Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
September 9, 2026 · via Europe PMC
In-Vivo Frame Dynamicity of Self-Expanding Transcatheter Aortic Valves.
Calì M, Sammartino S, Rosa L, +10 more, Costa G.
AI summary — for doctors, generated from the abstract only
This imaging study found that self-expanding transcatheter aortic valves subtly change shape throughout the cardiac cycle, with the degree of this dynamic expansion varying by specific valve design; the long-term clinical significance of this finding is not yet known.
What was studied
A substudy of the RE-ACCESS 2 study involving 83 of 127 eligible patients who underwent transcatheter aortic valve replacement (TAVR) with self-expanding valve platforms (Evolut or Acurate Neo2), using post-procedure four-dimensional CT to measure valve frame dimensions at three anatomical levels during systolic and diastolic phases of the cardiac cycle.
Key findings
- Stent frame expansion across the cardiac cycle was observed at the native virtual basal ring (median perimeter variability 0.30 mm) and bioprosthetic leaflets plane (0.25 mm) levels, but not at the inflow level (-0.05 mm).
- Acurate Neo2 valves showed greater dynamic variability than Evolut valves at both the virtual basal ring (0.50 mm vs 0.10 mm, p=0.02) and bioprosthetic leaflets plane (0.60 mm vs 0.20 mm, p=0.05).
- The study included 49 Evolut and 34 Acurate Neo2 valve recipients among the 83 analyzed patients.
Clinical relevance
This suggests self-expanding transcatheter aortic valves exhibit measurable dynamic behavior during the cardiac cycle that differs by valve design, which could have implications for long-term valve durability, but the authors explicitly state whether this affects long-term outcomes remains to be determined.
Who should care
Limitations
This is an imaging substudy with a moderate sample size (83 patients) and no long-term durability outcome data; the clinical significance of the measured frame dynamicity is not yet established, as stated by the authors themselves.
Different brands of self-expanding replacement heart valves flex slightly differently with each heartbeat, but whether this affects how long the valves last is still unknown.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Due to nitinol stent properties, self-expanding transcatheter heart valves (THVs) have the potential to adapt their frames to native annular dimension excursions during the cardiac cycle and therefore to maintain the physiological relevance of this behaviour.
Aims
To assess the in-vivo variations of THV frame dimensions during the cardiac cycle.
Methods
Patients undergoing transcatheter aortic valve replacement (TAVR) with self-expanding THV platforms enrolled in the RE-ACCESS 2 study were considered. Patients with post-TAVR four-dimensional computed tomography (4-D CT) assessment not eligible for stent frame analysis were excluded from the analysis. The THV frame dimensions were assessed at three levels: inflow edge, native virtual basal ring (VBR) and bioprosthetic leaflets plane (BLP). Measurements were performed in systolic (30° of the cardiac cycle) and diastolic (70° of the cardiac cycle) phase acquisitions for each patient. Stent expansion was reported as the difference among systolic and diastolic measurements.
Results
Among a total of 127 patients, 83 patients were considered eligible for the present analysis. Forty-nine and 34 patients received Evolut and Acurate Neo2 THV, respectively. Stent frame expansion across the cardiac cycle was encountered at VBR (median perimeter variability 0.30 mm) and BLP (median perimeter variability 0.25 mm) levels, but not at the inflow level (median perimeter variability -0.05 mm). Acurate Neo2 had greater variability compared to Evolut THVs (VBR median perimeter variability 0.50 mm vs. 0.10 mm, p = 0.02; BLP median perimeter variability 0.60 mm vs. 0.20 mm, p = 0.05).
Conclusions
Self-expanding THVs exhibited dynamic behavior throughout the cardiac cycle, with stent expansion during systole at both VBR and BLP levels. Stent design influenced this dynamicity, as Acurate Neo2 had greater stent variability compared to Evolut THV. Whether these features affect long-term THV durability remains to be determined.
DOI
10.1002/ccd.70855
PMID
42713912
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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