Percutaneous Pulmonary Valve Replacement: 3-Month Evaluation of Self-Expanding Valved Stents

Attmann, Tim; Quaden, René; Jahnke, Thomas; Müller‐Hülsbeck, Stefan; Boening, Andreas; Cremer, Jochen; Lutter, Georg

doi:10.1016/j.athoracsur.2006.01.096

Cited by 30 publications

(18 citation statements)

References 11 publications

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“…displacement (along x and y axes) was applied such that the expanded device diameter would be 20% more than the systolic inner diameter of sinus of the respective device's carotid model. Previous studies have indicated that oversizing the unloaded diameter of such devices by 20% more than vessel wall diameter would provide sufficient fixation force within blood vessels that will prevent migration of the device post-deployment [35,36]. Displacement of struts was stopped once the stretching of the arterial wall was established.…”

Section: Methodsmentioning

confidence: 99%

Fluid Structure Interaction With Contact Surface Methodology for Evaluation of Endovascular Carotid Implants for Drug-Resistant Hypertension Treatment

Peter

Alemu

Xenos

et al. 2012

Journal of Biomechanical Engineering

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Drug-resistant hypertensive patients may be treated by mechanical stimulation of stretch-sensitive baroreceptors located in the sinus of carotid arteries. To evaluate the efficacy of endovascular devices to stretch the carotid sinus such that the induced strain might trigger baroreceptors to increase action potential firing rate and thereby reduce systemic blood pressure, numerical simulations were conducted of devices deployed in subject-specific carotid models. Two models were chosen--a typical physiologic carotid and a diminutive atypical physiologic model representing a clinically worst case scenario--to evaluate the effects of device deployment in normal and extreme cases, respectively. Based on the anatomical dimensions of the carotids, two different device sizes were chosen out of five total device sizes available. A fluid structure interaction (FSI) simulation methodology with contact surface between the device and the arterial wall was implemented for resolving the stresses and strains induced by device deployment. Results indicate that device deployment in the carotid sinus of the physiologic model induces an increase of 2.5% and 7.5% in circumferential and longitudinal wall stretch, respectively, and a maximum of 54% increase in von Mises arterial stress at the sinus wall baroreceptor region. The second device, deployed in the diminutive carotid model, induces an increase of 6% in both circumferential and longitudinal stretch and a 50% maximum increase in von Mises stress at the sinus wall baroreceptor region. Device deployment has a minimal effect on blood-flow patterns, indicating that it does not adversely affect carotid bifurcation hemodynamics in the physiologic model. In the smaller carotid model, deployment of the device lowers wall shear stress at sinus by 16% while accelerating flow entering the external carotid artery branch. Our FSI simulations of carotid arteries with deployed device show that the device induces localized increase in wall stretch at the sinus, suggesting that this will activate baroreceptors and subsequently may control hypertension in drug-resistant hypertensive patients, with no consequential deleterious effects on the carotid sinus hemodynamics.

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Section: Methodsmentioning

confidence: 99%

Fluid Structure Interaction With Contact Surface Methodology for Evaluation of Endovascular Carotid Implants for Drug-Resistant Hypertension Treatment

Peter

Alemu

Xenos

et al. 2012

Journal of Biomechanical Engineering

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“…As the development of hybrid approaches to pulmonary valve implantation are under way, LMT may prove to be a bailout procedure to overcome percutaneous challenges [11,12]. Thus, LMT offers a minimally invasive alternative for the surgical management of pulmonary valve pathologies, including primary interventions and reoperations.…”

Section: Commentmentioning

confidence: 98%

Pulmonary Valve Replacement Through a Left Minithoracotomy: An Alternate Approach

Cheema

Heng

Rehman

2014

The Annals of Thoracic Surgery

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“…Although several reports of other challenging techniques using the two approved valves describe good immediate hemodynamic results, no data on long-term follow-up are available. Therefore, more recent efforts have concentrated on designing a self-expanding system to provide valve competence despite significant dilation of the native RVOT [18,19].…”

Section: Limitation Of Currently Available Devicesmentioning

confidence: 99%

Transcatheter Pulmonary Valve Replacement: The Venus P valve-Current Status

Alkashkari¹,

AlRahimi²,

Albugami³

et al. 2018

jshd

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There is growing appreciation for the long-term adverse impact of right-sided dysfunction of the pulmonary valve in patients with congenital heart disease. Although pulmonary valve stenosis or regurgitation is often tolerated over the short and intermediate terms, the long-term consequences are numerous and include, but are not limited to, right-sided heart failure, arrhythmias, and sudden cardiac death. Surgical right ventricular outflow tract (RVOT) interventions have been performed for many decades as an initial therapy, but comorbidities associated with repeated surgeries are a concern. Transcatheter pulmonary valve replacement is safe, effective, and performed at an increasing number of centers around the world. It offers an alternative to traditional surgical techniques and may potentially alter the decision-making process whereby valvular replacement is performed prior to the development of long-term sequelae of RVOT dysfunction. However, only ~15% of potential patients with RVOT dysfunction are suitable for currently approved implantable valves (i.e., Melody valve from Medtronic and Edwards Sapien valves from Edwards Lifesciences). These two valve systems are designed and approved for patients with a conduit or bioprosthetic valve between the right ventricle and pulmonary artery, and they exclude most patients who undergo transannular patch repair techniques. The Venus P-valve (Venus Medtech, Shanghai, China) is a recently developed self-expanding transcatheter heart valve designed to adapt to a dilated RVOT and in such it provide patients with a percutaneous interventional option after tran-

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Percutaneous Pulmonary Valve Replacement: 3-Month Evaluation of Self-Expanding Valved Stents

Cited by 30 publications

References 11 publications

Fluid Structure Interaction With Contact Surface Methodology for Evaluation of Endovascular Carotid Implants for Drug-Resistant Hypertension Treatment

Fluid Structure Interaction With Contact Surface Methodology for Evaluation of Endovascular Carotid Implants for Drug-Resistant Hypertension Treatment

Pulmonary Valve Replacement Through a Left Minithoracotomy: An Alternate Approach

Transcatheter Pulmonary Valve Replacement: The Venus P valve-Current Status

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