symptomatic aortic stenosis, and continuous technological advances have led to the development of different transcatheter heart valve (THV) systems. This study aimed to compare the short- and mid-term clinical outcomes of the balloon-expandable Myval (Meril Life Sciences, India) and the self-expanding Acurate Neo (Boston Scientific, MA, USA) transcatheter heart valves during a mean follow-up of 18 months. Materials and Methods: This retrospective single-center study included consecutive patients who underwent transfemoral TAVR with either the Myval or Acurate Neo valve between January 2020 and September 2022. Demographic, clinical, laboratory, electrocardiographic, echocardiographic, procedural, and follow-up data were collected and compared. Clinical outcomes were evaluated according to the Valve Academic Research Consortium-3 (VARC-3) criteria. Results: A total of 147 patients were included (Myval, n = 116; Acurate Neo, n = 31). Predilatation was performed in all patients in the Acurate Neo group but in only 22 (18.9%) patients in the Myval group (p < 0.001). In-hospital mild paravalvular leak (PVL) was more frequent in the Acurate Neo group (38.7% vs. 20.6%; p = 0.038), whereas moderate or greater PVL did not differ between the groups. During a mean follow-up of 18 months (range, 10-32 months), mild PVL remained significantly more frequent in the Acurate Neo group (p = 0.028). No significant differences were observed between the two valve systems regarding mortality, permanent pacemaker implantation, or other major VARC-3 clinical outcomes. Conclusions: The Myval and Acurate Neo transcatheter heart valves demonstrated comparable short- and mid-term clinical outcomes in patients undergoing TAVR. Although mild PVL was more frequent with the Acurate Neo valve, mortality, permanent pacemaker implantation, and moderate or greater PVL were similar between the two valve systems, supporting the safety and effectiveness of both prostheses in the treatment of severe symptomatic aortic stenosis.