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Objectives: The PROGRESS PVL registry evaluated transcatheter aortic valve implantation (TAVI) in patients treated with ACURATE neo, a supra-annular self-expanding bioprosthetic aortic valve.Background: While clinical outcomes with TAVI are comparable with those achieved with surgery, residual aortic regurgitation (AR) and paravalvular leak (PVL) are common complications. The ACURATE neo valve has a pericardial sealing skirt designed to minimize PVL.Methods: The primary endpoint was the rate of total AR over time, as assessed by a core echocardiographic laboratory. The study enrolled 500 patients (mean age: 81.8 ± 5.1 years; 61% female; mean baseline STS score: 6.0 ± 4.5%) from 22 centers in Europe and Canada; 498 patients were treated with ACURATE neo.Results: The rate of ≥ moderate AR was 4.6% at discharge and 3.1% at 12 months; the rate of ≥ moderate PVL was 4.6% at discharge and 2.6% at 12 months. Paired analyses showed significant improvement in overall PVL between discharge and 12 months (P < 0.001); 64.6% of patients had no change in PVL grade, 24.9% improved, and 10.5% worsened. Patients also exhibited significant improvement in transvalvular gradient (P < 0.001) and effective orifice area (P=0.01). The mortality rate was 2.2% at 30 days and 11.3% at 12 months. The permanent pacemaker implantation (PPI) rate was 10.2% at 30 days and 12.2% at 12 months.Conclusions: Results from PROGRESS PVL support the sustained safety and performance of TAVI with the ACURATE neo valve, showing excellent valve hemodynamics, good clinical outcomes, and significant interindividual improvement in PVL from discharge to 12-month follow-up. [ABSTRACT FROM AUTHOR]

This paper presents the modeling, design, fabrication and testing of monolithic electrostatic curved-electrode zipping actuators fabricated by deep reactive ion etching (DRIE). In contrast to traditional curved-electrode zipping actuators, the design of the actuators presented here utilizes a compliant starting cantilever to significantly reduce the initial pull-in voltage by closing the gap (kerf) generated by DRIE. Thus, the actuators achieve high actuation force at a relatively low voltage. For example, two actuators each with dimensions of 4.5 mm * 100 [micro]m * 300 [micro]m are used to drive a bistable MEMS relay. Together, the two actuators provide up to 10 mN of force over their 80 [micro]m stroke at 140 V. Measurements of the force-displacement relation of these actuators confirm theoretical expectations based both on numerical and analytical methods. Finite element analysis is employed to predict the behavior of the complete bistable relay system. Index Terms--Curved-electrode, deep-reactive ion-etched (DRIE), electrostatic, zipping actuator.

The characteristics of the electric double layer formed at a negatively charged metal electrode in contact with pure water are explored in this article. Based on the electric field distribution of the Modified Poisson Boltzmann (MPB) model, which contains the activity corrections only, the study evaluates the effects of finite ion size, polarization, image potential and field dissociation on the distribution of the hydronium ion concentration.