Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.

Details

Serval ID
serval:BIB_84095104F1A2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.
Journal
Circulation. Cardiovascular interventions
Author(s)
Yoon J., Gill H., Jelisejevas J., Lai A., Khan J.M., Payne G.W., Webb J.G., Sathananthan J., Seidman M.A., Meier D., Sellers S.L.
ISSN
1941-7632 (Electronic)
ISSN-L
1941-7640
Publication state
Published
Issued date
12/2024
Peer-reviewed
Oui
Volume
17
Number
12
Pages
e014379
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Transcatheter aortic valve replacement (TAVR) pushes aside the diseased native aortic valve and creates a native neo-sinus bordered by the aortic root wall and the displaced native valve. There are limited data on the progression of native valve disease post-TAVR and no previous analysis of the native neo-sinus.
Native aortic valves and native neo-sinus explants obtained post-TAVR were evaluated histologically (hematoxylin and eosin, Movat pentachrome, and Martius Scarlet Blue stains) and by immunohistochemistry (TGF-β1 [transforming growth factor-beta 1], FAP [fibroblast activation protein], and ALP [alkaline phosphatase]) to assess disease mechanisms.
Native aortic valves were obtained from 20 patients from 0 to 2583 days (7.08 years) post-TAVR. Native leaflets showed persistent calcific aortic stenosis-like disease activity with positivity for ALP and FAP. Native valve remodeling was observed as changes in architecture evident in explants >1.5 years, which was observed as crumpling of the leaflets. Disease activity was also present in native neo-sinuses with transcatheter heart valve implant durations >1 year with positive staining for TGF-β1, FAP, and ALP. Extensive native neo-sinus remodeling occurred with replacement and filling-in of this space with contiguous extracellular matrix, calcific deposits, and microvessels.
Following TAVR, there is ongoing calcific aortic stenosis-like disease with architectural changes to native leaflets and extensive remodeling of the native neo-sinus, evidenced by replacement and contiguous filling-in of the native neo-sinus blood pool space with increasing implant duration. The dynamic nature of these tissues has potential implications for neo-sinus flow, valve degeneration, and re-intervention.
Keywords
Humans, Transcatheter Aortic Valve Replacement/adverse effects, Transcatheter Aortic Valve Replacement/instrumentation, Aortic Valve/surgery, Aortic Valve/pathology, Aortic Valve/physiopathology, Aortic Valve Stenosis/surgery, Aortic Valve Stenosis/physiopathology, Aortic Valve Stenosis/pathology, Aortic Valve Stenosis/diagnostic imaging, Male, Female, Aged, 80 and over, Treatment Outcome, Aged, Time Factors, Calcinosis/surgery, Calcinosis/pathology, Transforming Growth Factor beta1/metabolism, aortic valve, aortic valve stenosis, pathology, sinus of Valsalva, transcatheter aortic valve replacement
Pubmed
Web of science
Create date
20/12/2024 11:46
Last modification date
21/01/2025 7:12
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