Cutting precision in a novel aortic valve resection tool. Research in progress☆☆☆

Wendt, Daniel; Stühle, Sebastian; Wendt, H; Thielmann, Matthias; Kipfmüller, Brigitte; Hauck, Florian; Vögel, Bernd; Jakob, Heinz

doi:10.1510/icvts.2009.211102

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…This innovative concept of collection/isolation chamber provides a safe tool for easily resecting the aortic valve. In comparison with the isolation chambers proposed by other authors, [11][12][13][14] based essentially on double balloon occlusion, our system provides better sealing of the aortic valve, with no risk for coronary ostia damage or occlusion. Furthermore, a balloon-based technology is easily damaged during the deployment or the resection procedure.…”

Section: Discussionmentioning

confidence: 89%

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Native Aortic Valve Resection Using a Novel Blade-Based Device

Navarra,

Bollen,

Zito

et al. 2024

Innovations�(Phila)

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Objective: The aim of this study was to validate the use of a new resection device in patient candidates for surgical aortic valve replacement. We evaluated the efficacy of this new circular blade to resect the aortic valve and the efficacy to collect the debris during the resection. Methods: For this study, a single size instrument was used, with an external diameter of 22 mm, and patients were selected on the basis of the preoperative assessment of the aortic diameters. Results: From October 2018 to June 2019, 10 patient candidates for surgical aortic valve replacement were selected to undergo native aortic valve resection using a new device, before surgical valve implantation. The mean age of the patients was 74 ± 7.6 years, and 8 of 10 were male. The mean aortic annulus diameter, measured before the procedure, was 25.7 ± 1.57 mm. The resection was complete in 9 (90%) patients. In 1 patient, due to an imprecise positioning of the device, the valve resection was partial. None of the patients showed signs or symptoms due to debris embolism. In all patients, the postoperative course was uneventful. Conclusions: These preliminary results show that resection of the aortic valve using a circular foldable blade is feasible. This prototype, used during conventional surgery even through a small incision, provided an efficient tool to easily resect the valve without debris release.

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Section: Discussionmentioning

confidence: 89%

“…[1][2][3][4][5][6][7][8][9] To avoid those complications, some authors speculate the necessity for resecting and removing the native aortic valve before transcatheter aortic valve implantation (TAVI). [10][11][12][13][14]…”

Section: Introductionmentioning

confidence: 99%

Native Aortic Valve Resection Using a Novel Blade-Based Device

Navarra,

Bollen,

Zito

et al. 2024

Innovations�(Phila)

View full text Add to dashboard Cite

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“…In contrast, we used human assembled calcified valves and observed with our mechanical resection tool slightly more annular lesions. This might be due to the faster one punch resection method of our group compared to the linear motor ablation and motion controller used by Wendt and coworkers (21).…”

Section: Discussionmentioning

confidence: 92%

Transcatheter aortic valve resection: new mechanical devices

Dai¹,

Lutter²,

Frank³

et al. 2020

J Thorac Dis

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Background: To improve periprocedural outcomes of transcatheter aortic valve implantation (TAVI), transcatheter mechanical resection devices were tested for prior ablation of the aortic cusps.Methods: Three mechanical transcatheter resection devices were tested in a series of native porcine (n=30) and reassembled calcified human valves (n=54). The resection time, the resected valve area, the number of released cusps, and the degree of surrounding tissue damage were measured. Afterwards, postmortem transapical-transcatheter-resections of the aortic valve in two humans were performed.Results: In the native porcine hearts, the Aesculap II device demonstrated significantly shorter resection time compared to the R&R II and the Randstad devices (6.5±2.0 vs. 28.6±24.1 vs. 23.3±14.4 sec; P=0.001).However, it created more lesions in the surrounding tissue (P=0.002). The R&R II achieved a smaller number of resected cusps than the other two devices (2.7±0.7 vs. 1.1±0.7 vs. 2.4±0.5; P<0.001, respectively).It also resected a smaller area of the aortic valve (306.5±149.2 vs. 106.7±29.6 vs. 256.8±81.3 mm2; P=0.09) but a larger mean area of the resected fragments (110.3±41.5 vs. 160.7±29.6 vs. 111.5±43.9 mm2; P=0.01).The resection of the reassembled human valves demonstrated the same results between the devices regarding resection time (P=0.001) and resected area (P=0.016), but not fragment sizes (P=0.610). Finally, transapical-transcatheter-resection of aortic valve was performed in two cadavers.Conclusions: Transcatheter aortic valve resection is feasible with variable aortic leaflet resection times and mild risk of lesions of the surrounding tissue.

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“…Although these astonishing technologies have rapidly emerged throughout the world, new developments and innovative surgical approaches, like sutureless aortic valves, are coming up for conventional surgery. 5,6 These surgical alternative options may be potentially incorporated into routine AVR programs in the foreseeable future as a capable treatment option for mid-or low-risk groups. By the use of sutureless heart valves (SHV) and other innovative tools, 7 a new field in heart surgery with less invasiveness and implantation time may improve outcomes for patients and potential cost reduction.…”

mentioning

confidence: 99%

Fluid Dynamic Investigation of the ATS 3F Enable Sutureless Heart Valve

Stühle

Wendt

Hou

et al. 2011

Innovations�(Phila)

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Objective Currently, sutureless heart valves (SHV) reveal good clinical results during aortic valve replacement. The aim of this study was to evaluate the fluid dynamics of the ATS 3F Enable SHV in the ascending aorta and their influence on the aortic wall in an in vitro setup. Methods A two-dimensional particle image velocimetry study with an image rate of 15 Hz was conducted to evaluate the fluid dynamics of the SHV in the aortic flow field. The prosthesis (diameter, 23 mm) was placed inside a silicone mock aorta under pulsatile flow conditions. Velocities, vorticity, and strain rate were obtained and calculated with a fixed frequency (70 Hz) at constant stroke volume (70 mL). Results 3F Enable showed a jet flow type profile with a maximum velocity of 1.01 ± 0.13 m/s during peak flow phase (PFP). The jet flow was surrounded by ambilateral vortices with a slightly higher percentage of clockwise than counterclockwise vorticity (377 ± 57/s vs 389 ± 76/s), strain rate (370 ± 79/s for elongation vs — 370 ± 102/s for contraction) was nearly similar. The point-of-interest analysis revealed a higher velocity for bottom compared with upper aortic wall (0.28 ± 0.07 m/s vs 0.31 ± 0.06 m/s, P = 0.024). All values were lower during acceleration and deceleration phase compared with PFP. Conclusions The peak flow of the 3F Enable SHV seems to be little higher compared with native aortic valves, thus simulating nearly physiologic conditions. Vorticity and strain rate are high during PFP and low during other phases and might have an influence on the aortic wall as well.

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Cutting precision in a novel aortic valve resection tool. Research in progress☆☆☆

Cited by 5 publications

References 15 publications

Native Aortic Valve Resection Using a Novel Blade-Based Device

Native Aortic Valve Resection Using a Novel Blade-Based Device

Transcatheter aortic valve resection: new mechanical devices

Fluid Dynamic Investigation of the ATS 3F Enable Sutureless Heart Valve

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