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Elton Pllaha, Paolo Pagnotta, Marco Rossi, Bernhard Reimers
During the past decade there has been a major shift in the use of surgical bioprostheses. Consequently, due to the increasing age of the population there will be a major increase in the incidence of failure of these prostheses. While mortality associated with the re-replacement of surgical valve failures remains high, advances in transcatheter interventions have permitted the use of transcatheter valves in degenerative surgical bioprostheses. Herein is described the first use of the Symetis transfemoral ACURATEneo™ valve-in-valve procedure, together with details of the associated technical challenges...
January 2017: Journal of Heart Valve Disease
Florian Deuschl, Niklas Schofer, Moritz Seiffert, Samer Hakmi, Isamu Mizote, Andreas Schaefer, Johannes Schirmer, Hermann Reichenspurner, Stefan Blankenberg, Lenard Conradi, Ulrich Schäfer
OBJECTIVES: The aim of this study was to evaluate safety, feasibility, and efficacy of transaxillary TAVI using a novel self-expandable transcatheter heart valve (THV) via a direct percutaneous technique. METHODS: The analysis comprises 12 consecutive patients with severe aortic stenosis treated with the ACURATE Neo™ THV (Symetis) by direct percutaneous transaxillary access. RESULTS: Patients presented with a mean age of 79.9 ± 6.2 years and high calculated surgical risk (logEuroSCORE I: 19...
March 15, 2017: Catheterization and Cardiovascular Interventions
Michael W A Chu, Rodrigo Bagur, Katie L Losenno, Philip M Jones, Pantelis Diamantouros, Patrick Teefy, Jill J Gelinas, Bob Kiaii
OBJECTIVE: Coronary obstruction remains a challenging complication of transcatheter aortic valve replacement; however, a new self-expanding transapical prosthesis may reduce this risk. The purpose of this study was to evaluate the early 1-year outcomes of patients with low coronary heights who received the Acurate TA bioprosthesis (Symetis, Ecublens, Switzerland). METHODS: Between May 2014 and April 2015, 30 consecutive patients (aged 85 ± 6 years, 63% were female, Society of Thoracic Surgeons score 8...
April 2017: Journal of Thoracic and Cardiovascular Surgery
Sina Ali, Yakup Alsancak, Mustafa Duran, Mehmet Bilge
No abstract text is available yet for this article.
November 2016: Anatolian Journal of Cardiology
Rodrigo Bagur, Patrick J Teefy, Bob Kiaii, Pantelis Diamantouros, Michael W A Chu
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative for patients presenting with severe symptomatic aortic stenosis and considered at high-surgical risk. Paravalvular leak (PVL), conduction disorders, and coronary obstruction remain unresolved procedure-related complications. The aim of this manuscript was to report the first North American experience with the ACURATE-neo(TM) aortic bioprosthesis and its ACURATE-TF(TM) delivery system (Symetis S...
September 28, 2016: Catheterization and Cardiovascular Interventions
Andreas Schaefer, Hendrik Treede, Gerhard Schoen, Florian Deuschl, Niklas Schofer, Yvonne Schneeberger, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
OBJECTIVES: The published literature has extensively documented clinical benefit derived from transcatheter aortic valve implantation (TAVI) in high-risk patients using self-expanding current-generation transfemoral (TF) transcatheter heart valves (THVs). However, it has also demonstrated apparent shortcomings such as paravalvular leakage (PVL) or need for permanent pacemaker (PM) implantation. We here present a case-matched analysis of acute 30-day outcomes using a novel nitinol-based THV (Symetis Acurate Neo TF™), which may overcome some limitations of currently used devices...
August 2016: European Journal of Cardio-thoracic Surgery
Alfredo Giuseppe Cerillo, Daniel Griese, Sergio Berti
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...
August 2016: Catheterization and Cardiovascular Interventions
Rodrigo Bagur, Bob Kiaii, Patrick J Teefy, Pantelis Diamantouros, Christopher Harle, Aashish Goela, Ian Chan, Michael W A Chu
Transcatheter aortic valve implantation (TAVI) in the presence of a mechanical mitral valve (MMV) prosthesis is still challenging because of the rigid mitral frame within the aortomitral curtain. Moreover, low-lying coronary ostia represent a hazardous problem of coronary obstruction, especially in narrow or porcelain aortic roots. The present case demonstrates the successful management of 2 challenging anatomical issues, the rigid cage of the MMV and the low-lying left main coronary ostium (LMCO), with the implantation of the ACURATE-TA bioprosthesis (Symetis SA, Ecublens, Switzerland)...
November 2015: Annals of Thoracic Surgery
U Schäfer, L Conradi, P Diemert, F Deuschl, N Schofer, M Seiffert, E Lubos, J Schirmer, H Reichenspurner, S Blankenberg, H Treede
The Symetis ACURATE TA and ACURATE neo technology is a novel transcatheter heart valve for treatment of aortic valvular stenosis. This review illustrates the implantation steps, which are designed for an easy and intuitive transapical and transfemoral TAVI procedure. The most important difference to other self-expanding platforms is the top-down deployment with minimal protrusion of the stent towards the left ventricular outflow tract. In addition, the supra-annularly placed porcine leaflets provide very low gradients and the pericardial skirt acts very effectively to seal against paravalvular leaks...
October 2015: Minerva Cardioangiologica
Moritz Seiffert, Buntaro Fujita, Maxim Avanesov, Clemens Lunau, Gerhard Schön, Lenard Conradi, Emir Prashovikj, Smita Scholtz, Jochen Börgermann, Werner Scholtz, Ulrich Schäfer, Gunnar Lund, Stephan Ensminger, Hendrik Treede
AIMS: Calcification of the device landing zone is linked to paravalvular regurgitation after transcatheter aortic valve implantation (TAVI). The mechanisms remain incompletely understood and the performance of next-generation transcatheter heart valves (THV) has not been investigated. We evaluated the impact of calcification patterns on residual aortic regurgitation (AR) after TAVI with different THV in patients with severe aortic stenosis. METHODS AND RESULTS: TAVI was performed in 537 patients at two centres...
May 2016: European Heart Journal Cardiovascular Imaging
Jeevan Nagendran, Jorge Catrip, Pantelis Diamantouros, Patrick Teefy, Bob Kiaii, Ian Chan, Aashish Goela, David M Holzhey, Michael W A Chu
Transcatheter treatment of patients with degenerated aortic valve stentless prosthesis and low proximal coronary ostia to the aortic annulus remain a challenge because of the elevated risk for coronary obstruction. Newer generation transcatheter aortic valve devices that engage and pull the aortic valve calcium towards the aortic annulus may be beneficial in these patients. We present a case of successful treatment of a degenerated tubular stentless prosthesis with low coronary ostia with a Symetis Acurate TA prosthesis...
April 2015: Annals of Thoracic Surgery
Johannes Blumenstein, Won-Keun Kim, Christoph Liebetrau, Luise Gaede, Joerg Kempfert, Thomas Walther, Christian Hamm, Helge Möllmann
OBJECTIVE: Since the beginning of the transcatheter aortic valve implantation (TAVI) era, many prosthetic valves have entered clinical practice. TAVI prostheses differ regarding stent design and some may potentially interfere with diagnostic or interventional catheters. The aim of our analysis was to evaluate the feasibility of coronary angiography (CA) or percutaneous coronary intervention (PCI) in patients with prior TAVI. METHODS: From 2011 to 2014, 1,000 patients were treated by TAVI at our center using eight different valve prostheses (Symetis ACURATE TA and ACURATE TF; Medtronic CoreValve and Engager; JenaValve, SJM Portico; Edwards Lifesciences SAPIEN and SAPIEN XT)...
August 2015: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Daniele Camboni, Andreas Holzamer, Bernhard Flörchinger, Kurt Debl, Dierk Endeman, York Zausig, Lars S Maier, Christof Schmid, Michael Hilker
BACKGROUND: Transcatheter valve-in-valve (VIV) implantation evolved as a therapeutic alternative, despite an increased risk of coronary obstruction in comparison with a regular transcatheter aortic valve implantation (TAVI). We report a comprehensive single-institution experience emphasizing strategies to reduce the risk of myocardial ischemia. METHODS: Since 2009, 639 patients underwent a TAVI procedure in our institution. All patients are prospectively collected into an institutional registry...
May 2015: Annals of Thoracic Surgery
Jörg Kempfert, David Holzhey, Steffen Hofmann, Evaldas Girdauskas, Hendrik Treede, Holger Schröfel, Matthias Thielmann, Thomas Walther
OBJECTIVES: The novel ACURATE TA™ transcatheter aortic valve (Symetis, Ecublens, Switzerland) is composed of a self-expanding nitinol stent covered by an anti-paravalvular leak skirt designed for transapical implantation. Since Conformite Europeenne (CE)-mark approval, the first 250 patients implanted with the newly approved device have been included in this post-market, multicentre registry. METHODS: The registry was conducted at 17 sites in Germany, Italy, Switzerland and Argentina to treat 250 high-risk elderly patients...
July 2015: European Journal of Cardio-thoracic Surgery
Christoph Huber, Peter Wenaweser, Stephan Windecker, Thierry Carrel
Transapical transcatheter aortic valve implantation (TA-TAVI) is the recognized first choice surgical TAVI access. Expansion of this well-established treatment modality with subsequent broader patient inclusion has accelerated development of second-generation TA-TAVI devices. The Swiss ACURATE TA Symetis valve allows for excellent anatomical positioning, resulting in a very low incidence of paravalvular leaks. The self-expanding stent features an hourglass shape to wedge the native aortic valve annulus. A specially designed delivery system facilitates controlled release aided by tactile operator feedback...
2014: Multimedia Manual of Cardiothoracic Surgery: MMCTS
Gabor Erdoes, Christoph Huber, Reto Basciani, Stefan Stortecky, Stephan Windecker, Peter Wenaweser, Thierry Carrel, Balthasar Eberle
OBJECTIVES: The aim of this study was to quantify potential differences in count, frequency and pattern of high-intensity transient signals (HITS) during transapical transcatheter aortic valve implantation (TA-TAVI), by comparing the Symetis Acurate TA (SA) with the balloon-expandable Edwards Sapien XT (ES) system. BACKGROUND: Recently, the Symetis Acurate TA revalving system has been introduced for TA-TAVI. The Symetis Acurate TA aortic bioprosthesis is self-expanding and is deployed by a specific two-step implantation technique...
2014: PloS One
Daniel Wendt, Philipp Kahlert, Susanne Pasa, Karim El-Chilali, Fadi Al-Rashid, Konstantinos Tsagakis, Daniel Sebastian Dohle, Raimund Erbel, Heinz Jakob, Matthias Thielmann
OBJECTIVES: This study sought to evaluate the self-expandable ACURATE TA device (Symetis SA, Ecublens, Switzerland) in a cohort of patients with pure aortic regurgitation (AR). BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been initially considered as an alternative for high-risk patients with aortic stenosis. Although the current experience is limited, TAVR might be also an alternative to treat patients with pure, severe AR. METHODS: Between April 2012 and December 2013, a total of 8 high-risk patients with pure, severe AR were enrolled (grade III+)...
October 2014: JACC. Cardiovascular Interventions
Lenard Conradi, Moritz Seiffert, Kazuo Shimamura, Johannes Schirmer, Stefan Blankenberg, Hermann Reichenspurner, Patrick Diemert, Hendrik Treede
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become routine for the treatment of high-risk patients with aortic stenosis. We assessed safety and feasibility of a left ventricular apical access and closure device combined with second-generation transapical (TA) TAVI transcatheter heart valves (THV). METHODS AND RESULTS: Three elderly, comorbid patients (logEuroSCORE I 13.0-31.1%) received transapical aortic valve implantation (TA-AVI) via the Apica ASC device (Apica Cardiovascular Ltd...
September 2014: Thoracic and Cardiovascular Surgeon
Michał Oskar Zembala, Jacek Piegza, Jacek Wacławski, Michał Hawranek, Michael Hilker, Tomasz Niklewski, Jan Głowacki, Monika Parys, Paweł Nadziakiewicz, Piotr Chodór, Krzysztof Wilczek, Roman Przybylski, Mariusz Gąsior, Marian Zembala
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high risk and surgically in operable patients who suffer from severe symptomatic aortic stenosis. However, a significant number of complications, associated with both the learning curve and device specificity, have required attention and subsequent improvement. The Symetis transapical TAVR system is a self-positioning bioprosthesis composed of a non-coronary leaflet of surgical quality porcine tissue valve sewn into a self-expanding nitinol stent that iscovered with a PET-skirt...
2014: Kardiologia Polska
Moritz Seiffert, Lenard Conradi, Benjamin Kloth, Dietmar Koschyk, Johannes Schirmer, Renate B Schnabel, Stefan Blankenberg, Hermann Reichenspurner, Patrick Diemert, Hendrik Treede
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) has become an established procedure in patients with aortic stenosis and high surgical risk. Experience with first-generation transcatheter heart valves (THVs) is broad but limitations, e.g. paravalvular regurgitation, have been demonstrated. Much hope rests on the recently Conformité Européenne mark approved next-generation devices to improve results in these patients. However, apart from the initial approval studies, clinical data with these new devices are still scarce...
January 2015: European Journal of Cardio-thoracic Surgery
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