Dual source computed tomography based analysis of stent performance, its association with valvular calcification and residual aortic regurgitation after implantation of a balloon-expandable transcatheter heart valve

Abstract

The SAPIEN ® /SAPIEN XT ® prostheses achieved good degrees of stent expansion and circularity regardless of the morphology of the landing zone. Increased stent ovality was associated with an elevated risk for aortic regurgitation. The total calcification volume, degree of annular ovality and stent expansion were not associated with residual AR.

Hemodynamic and Imaging Assessment of Transcatheter Aortic Valve Replacement with the Inovare® Proseal using Multislice Computed Tomography

“…One study has found that the SAPIEN has a mean expansion index of 104.1%, compared to 94% (outflow) found in our study [14] . Another study, however, has shown an expansion index of only 84%, substantially inferior to our findings [15] .This variability may be due to different sizing protocols, and also due to differences in the prevalence of bicuspid valve between studies.…”

“…The same finding has been published by other authors [14] . The eccentricity of the device may be correlated to the degree of PVL [15,17] . New mechanisms of leak prevention, such as polytetrafluoroethylene (PTFE) skirts and embolization coils, may, alongside objectively reducing PVL by occupying small empty spaces of malapposition, avoid that structural deformities stemming from imperfect circularity cause such leaks.…”