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A bench test study of bioprosthetic valve fracture performed before versus after transcatheter valve-in-valve intervention: Insights from bench testing

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  1. A novel supra-annular plane to predict TAVI prosthesis anchoring in raphe-type bicuspid aortic valve disease: the LIRA plane

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  2. Myocardial damage after ST-segment elevation myocardial infarction by use of bivalirudin or heparin: a DANAMI-3 substudy

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  3. Feasibility and safety of transcaval transcatheter aortic valve implantation: a multicentre European registry

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  4. Impact of implant depth on hydrodynamic function of the ALLEGRA bioprosthesis in valve-in-valve interventions

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  1. Early and late risk of ischemic stroke after TAVR as compared to a nationwide background population

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. A novel supra-annular plane to predict TAVI prosthesis anchoring in raphe-type bicuspid aortic valve disease: the LIRA plane

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Cardiovascular complications in patients with total cavopulmonary connection: A nationwide cohort study

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  4. Intravascular iliac artery lithotripsy to enable transfemoral thoracic endovascular aortic repair

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  5. Feasibility and safety of transcaval transcatheter aortic valve implantation: a multicentre European registry

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Janarthanan Sathananthan
  • Rob Fraser
  • Hoda Hatoum
  • Aaron M Barlow
  • Viktória Stanová
  • Keith B Allen
  • Adnan K Chhatriwalla
  • Régis Rieu
  • Philippe Pibarot
  • Lakshmi Prasad Dasi
  • Lars Søndergaard
  • David A Wood
  • John G Webb
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AIMS: Bioprosthetic valve fracture (BVF) may improve transvalvular gradients and transcatheter heart valve (THV) expansion during VIV interventions. However, the optimal timing of BVF is unknown. We assessed the impact of timing of BVF (before versus after) for valve-in-valve (VIV) intervention, on hydrodynamic function and THV expansion.

METHODS AND RESULTS: Three THV designs were assessed, a 23 mm SAPIEN 3 (S3), small ACURATE neo (ACn) and 23 mm Evolut R, deployed into 21 mm Mitroflow bioprosthetic surgical valves. We evaluated each THV in three groups: 1) no BVF, 2) BVF before VIV, and 3) BVF after VIV. Hydrodynamic testing was performed using a pulse duplicator to ISO 5840:2013 standard. Transvalvular gradients were lower when BVF was performed after VIV for the S3 (no BVF 15.5 mmHg, BVF before VIV 8.0 mmHg, BVF after VIV 5.6 mmHg), and the ACn (no BVF 9.8 mmHg, BVF before VIV 8.4 mmHg, BVF after VIV 5.1 mmHg). Transvalvular gradients were similar for the Evolut R, irrespective of performance of BVF or timing of BVF. BVF performed after VIV resulted in better expansion in all three THV designs. The ACn and Evolut R samples all had a mild degree of pinwheeling, and BVF timing did not impact on pinwheeling severity. The S3 samples had severe pinwheeling with no BVF, and significant improvement in pinwheeling when BVF was performed after VIV.

CONCLUSIONS: BVF performed after VIV was associated with superior THV expansion in all three THV designs tested, with lower residual transvalvular gradients in the S3 and ACn THVs. The Evolut R had similar hydrodynamic performance irrespective of BVF timing. Timing of BVF has potential implications on THV function.

Original languageEnglish
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume15
Issue number16
Pages (from-to)1409-1416
Number of pages8
ISSN1774-024X
DOIs
Publication statusPublished - 20 Mar 2020

    Research areas

  • Aortic Valve Stenosis/physiopathology, Aortic Valve/physiopathology, Bioprosthesis, Fluoroscopy, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/adverse effects, Hemodynamics, Humans, Prosthesis Design, Time Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome

ID: 59144270