Repeat transcatheter aortic valve implantation and implications for transcatheter heart valve performance: Insights from bench testing
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Background: THV implantation within failed surgical valves is well established. However, the implications of THV implantation within failed THVs are poorly understood. Aims: This study aimed to assess the impact of different transcatheter heart valve (THV) designs and implant positioning strategies on hydrodynamic performance after redo transcatheter aortic valve implantation (TAVI). Methods: THVs of varying design (SAPIEN 3, Evolut PRO, ACURATE neo, ALLEGRA, and Portico) and size were implanted inside SAPIEN XT and Evolut R THVs. Hydrodynamic function as per International Organization for Standardization (ISO) specifications was evaluated using a pulse duplicator, and multimodality imaging was performed. Results: The majority of tested THV-in-THV combinations resulted in stable anchoring of the new implant. However, some combinations resulted in unstable anchoring with the potential for dislodgement or embolisation. Hydrodynamic function was favourable for all tested THV designs implanted in the intraannular SAPIEN XT THV. SAPIEN 3 implantation within an Evolut THV with supra-annular leaflets must be appropriately sized to ensure adequate anchoring. Avoidance of an intra-annular deployment mitigated leaflet overhang of the Evolut leaflets and optimised hydrodynamic performance. Conclusions: This study demonstrates that most THV designs and implantation strategies can result in favourable hydrodynamic performance following redo TAVI. Whether the leaflets of a failed THV are intraor supra-annular may have important implications for the positioning of a redo-THV implant. Certain THV designs or implantation positions may be more desirable when performing redo TAVI.
Originalsprog | Engelsk |
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Tidsskrift | EuroIntervention |
Vol/bind | 17 |
Udgave nummer | 10 |
Sider (fra-til) | 856-864 |
Antal sider | 9 |
ISSN | 1774-024X |
DOI | |
Status | Udgivet - 2021 |
Bibliografisk note
Funding Information:
which no direct compensation is received. P. Blanke is a consultant to Abbott, Neovasc and Circle Cardiovascular Imaging. D. Frank is a consultant to Edwards Lifesciences and Medtronic and has received research funding from Edwards Lifesciences. J.G. Webb is a consultant to, and has received research funding from, Edwards Lifesciences, Abbott, and ViVitro Labs.
Funding Information:
J. Sathananthan is a consultant to Edwards Lifesciences and Medtronic. L. Søndergaard has received consultant fees and institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and Symetis. D. Wood is a consultant to, and has received research funding from, Edwards Lifesciences and Abbott. The other authors have no conflicts of interest to declare.
Publisher Copyright:
© Europa Digital & Publishing 2021.
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