{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T20:00:21Z","timestamp":1770235221957,"version":"3.49.0"},"reference-count":21,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"unspecified","delay-in-days":146,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003196","name":"Italian Ministry of Health","doi-asserted-by":"crossref","award":["Ricerca Corrente"],"award-info":[{"award-number":["Ricerca Corrente"]}],"id":[{"id":"10.13039\/501100003196","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2025,4,16]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>During transcatheter aortic valve implantation (TAVI), increased aortic angulation can affect the final implantation depth of self-expandable (SE) devices due to the interaction between the high stent frame and the targeted aortic landing zone (LZ). We herein sought to investigate the behaviour of the ACURATE <jats:italic>neo<\/jats:italic>2, a SE device with a unique release mechanism, in relation to patient-specific angulation and curvature of the aortic LZ.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The mismatch between the intended and the final implantation depth (\u2206H) was compared between patients treated with ACURATE <jats:italic>neo2<\/jats:italic> (Acurate, n=106) and Evolut\/Portico (n=101) SE devices. To do so, curvature (<jats:italic>\u03ba<\/jats:italic>\n                     <jats:sub>\n                        <jats:italic>LZ,tot<\/jats:italic>\n                     <\/jats:sub>) and angulation (<jats:italic>\u03b1<jats:sub>LZ,Dist<\/jats:sub>\n                     <\/jats:italic>) were calculated based on the three-dimensional aortic LZ centerline available from pre-TAVI CT.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The Acurate and Evolut\/Portico groups showed a negligible difference (p=0.09) for \u2206H averaged between non-coronary (NCC) and left coronary cusp (LCC). However, when splitting both \u2206H<jats:sub>NCC<\/jats:sub> and \u2206H<jats:sub>LCC<\/jats:sub> values into two subgroups based on <jats:italic>\u03ba<\/jats:italic>\n                     <jats:sub>\n                        <jats:italic>LZ,tot<\/jats:italic>\n                     <\/jats:sub> and <jats:italic>\u03b1<jats:sub>LZ,Dist<\/jats:sub>\n                     <\/jats:italic> median values, \u2206H significantly increased on LCC compared with NCC in Evolut\/Portico patients with high LZ curvature (\u03ba<jats:sub>LZ,tot<\/jats:sub> &gt;0.123\/mm, p=0.016) and high LZ distal angulation (<jats:italic>\u03b1<jats:sub>LZ,Dist<\/jats:sub>\n                     <\/jats:italic> &gt;28.5\u00b0, p=0.012). No statistically significant differences arose within the Acurate group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Among SE devices, the ACURATE <jats:italic>neo<\/jats:italic>2 was the least affected by the curvature and angulation of the LZ anatomy, leading to a more predictable and symmetrical implantation depth. The clinical impact of this finding on TAVI outcomes in patients with an angulated aortic LZ warrants further investigation in larger studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2025-003181","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T23:20:22Z","timestamp":1748388022000},"page":"e003181","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of aortic landing zone geometry on TAVI implantation depth: comparison between ACURATE <i>neo2<\/i> and Portico\/Evolut"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7317-304X","authenticated-orcid":false,"given":"Francesco","family":"Sturla","sequence":"first","affiliation":[{"name":"3D and Computer Simulation Laboratory, IRCCS Policlinico, San Donato Milanese, Italy"},{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Pensotti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar Alessandro","family":"Oliva","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mattia","family":"Squillace","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico","family":"Poletti","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Tusa","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Zannoni","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emiliano","family":"Votta","sequence":"additional","affiliation":[{"name":"Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nedy","family":"Brambilla","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Testa","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Bedogni","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Gorla","sequence":"additional","affiliation":[{"name":"Department of Clinical and Interventional Cardiology, IRCCS Policlinico, San Donato Milanese, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"2025081611541551000_12.1.e003181.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60308-7"},{"key":"2025081611541551000_12.1.e003181.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1514616"},{"key":"2025081611541551000_12.1.e003181.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"2025081611541551000_12.1.e003181.4","first-page":"1511","article-title":"Novel insights on outcome in horizontal aorta with self\u2010expandable new\u2010generation transcatheter aortic valve replacement devices","volume":"96","author":"Veulemans","year":"2020","journal-title":"Cathet Cardio Intervent"},{"key":"2025081611541551000_12.1.e003181.5","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.121.010641","article-title":"Horizontal Aorta in Transcatheter Self-Expanding Valves: Insights From the HORSE International Multicentre Registry","volume":"14","author":"Gallo","year":"2021","journal-title":"Circ Cardiovasc Interv"},{"key":"2025081611541551000_12.1.e003181.6","first-page":"E135","article-title":"Impact of aortic angle on transcatheter aortic valve implantation outcome with Evolut-R, Portico, and Acurate-NEO","volume":"97","author":"Gorla","year":"2021","journal-title":"Catheter Cardiovasc Interv"},{"key":"2025081611541551000_12.1.e003181.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.02.030"},{"key":"2025081611541551000_12.1.e003181.8","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1016\/j.jcin.2021.03.027","article-title":"The Impact of Aortic Angulation on Contemporary Transcatheter Aortic Valve Replacement Outcomes","volume":"14","author":"Medranda","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2025081611541551000_12.1.e003181.9","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-024-61084-5","article-title":"Angulation and curvature of aortic landing zone affect implantation depth in transcatheter aortic valve implantation","volume":"14","author":"Gorla","year":"2024","journal-title":"Sci Rep"},{"key":"2025081611541551000_12.1.e003181.10","doi-asserted-by":"crossref","first-page":"37","DOI":"10.17925\/HI.2021.15.1.37","article-title":"The ACURATE neo\u2122 and neo2\u2122 Valve Systems","volume":"15","author":"Reardon","year":"2021","journal-title":"Heart Int"},{"key":"2025081611541551000_12.1.e003181.11","doi-asserted-by":"crossref","first-page":"131236","DOI":"10.1016\/j.ijcard.2023.131236","article-title":"Transcatheter aortic valve replacement with the self-expanding ACURATE Neo2 in patients with horizontal aorta: Insights from the ITAL-neo registry","volume":"389","author":"Barki","year":"2023","journal-title":"Int J Cardiol"},{"key":"2025081611541551000_12.1.e003181.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.02.005"},{"key":"2025081611541551000_12.1.e003181.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.02.038"},{"key":"2025081611541551000_12.1.e003181.14","doi-asserted-by":"crossref","first-page":"e749","DOI":"10.4244\/EIJ-D-19-00455","article-title":"Impact of horizontal aorta on procedural and clinical outcomes in second-generation transcatheter aortic valve implantation","volume":"15","author":"Di Stefano","year":"2019","journal-title":"EuroIntervention"},{"key":"2025081611541551000_12.1.e003181.15","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.051547"},{"key":"2025081611541551000_12.1.e003181.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.05.020"},{"key":"2025081611541551000_12.1.e003181.17","doi-asserted-by":"crossref","DOI":"10.1093\/ehjimp\/qyae040","article-title":"Paravalvular regurgitation after transcatheter aortic valve replacement: incidence, quantification, and prognostic impact","volume":"2","author":"van Wely","year":"2024","journal-title":"Eur Heart J Imaging Methods Pract"},{"key":"2025081611541551000_12.1.e003181.18","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1016\/j.jacc.2023.08.044","article-title":"Association of Age and Sex With Use of Transcatheter Aortic Valve Replacement in France","volume":"82","author":"Prosperi-Porta","year":"2023","journal-title":"J Am Coll Cardiol"},{"key":"2025081611541551000_12.1.e003181.19","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.carrev.2022.05.008","article-title":"Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement in Patients <60 Years of Age","volume":"43","author":"Gad","year":"2022","journal-title":"Cardiovasc Revasc Med"},{"key":"2025081611541551000_12.1.e003181.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1814052"},{"key":"2025081611541551000_12.1.e003181.21","doi-asserted-by":"crossref","first-page":"107147","DOI":"10.1016\/j.compbiomed.2023.107147","article-title":"A CT-based deep learning system for automatic assessment of aortic root morphology for TAVI planning","volume":"163","author":"Saitta","year":"2023","journal-title":"Comput Biol Med"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2025-003181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T18:54:24Z","timestamp":1755370464000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2025-003181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,5,27]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/openhrt-2025-003181"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2025-003181","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}