{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:14:04Z","timestamp":1788329644686,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transcatheter aortic valve implantation (TAVI) with the Acurate Neo has been linked to a significant incidence of paravalvular leakage (PVL), addressed by the Acurate Neo 2 incorporating an active sealing skirt. Recent findings suggest that midframe under\u2010expansion is associated with worse outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We investigated the hemodynamic and clinical outcomes after TAVI with Acurate Neo 2 compared to Acurate Neo and assessed the impact of midframe under\u2010expansion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients who received Acurate Neo (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009124) or Acurate Neo 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009133) between February 2018 and December 2021 (switch to Acurate Neo 2 in November 2020) were included. The primary outcomes were VARC\u20103 defined device success and early safety.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Device success was higher with Acurate Neo 2 compared with Acurate Neo (94.7% vs. 86.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020), as was early safety (87.2% vs. 74.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008). The rate of mild\/moderate PVL was significantly lower in Acurate Neo 2. Kaplan\u2212Meier estimated 1\u2010year survival (Acurate Neo 2: 87.8% vs. Acurate Neo: 89.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.930) and freedom from the combined clinical endpoint death, stroke, myocardial infarction, and heart failure rehospitalization at 1 year (Acurate Neo 2: 81.2% vs. Acurate Neo: 79.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.528) were comparable between groups. A long\u2010term analysis of these endpoints revealed no difference between groups. Midframe under\u2010expansion occurred in 13.3% and was associated with lower freedom from the combined clinical endpoint at 1 year, irrespective of prosthesis generation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Acurate Neo 2 demonstrated significant improvements in device success and early safety compared to Acurate Neo. Midframe under\u2010expansion occurred with both generations and was associated with worse clinical outcomes within the first year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70839","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:32:19Z","timestamp":1788327139000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison Between the Acurate Neo and the Acurate Neo 2 Transcatheter Heart Valve System: Impact of Midframe Under\u2010Expansion"],"prefix":"10.1002","author":[{"given":"Lisa","family":"Crusius","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9857-6936","authenticated-orcid":false,"given":"Thadd\u00e4us","family":"Ast","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Haussig","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Honor\u00e9","family":"Steul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix J.","family":"Woitek","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sick","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4563-1962","authenticated-orcid":false,"given":"Tomas","family":"Madej","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8202-7570","authenticated-orcid":false,"given":"Utz","family":"Kappert","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Linke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0793-7923","authenticated-orcid":false,"given":"Norman","family":"Mangner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Cardiology Heart Center Dresden, Technische Universit\u00e4t Dresden Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"issue":"17","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1056\/NEJMoa1008232","article-title":"Transcatheter Aortic\u2010Valve Implantation for Aortic Stenosis in Patients Who Cannot Undergo Surgery","volume":"363","author":"Leon M. B.","year":"2010","journal-title":"New England Journal of Medicine"},{"issue":"18","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1706","DOI":"10.1056\/NEJMoa1816885","article-title":"Transcatheter Aortic\u2010Valve Replacement With a Self\u2010Expanding Valve in Low\u2010Risk Patients","volume":"380","author":"Popma J. J.","year":"2019","journal-title":"New England Journal of Medicine"},{"issue":"18","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter Aortic\u2010Valve Replacement With a Balloon\u2010Expandable Valve in Low\u2010Risk Patients","volume":"380","author":"Mack M. J.","year":"2019","journal-title":"New England Journal of Medicine"},{"issue":"7","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS Guidelines for the Management of Valvular Heart Disease","volume":"43","author":"Vahanian A.","year":"2022","journal-title":"European Heart Journal"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1016\/j.jacc.2020.11.035","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: Executive Summary","volume":"77","author":"Otto C. M.","year":"2021","journal-title":"Journal of the American College of Cardiology"},{"issue":"4","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1159\/000531401","article-title":"The Influence of the Learning Curve on Clinical Outcomes in Balloon\u2010Expandable Versus Self\u2010Expandable Transfemoral Transcatheter Aortic Valve Implantation","volume":"148","author":"Istrate M.","year":"2023","journal-title":"Cardiology"},{"issue":"20","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"6117","DOI":"10.3390\/jcm11206117","article-title":"Long\u2010Term Prognosis Value of Paravalvular Leak and Patient\u2010Prosthesis Mismatch Following Transcatheter Aortic Valve Implantation: Insight From the France\u2010TAVI Registry","volume":"11","author":"Deharo P.","year":"2022","journal-title":"Journal of Clinical Medicine"},{"issue":"12","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1093\/eurheartj\/ehs003","article-title":"The Impact of Prosthesis\u2010Patient Mismatch on Long\u2010Term Survival After Aortic Valve Replacement: A Systematic Review and Meta\u2010Analysis of 34 Observational Studies Comprising 27 186 Patients With 133 141 Patient\u2010Years","volume":"33","author":"Head S. J.","year":"2012","journal-title":"European Heart Journal"},{"issue":"1","key":"e_1_2_10_10_1","first-page":"52","article-title":"Mortality and Heart Failure Hospitalization in Patients With Conduction Abnormalities After Transcatheter Aortic Valve Replacement","volume":"12","author":"J\u00f8rgensen T. H.","year":"2019","journal-title":"JACC: Cardiovascular Interventions"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.4244\/EIJV9SSA22","article-title":"Symetis ACURATE TF Aortic Bioprosthesis","volume":"9","author":"M\u00f6llmann H.","year":"2013","journal-title":"EuroIntervention"},{"issue":"10","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1080\/17434440.2018.1526675","article-title":"The ACURATE Neo Transcatheter Aortic Valve System","volume":"15","author":"Choudhury T.","year":"2018","journal-title":"Expert Review of Medical Devices"},{"issue":"10209","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/S0140-6736(19)32220-2","article-title":"Safety and Efficacy of a Self\u2010Expanding Versus a Balloon\u2010Expandable Bioprosthesis for Transcatheter Aortic Valve Replacement in Patients With Symptomatic Severe Aortic Stenosis: A Randomised Non\u2010Inferiority Trial","volume":"394","author":"Lanz J.","year":"2019","journal-title":"Lancet"},{"issue":"25","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1161\/CIRCULATIONAHA.120.051547","article-title":"Comparison of Self\u2010Expanding Bioprostheses for Transcatheter Aortic Valve Replacement in Patients With Symptomatic Severe Aortic Stenosis: SCOPE 2 Randomized Clinical Trial","volume":"142","author":"Tamburino C.","year":"2020","journal-title":"Circulation"},{"issue":"1","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.17925\/HI.2021.15.1.37","article-title":"The ACURATE neo and neo2 Valve Systems","volume":"15","author":"Reardon M. J.","year":"2021","journal-title":"Heart International"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"2061","DOI":"10.1016\/S0140-6736(25)00319-8","article-title":"ACURATE neo2 Valve Versus Commercially Available Transcatheter Heart Valves in Patients With Severe Aortic Stenosis (ACURATE IDE): A Multicentre, Randomised, Controlled, Non\u2010Inferiority Trial","volume":"405","author":"Makkar R. R.","year":"2025","journal-title":"Lancet"},{"issue":"4","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.jacc.2025.05.011","article-title":"Valve Under\u2010Expansion and Clinical Outcomes With ACURATE neo2: Findings From the ACURATE IDE Trial","volume":"86","author":"Makkar R. R.","year":"2025","journal-title":"Journal of the American College of Cardiology"},{"issue":"21","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1016\/j.jacc.2021.02.038","article-title":"Valve Academic Research Consortium 3: Updated Endpoint Definitions for Aortic Valve Clinical Research","volume":"77","author":"G\u00e9n\u00e9reux P.","year":"2021","journal-title":"Journal of the American College of Cardiology"},{"issue":"3","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.shj.2023.100277","article-title":"Short\u2010Term Outcomes of ACURATE neo2","volume":"8","author":"Tobe A.","year":"2024","journal-title":"Structural Heart"},{"issue":"12","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1007\/s00392-021-01882-3","article-title":"The ACURATE neo2 Valve System for Transcatheter Aortic Valve Implantation: 30\u2010Day and 1\u2010Year Outcomes","volume":"110","author":"M\u00f6llmann H.","year":"2021","journal-title":"Clinical Research in Cardiology"},{"issue":"11","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"1208","DOI":"10.1001\/jamacardio.2017.3425","article-title":"Association of Paravalvular Regurgitation With 1\u2010Year Outcomes After Transcatheter Aortic Valve Replacement With the SAPIEN 3 Valve","volume":"2","author":"Pibarot P.","year":"2017","journal-title":"JAMA Cardiology"},{"key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.ijcard.2016.07.006","article-title":"Impact of Paravalvular Aortic Regurgitation After Transcatheter Aortic Valve Implantation on Survival","volume":"221","author":"Takagi H.","year":"2016","journal-title":"International Journal of Cardiology"},{"issue":"10","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"804","DOI":"10.4244\/EIJ-D-22-00289","article-title":"Haemodynamic Performance and Clinical Outcomes of Transcatheter Aortic Valve Replacement With the Self\u2010Expanding ACURATE neo2","volume":"18","author":"Scotti A.","year":"2022","journal-title":"EuroIntervention"},{"issue":"8","key":"e_1_2_10_24_1","first-page":"1028","article-title":"Clinical Impact of Midframe Underexpansion Following TAVR Using a Self\u2010Expanding Transcatheter Heart Valve","volume":"18","author":"Kim W.\u2010K.","year":"2025","journal-title":"JACC: Cardiovascular Interventions"},{"issue":"10","key":"e_1_2_10_25_1","doi-asserted-by":"crossref","first-page":"555","DOI":"10.4244\/EIJ-D-26-00001","article-title":"Comparison of Self\u2010Expanding Transcatheter Heart Valves for Aortic Stenosis: The Multicentre, Randomised, Controlled, Non\u2010Inferiority DOUBLE\u2010CHOICE Trial","volume":"22","author":"Feistritzer H.\u2010J.","year":"2026","journal-title":"EuroIntervention"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70839","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:32:23Z","timestamp":1788327143000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":24,"alternative-id":["10.1002\/ccd.70839"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70839","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"2025-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ccd.70839"}}