Transcatheter Aortic Valve Replacement: Game-Changing Innovation for Patients with Aortic Stenosis

Harjai, Kishore J.; Paradis, Jean‐Michel; Kodali, Susheel

doi:10.1146/annurev-med-010813-102251

Cited by 4 publications

References 50 publications

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The Effect of Valve-in-Valve Implantation Height on Sinus Flow

et al. 2016

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Valve-in-valve transcatheter aortic valve replacement (VIV-TAVR) has proven to be a successful treatment for high risk patients with failing aortic surgical bioprostheses. However, thrombus formation on the leaflets of the valve has emerged as a major issue in such procedures, posing a risk of restenosis, thromboembolism, and reduced durability. In this work we attempted to understand the effect of deployment position of the transcatheter heart valve (THV) on the spatio-temporal flow field within the sinus in VIV-TAVR. Experiments were performed in an in vitro pulsatile left heart simulator using high-speed Particle Image Velocimetry (PIV) to measure the flow field in the sinus region. The time-resolved velocity data was used to understand the qualitative and quantitative flow patterns. In addition, a particle tracking technique was used to evaluate relative thrombosis risk via sinus washout. The velocity data demonstrate that implantation position directly affects sinus flow patterns, leading to increased flow stagnation with increasing deployment height. The particle tracking simulations showed that implantation position directly affected washout time, with the highest implantation resulting in the least washout. These results clearly demonstrate the flow pattern and flow stagnation in the sinus is sensitive to THV position. It is, therefore, important for the interventional cardiologist and cardiac surgeon to consider how deployment position could impact flow stagnation during VIV-TAVR.

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The Effect of Valve-in-Valve Implantation Height on Sinus Flow

et al. 2016

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How Can We Help a Patient With a Small Failing Bioprosthesis?

Midha

Raghav

Condado

et al. 2015

JACC: Cardiovascular Interventions

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Valve Type, Size, and Deployment Location Affect Hemodynamics in an In Vitro Valve-in-Valve Model

Midha

Raghav

Condado

et al. 2016

JACC: Cardiovascular Interventions

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The optimal deployment location for VIV in a 23 PERIMOUNT surgical bioprosthesis was at a +6 mm supra-annular position for a 23-mm SAPIEN valve and at the normal position for both the 23-mm and 26-mm CoreValves. The 26-mm CoreValve had lower gradients, but higher RF and PI than the 23-mm CoreValve and the 23-mm SAPIEN. In their optimal positions, all valves resulted in hemodynamics consistent with the definitions of Valve Academic Research Consortium-2 procedural success. Long-term studies are needed to understand the clinical impact of these hemodynamic performance differences in patients who undergo VIV transcatheter aortic valve replacement.

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Transcatheter Aortic Valve Replacement: Game-Changing Innovation for Patients with Aortic Stenosis

Cited by 4 publications

References 50 publications

The Effect of Valve-in-Valve Implantation Height on Sinus Flow

The Effect of Valve-in-Valve Implantation Height on Sinus Flow

How Can We Help a Patient With a Small Failing Bioprosthesis?

Valve Type, Size, and Deployment Location Affect Hemodynamics in an In Vitro Valve-in-Valve Model

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