Objectives: Transcatheter aortic valve implantation (TAVI) is an established procedure in patients
with severe aortic stenosis (AS). The transapical access remains important for patients
not feasible for transfemoral TAVI. We present the results of 155 patients that underwent
transapical TAVI and received a self-expanding transapical aortic valve prosthesis.
Since the development of new prosthesis generations is expected to result in better
device success and hemodynamics, we aim to examine the short- and long-term outcome,
periprocedural complications and hemodynamics of two different generations of self-expanding
transapical devices (Acurate TA vs. Acurate neo).
Methods: A total of 155 consecutive patients with severe aortic stenosis treated with transapical
TAVI in our center were retrospectively analyzed. 85 patients received the early generation
device and 70 the new generation device.
Results: Baseline characteristics showed no significant differences in both groups, except
patients treated with early generation prosthesis had a significant higher STS score(5,3[3,7-7,6]vs. 4,1 [2,9-5,8]; p=0,002).There was a significant higher device success in the group of the new generation
device (63 (74.1%) vs. 67 (97.1%); P< 0.001). This group had a significant higher post-procedural, echocardiographic Aortic Valve
Area (1.35 [1.1-1.5]vs.1.6[1.4-1.9]; P=0.001) and lower a mean gradient (13.0 [9.3-17.0] vs.7.0 [5.0-11.0]; P< 0.001). 30-day and 1-year mortality rates did not differ significantly as well as major
adverse cardiac events and major vascular complications.
Conclusions: Our single center experience shows that new generation self-expanding devices result
in a higher device success and better hemodynamics compared to earlier generations
of self-expanding TAVI prosthesis. Transapical TAVI remains an important treatment
option for patients with severe AS not eligible for transfemoral access.
