Valvular & structural heart diseaseCohort study
Clinical Impact of Midframe Underexpansion Following TAVR Using a Self-Expanding Transcatheter Heart Valve
- Retrospective cohort study
- 2 European high-volume centres
Authors' conclusion
In this European cohort of ACURATE neo2 recipients, midframe underexpansion occurred in a minor proportion and was associated with poorer clinical outcomes through 1 year.
Study context
- Population
- Patients treated with the self-expanding ACURATE neo2 TAVR device (median age 82 years; 61.4% women)
- Participants
- 604 patients
- Exposure
- Midframe underexpansion vs no midframe underexpansion after TAVR
- Midframe underexpansionn = 84
- No midframe underexpansionn = 520reference
- Outcome
- Composite of:
- All-cause mortality
- Stroke
- Rehospitalization
- Follow-up
- 1 year
Main finding
As reported in the abstract
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause mortality · 1 year | adjusted HR 4.07 (95% CI 2.26–7.33) | P < 0.001 | |
| Predictor of midframe underexpansion: absence of postdilatation · only independent predictor | adjusted OR 5.76 (95% CI 2.60–12.77) | P < 0.001 | |
| 0.050.21520Ratio (log scale) |
Midframe underexpansion incidence
- Midframe underexpansion identified (84 of 604)
- 13.9%
Predictor of midframe underexpansion: absence of postdilatation
- Postdilatation significantly decreased the rate and extent of midframe underexpansion
Original publication
Clinical Impact of Midframe Underexpansion Following TAVR Using a Self-Expanding Transcatheter Heart Valve. JACC Cardiovasc Interv. Published 28 April 2025. doi:10.1016/j.jcin.2025.02.013
Summarised from the published abstract; every number is checked against it