Fluoroscopic Guide to an Ideal Implant Position for Sapien XT and CoreValve During a Valve-in-Valve Procedure

Bapat, Vinayak; Attia, Rizwan; Condemi, Fortunata; Visagan, Ravi; Guthrie, Maya; Sunni, Shelina; Thomas, Martyn

doi:10.1016/j.jcin.2013.05.020

Cited by 40 publications

(29 citation statements)

References 14 publications

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“…The CoreValve was chosen to be placed sub-annularly with respect to the BPV annulus. This valve combination and TAV placement location also compare well with published recommendations for valve-in-valve implantation (18,19). …”

Section: Methodssupporting

confidence: 80%

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Hatoum

Moore

Maureira

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Objective Valve in valve (ViV) procedures using transcatheter aortic valves (TAV) are increasingly performed to treat degenerated bioprosthetic surgical aortic valves (SAV) due to being less invasive than redo aortic valve replacement. The objective of this study is to quantify the changes in aortic sinus blood flow dynamics before and after ViV to gain insight into mechanisms for clinical and sub-clinical thrombosis of leaflets. Methods A detailed description of the sinus hemodynamics for ViV implantation was performed in-vitro. A Medtronic Hancock II porcine bioprosthesis was modeled as SAV and a Medtronic CoreValve and Edwards Sapien were used as the TAVs. High-resolution particle image velocimetry (PIV) was employed to compare the flow patterns from these two valves within both the left coronary and non-coronary sinuses in vitro. Results Velocity and vorticity within the surgical valve sinuses reached peak values of 0.7 m/s and 1000 s−1, with a 70% decrease in peak fluid shear stress near the aortic side of the leaflet in the non-coronary sinus. With the introduction of TAV, peak velocity and vorticity were reduced to around 0.4 m/s and 550 s−1 and 0.58 m/s and 653 s−1 without coronary flow and 0.60 m/s and 631 s−1 and 0.81 m/s and 669 s−1 with coronary flow for CoreValve and Sapien ViV respectively. Also, peak shear stress was around 38% higher along the aortic side of the coronary vs non-coronary TAV leaflet. Conclusions Decreased flow and shear stress in ViV indicates higher risk of leaflet thrombosis secondary to flow stasis in the non-coronary sinus.

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Section: Methodssupporting

confidence: 80%

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Hatoum

Moore

Maureira

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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show abstract

“…The range of annulus size for TAVR suggests that not all patients will achieve complete TAV expansion to the manufactured size, and some degree of incomplete stent expansion may exist. Incomplete stent expansion has been commonly observed flowing TAVR with Medtronic CoreValve in native calcified aortic valves, and flowing TAVR with Edwards SAPIEN valve within degenerated stented bioprostheses, the valvein-valve procedure (Bapat et al, 2013;Jilaihawi et al, 2011;Schultz et al, 2009;Willson et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Leaflet stress and strain distributions following incomplete transcatheter aortic valve expansion

Abbasi

Azadani

2015

Journal of Biomechanics

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“…Guidance with respect to the technical aspects of the procedure is found in several manuscripts [1,[6][7][8][9][10][11] and a widely used smartphone and tablet app [12]. The radiographic appearance, sizing for transcatheter valve selection, and procedural tips are described for a variety of different surgical bioprosthetic valve types.…”

Section: To the Editormentioning

confidence: 99%

Fluoroscopic characterization of surgical bioprosthetic heart valves

Kiefer

Halim

Wang

et al. 2015

Cathet Cardio Intervent

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Fluoroscopic Guide to an Ideal Implant Position for Sapien XT and CoreValve During a Valve-in-Valve Procedure

Abstract: To achieve an optimal result when considering VIV, it is important to be familiar with the structure and fluoroscopic appearances of the failed SHV, the THV used, and their combination.

Cited by 40 publications

References 14 publications

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Aortic sinus flow stasis likely in valve-in-valve transcatheter aortic valve implantation

Leaflet stress and strain distributions following incomplete transcatheter aortic valve expansion

Fluoroscopic characterization of surgical bioprosthetic heart valves

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