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Rigshospitalet - a part of Copenhagen University Hospital
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Overexpansion of older generation balloon expandable transcatheter heart valves: An ex-vivo bench study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Implications of hydrodynamic testing to guide sizing of self-expanding transcatheter heart valves for valve-in-valve procedures

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  3. Vascular function in adults with cyanotic congenital heart disease

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  4. Implications of hydrodynamic testing to guide sizing of self-expanding transcatheter heart valves for valve-in-valve procedures

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Performance of the TRUE dilatation balloon valvuloplasty catheter beyond rated burst pressure: A bench study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Janarthanan Sathananthan
  • Stephanie Sellers
  • Aaron Barlow
  • Mark Hensey
  • Uri Landes
  • Anson Cheung
  • Jian Ye
  • Abdullah Alkhodair
  • Philipp Blanke
  • Lars Søndergaard
  • Phillippe Pibarot
  • David Wood
  • Jonathan Leipsic
  • John Webb
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BACKGROUND: The SAPIEN 3 (S3) transcatheter heart valve (THV) can be over-expanded beyond its labeled diameter. Overexpansion can be achieved with use of either a compliant or non-compliant balloon. Objective data regarding the ability to over-expand older generation balloon expandable valves are limited. We sought to assess the effects of over-expanding the SAPIEN and SAPIEN XT (Edwards Lifesciences, Irvine, CA) valve beyond labeled size (diameter) through an ex-vivo bench study.

METHODS AND RESULTS: We assessed SAPIEN and SAPIEN XT THVs, sized 23/26 mm and 23/26/29 mm, respectively. The SAPIEN THVs were explanted samples. Valves were expanded to nominal dimensions, and then incrementally overexpanded with balloons sized 1-, 2-, and 3-mm larger than the recommended diameter. When an appropriate sized non-compliant balloon was not available, a compliant balloon was utilized. Valves underwent visual and radiographic assessment of overexpansion. SAPIEN THVs with labeled size of 23 and 26 mm could be incrementally overexpanded to midvalve (MV) diameters of 26.7 and 27.4 mm, respectively. SAPIENT XT THVs with labeled size of 23, 26, and 29 mm could be incrementally overexpanded to MV diameters of 26.8, 28.3, and 28.8 mm, respectively. The desired degree of overexpansion was only achieved with use of non-compliant balloons and not with compliant balloons. The outflow of the SAPIEN and SAPIEN XT had larger diameters than the MV and inflow of the THV.

CONCLUSION: Overexpansion of older generation SAPIEN and SAPIEN XT THVs is possible. Achieving the desired degree of overexpansion was only achieved with use of non-compliant balloons. This has potential implications for the treatment of failed THVs.

Original languageEnglish
JournalCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Volume94
Issue number6
Pages (from-to)806-811
Number of pages6
ISSN1522-1946
DOIs
Publication statusPublished - 15 Nov 2019

ID: 59141928