Effect of Eccentric Calcification of an Aortic Valve on the Implant Depth of a Venus-A Prosthesis During Transcatheter Aortic Valve Replacement: A Retrospective Study

Li, Lanlan; Liu, Yang; Park, Jin; Tang, Jiayou; Lu, Linhe; Zhu, Guangyu; Xu, Chun; Ma, Yanyan

doi:10.3389/fphys.2021.718065

Cited by 3 publications

(3 citation statements)

References 34 publications

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“…A large prosthesis was also supposed to shorten the distance between the AML and the implanted valve frame owing to its wide bottom in the LVOT. Moreover, we noticed that the difference of calcification volume at NCC was statistically significant between the groups, the reason remains speculative, but a possible explanation is that the distribution of eccentric calcification in the aortic valve facilitate deeper implantation (25).…”

Section: Discussionmentioning

confidence: 90%

Interference between Venus-A Valve and Anterior Mitral Valve Leaflets after Transcatheter Aortic Valve Replacement: Insight from FEops HEARTguide simulation

Wang

Liu

Zhang

et al. 2023

Preprint

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Background Scarce data exist regarding the occurrence of mitral valve interference after transcatheter aortic valve replacement (TAVR) with Venus-A valve implantation. Several case reports have noted that the anterior mitral leaflet (AML) is mechanically affected by the prosthesis frame, particularly when implanted in a low position. This study aimed to investigate the potential factors influencing the clinical outcomes of AML interference after Venus-A valve implantation. Methods We retrospectively included 20 severe aortic valve stenosis patients who had undergone TAVR and had been implanted with the Venus-A valve at our hospital between October 2020 and June 2021. Pre- and post-procedural CT scans were used for the FEops HEARTguide simulation. Anatomically influencing factors were measured using the 3mensio software and derived from the FEops HEARTguide. The prosthesis-AML interference (PAI) was defined when it met both of two criteria:1) significant interference and limited AML movement shown by transthoracic or transoesophageal echocardiography, and 2) more than half cell intersection between the simulated Venus-A valve and the reconstructed AML revealed by the FEops HEARTguide. Anatomical factors and clinical outcomes were compared between the PAI and non-PAI groups. Results Nine PAI patients and 11 non-PAI cases were identified. PAI was associated with shorter mitral-aortic annulus distance (2.7{plus minus}1.7 mm vs 5.0{plus minus}2.2 mm, P = 0.019), larger prosthesis valve size (P = 0.013), deeper implantation (12.2{plus minus}3.3 mm vs 6.2{plus minus}2.9 mm at non-coronary cusp side, P < 0.001) and less calcification of non-coronary cusp (median calcification score, 52.2 mm3 vs 156.0 mm3, P = 0.046). Regarding the clinical impact, PAI was associated with a higher rate of moderate or severe perivalvular leakage before discharge than those associated with the absence of PAI, with no difference in haemodynamic parameters and incidence of adverse events at the 30-day and 12-month follow-ups between the groups. Conclusions Interference between the Venus-A prosthesis valve and AML after TAVR was associated with a shorter mitral-aortic annulus distance, larger prosthesis usage, greater implantation depth, and less calcification of the non-coronary cusp. However, further studies are required to explore its long-term clinical impact.

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Section: Discussionmentioning

confidence: 90%

Interference between Venus-A Valve and Anterior Mitral Valve Leaflets after Transcatheter Aortic Valve Replacement: Insight from FEops HEARTguide simulation

Wang

Liu

Zhang

et al. 2023

Preprint

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“…All transcatheter aortic valve replacement procedures were performed with the patients under general anesthesia in the hybrid catheterization laboratory, and the preprocedural work-ups were completed according to institutional guidelines ( 15 ). CTA data were used for the accurate assessment of native aortic valve anatomy.…”

Section: Methodsmentioning

confidence: 99%

“…The procedure was performed via a transfemoral approach. The procedural details of TAVR with the self-expandable devices have been described previously ( 15 , 18 ). Balloon predilatation is a routine procedure for patients with severe AS.…”

Section: Methodsmentioning

confidence: 99%

Transcatheter aortic valve replacement in patients with quadricuspid aortic valve in a single center

Liu

Zhai

et al. 2022

Front. Cardiovasc. Med.

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BackgroundQuadricuspid aortic valve (QAV) is a rare congenital malformation that can present with aortic regurgitation or aortic stenosis (AS)), requiring surgical treatment. Transcatheter aortic valve replacement (TAVR) is an alternative treatment for older patients and its prognosis for QAV therapy remains challenging. We sought to examine our early experience with TAVR in patients with QAV.Materials and methodsProspectively collected data were retrospectively reviewed in patients with QAV undergoing TAVR in our institution.ResultsFive patients with QAV and AR or AS were treated with TAVR between January 2016 and January 2022. The mean age was 73.8 years (range 69–82 years), and the median Society of Thoracic Surgeons score was 7.51% (range 2.668–18.138%). Two patients had type B and three had either type A, D, or F according to the Hurwitz and Roberts classification for QAV. Four patients with pure aortic regurgitation underwent transapical TAVR using the J-Valve system, and the patient with severe AS underwent transfemoral TAVR using the Venus-A system. Procedural success was achieved in all five patients. Trivial paravalvular leak was only detected in one case after the procedure, and one patient received a permanent pacemaker due to high-degree atrioventricular block three days later. The median follow-up period was 18 (12–56) months. After discharge, no deaths occurred during the 1 year follow-up. All patients improved by ≥1 New York Heart Association functional class at 30 days; four patients were in functional class ≤II later in the follow-up period. All patients’ heart failure symptoms improved considerably.ConclusionOur early experience with TAVR in QAV demonstrates these procedures to be feasible with acceptable early results. Further follow-up is necessary to determine the long-term outcomes of this modality.Clinical trial registration[ClinicalTrials.gov], identifier [NCT02917980].

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Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement

Mao,

Liu,

et al. 2024

Open Medicine

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In the study of TAVR, 3-dimensional (3D) printed aortic root models and pulsatile simulators were used for simulation training and teaching before procedures. The study was carried out in the following three parts: (1) experts were selected and equally divided into the 3D-printed simulation group and the non-3D-printed simulation group to conduct four times of TAVR, respectively; (2) another 10 experts and 10 young proceduralists were selected to accomplish three times of TAVR simulations; (3) overall, all the doctors were organized to complete a specific questionnaire, to evaluate the training and teaching effect of 3D printed simulations. For the 3D-printed simulation group, six proceduralists had a less crossing-valve time (8.3 ± 2.1 min vs 11.8 ± 2.7 min, P < 0.001) and total operation time (102.7 ± 15.3 min vs 137.7 ± 15.4 min, P < 0.001). In addition, the results showed that the median crossing-valve time and the total time required were significantly reduced in both the expert group and the young proceduralist group (all P<0.001). The results of the questionnaire showed that 3D-printed simulation training could enhance the understanding of anatomical structure and improve technical skills. Overall, cardiovascular 3D printing may play an important role in assisting TAVR, which can shorten the operation time and reduce potential complications.

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Effect of Eccentric Calcification of an Aortic Valve on the Implant Depth of a Venus-A Prosthesis During Transcatheter Aortic Valve Replacement: A Retrospective Study

Cited by 3 publications

References 34 publications

Interference between Venus-A Valve and Anterior Mitral Valve Leaflets after Transcatheter Aortic Valve Replacement: Insight from FEops HEARTguide simulation

Interference between Venus-A Valve and Anterior Mitral Valve Leaflets after Transcatheter Aortic Valve Replacement: Insight from FEops HEARTguide simulation

Transcatheter aortic valve replacement in patients with quadricuspid aortic valve in a single center

Feasibility of 3-dimensional printed models in simulated training and teaching of transcatheter aortic valve replacement

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