A bench study of balloon-expandable valves for the treatment of self-expanding valve failure.

Details

Serval ID
serval:BIB_EF395AD7E839
Type
Article: article from journal or magazin.
Collection
Publications
Title
A bench study of balloon-expandable valves for the treatment of self-expanding valve failure.
Journal
EuroIntervention
Author(s)
Akodad M., Meier D., Sellers S., de Backer O., Mylotte D., Landes U., Frawley C., Lynch L., Tang GHL, Sondergaard L., Wood D.A., Webb J.G., Sathananthan J.
ISSN
1969-6213 (Electronic)
ISSN-L
1774-024X
Publication state
Published
Issued date
15/05/2023
Peer-reviewed
Oui
Volume
19
Number
1
Pages
93-102
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Coronary obstruction and access are concerns in patients undergoing redo transcatheter aortic valve implantation (TAVI).
We sought to assess the neoskirt height, leaflet overhang, leaflet deflection,and transcatheter heart valve (THV) expansion and performance, at 2 different implant depths, of the SAPIEN 3 Ultra (S3U) within the ACURATE neo2 (ACn2) THV.
An in vitro study was performed with a 23 mm S3U deployed within a small (S) ACn2 and a 26 mm S3U deployed within a medium (M) and a large (L) ACn2. The S3U outflow was positioned at the top of the ACn2 crown (low implant) and at the base of the commissural post of the ACn2 (high implant). Testing was performed under physiological conditions as per ISO-5840-3 standard.
The neoskirt height was shorter when the S3U outflow was positioned at a low implantation depth (S: 9.6 mm, M: 12.2 mm, L: 13.8 mm vs S: 15.2 mm, M: 15.1 mm, L: 17.8 mm ACn2 for high implants). Hydrodynamic performance was acceptable for all configurations. Leaflet overhang was <50% for all configurations except the low implant of the 26 mm S3U in the L ACn2 (77.6%). There was a gap from the side of the neoskirt to the outer border of the THV frame which was >2 mm for all configurations. The S3U was underexpanded for all configurations, and the achieved area was 77.9%-92.9% of the expected nominal area.
Redo TAVI with an S3U within an ACn2 has favourable hydrodynamics and moderate leaflet overhang. Importantly, the design of the ACn2 results in a neoskirt that is not deflected all the way to the outer dimensions of the THV, hence creating a space that facilitates coronary flow and access.
Keywords
Humans, Transcatheter Aortic Valve Replacement, Heart Valve Prosthesis, Aortic Valve/diagnostic imaging, Aortic Valve/surgery, Catheters, Prosthesis Design, Treatment Outcome, Aortic Valve Stenosis/surgery
Pubmed
Web of science
Create date
17/01/2025 5:45
Last modification date
24/02/2025 11:47
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