Current Status of Surgical Treatment for Aortic Valve Stenosis

Wollersheim, Laurens W.; Li, Wilson W.; Mol, Bas A.J.M. de

doi:10.1111/jocs.12384

Cited by 6 publications

(5 citation statements)

References 85 publications

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“…The only definitive treatment for severe aortic valve disease is aortic valve replacement (AVR), which is performed by replacing the dysfunctional aortic valve by a either a mechanical heart valve or a bioprosthetic tissue valve [ 1 ]. Mechanical valves are made of pyrolytic carbon, have a bileaflet design and are designed to last a lifetime, but the effect of mechanical aortic valve replacement (mAVR) on progressive aortic dilatation is disputed [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Bileaflet mechanical aortic valves do not alter ascending aortic wall shear stress

Farag

Schade

Ooij

et al. 2019

Int J Cardiovasc Imaging

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Progressive ascending aortic dilatation has been observed after mechanical aortic valve replacement (mAVR), possibly due to altered blood flow and wall shear stress (WSS) patterns induced by their bileaflet design. We examined the effect of mAVR on WSS in the ascending aorta using time-resolved 4D flow MRI. Fifteen patients with mechanical aortic valve prostheses, 10 patients with bicuspid aortic valve disease and 10 healthy individuals underwent thoracic 4D flow MRI. Peak systolic hemodynamic parameters (velocity and WSS) and vessel diameters were assessed in the ascending aorta. In addition, three-dimensional per-voxel analysis was used to compare velocity and WSS between patient groups and healthy controls. Peak aortic diameters were significantly higher in mAVR and BAV patients compared to healthy controls (p = 0.011). Mean aortic diameters were comparable between mAVR and BAV patients. No differences in 4D flow MRI-derived mean blood flow velocity and peak WSS were found between the three groups. Compared to healthy controls, mean WSS was significantly lower in mAVR patients (p = 0.031). Per-voxel analysis revealed no increased WSS in the ascending aortic wall and significantly lower velocity and WSS values in mAVR patients compared to healthy controls. In contrast, regions of significantly increased outer lumen velocities and WSS in BAV patients compared to healthy controls were found. This study shows that there is no increased ascending aortic WSS after mAVR. Our results suggest that, in contrast to BAV patients, there is no indication for intensified follow-up of the ascending aorta after mAVR.

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Section: Introductionmentioning

confidence: 99%

Bileaflet mechanical aortic valves do not alter ascending aortic wall shear stress

Farag

Schade

Ooij

et al. 2019

Int J Cardiovasc Imaging

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“…This field of surgery demands very precise alignment of the heart valve with the aortic annulus, as the occurrence of patient prosthesis mismatch results in early and long-term leakages [18]. In addition, a rotational mismatch between the prosthesis and aortic root might result in the blockage of side coronary arteries [39]. Possibly, other equipment or dedicated sensors could be necessary for even more accurate positioning.…”

Section: Discussionmentioning

confidence: 99%

Semiautonomous Robotic Manipulator for Minimally Invasive Aortic Valve Replacement

Tamadon,

Sadati,

Mamone

et al. 2023

IEEE Trans. Robot.

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Aortic valve surgery is the preferred procedure for replacing a damaged valve with an artificial one. The ValveTech robotic platform comprises a flexible articulated manipulator and surgical interface supporting the effective delivery of an artificial valve by teleoperation and endoscopic vision. This article presents our recent work on force-perceptive, safe, semiautonomous navigation of the ValveTech platform prior to valve implantation. First, we present a force observer that transfers forces from the manipulator body and tip to a haptic interface. Second, we demonstrate how hybrid forward/inverse mechanics, together with endoscopic visual servoing, lead to autonomous valve positioning. Benchtop experiments and an artificial phantom quantify the performance of the developed robot controller and navigator. Valves can be autonomously delivered with a 2.0±0.5 mm position error and a minimal misalignment of 3.4±0.9°. The hybrid force/shape observer (FSO) algorithm was able to predict distributed external forces on the articulated manipulator body with an average error of 0.09 N. FSO can also estimate loads on the tip with an average accuracy of 3.3%. The presented system can lead to better patient care, delivery outcome, and surgeon comfort during aortic valve surgery, without requiring sensorization of the robot tip, and therefore obviating miniaturization constraints.

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“…Видеоторакоскопия используется для лигирования открытого артериального протока. В последнее вре-мя пока только в западной печати появились работы по ее использованию для протезирования клапанов сердца [40][41][42][43][44].…”

Section: Introductionunclassified

20-year history of thoracic surgery in Russian Federation

Порханов¹

2017

PKiK

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<p>The article demonstrates thoracic surgery advances in Russia for the last 20 years. The main patterns of thoracic diagnosis for chest pathologies are described. The directions of open thoracic surgery development over the above period are defined, with focus on the challenges waiting to be met. The state-of-the art and perspectives for videothoracoscopic surgery are overviewed. Possible directions for new scientific and clinical avenues of Russian thoracic surgery are outlined: reconstructive surgery, transplantology and bioengineering technologies. Also analyzed are the changes in continuous training of thoracic surgeons.</p><p>Received 5 August 2017. Accepted 21 August 2017.</p>

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Current Status of Surgical Treatment for Aortic Valve Stenosis

Cited by 6 publications

References 85 publications

Bileaflet mechanical aortic valves do not alter ascending aortic wall shear stress

Bileaflet mechanical aortic valves do not alter ascending aortic wall shear stress

Semiautonomous Robotic Manipulator for Minimally Invasive Aortic Valve Replacement

20-year history of thoracic surgery in Russian Federation

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