Prosthetic Valve Function after Aortic Valve Replacement for Severe Aortic Stenosis by Transcatheter Procedure versus Surgery

Saito, Shunsuke; Sairenchi, Toshimi; Hirota, Shotaro; Niitsuma, Ken; Yokoyama, Shohei; Kanno, Yasuyuki; Kanazawa, Yuta; Tezuka, Masahiro; Takei, Yusuke; Tsuchiya, Go; Konishi, Taisuke; Shibasaki, Ikuko; Ogata, Koji; Monta, Osamu; Tsutsumi, Yasushi; Fukuda, Hirotsugu

doi:10.3390/jcdd9100355

Cited by 2 publications

(1 citation statement)

References 35 publications

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“…Padang et al [19] demonstrated that mild and tract PVL had a lower survival rate (50.9%) compared to no PVL (62.7%) at 5 years. In a recent study, Saito et al [20] showed that mild or greater PVL had significantly lower freedom from events (70 months) compared to trace and no PVL. Additionally, PVL severity has been shown to be related to hemolysis rates [21].…”

Section: Introductionmentioning

confidence: 97%

Mild Paravalvular Leak May Pose an Increased Thrombogenic Risk in Transcatheter Aortic Valve Replacement (TAVR) Patients-Insights from Patient Specific In Vitro and In Silico Studies

et al. 2023

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In recent years, the treatment of aortic stenosis with TAVR has rapidly expanded to younger and lower-risk patients. However, persistent thrombotic events such as stroke and valve thrombosis expose recipients to severe clinical complications that hamper TAVR’s rapid advance. We presented a novel methodology for establishing a link between commonly acceptable mild paravalvular leak (PVL) levels through the device and increased thrombogenic risk. It utilizes in vitro patient-specific TAVR 3D-printed replicas evaluated for hydrodynamic performance. High-resolution µCT scans are used to reconstruct in silico FSI models of these replicas, in which multiple platelet trajectories are studied through the PVL channels to quantify thrombogenicity, showing that those are highly dependent on patient-specific flow conditions within the PVL channels. It demonstrates that platelets have the potential to enter the PVL channels multiple times over successive cardiac cycles, increasing the thrombogenic risk. This cannot be reliably approximated by standard hemodynamic parameters. It highlights the shortcomings of subjectively ranked PVL commonly used in clinical practice by indicating an increased thrombogenic risk in patient cases otherwise classified as mild PVL. It reiterates the need for more rigorous clinical evaluation for properly diagnosing thrombogenic risk in TAVR patients.

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Section: Introductionmentioning

confidence: 97%

Mild Paravalvular Leak May Pose an Increased Thrombogenic Risk in Transcatheter Aortic Valve Replacement (TAVR) Patients-Insights from Patient Specific In Vitro and In Silico Studies

et al. 2023

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Comparison of Sutureless and Sutured Aortic Valve Replacements in Patients with Redo Infective Endocarditis

Baran,

Kayan,

Baran

et al. 2024

Medicina

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Background and Objectives: This study aims to assess the postoperative outcomes and complications of sutureless and sutured aortic valve replacement in patients with infective endocarditis. Materials and Methods: A total of 58 patients who underwent redo aortic valve replacement for bacterial or non-bacterial endocarditis between January 2018 and March 2023 were included in our study. Surgical procedures were performed through a full median sternotomy due to redo cases and to provide optimal access. Demographic characteristics, operative times, postoperative complications and some echocardiographic data were compared. All cases were meticulously evaluated preoperatively by a cardiac team to select the best treatment option. Results: The mean ICU length of stay was significantly shorter in the sutureless valve group at 5.4 ± 3.9 days compared to 7.9 ± 4.1 days in the sutured valve group (p = 0.029). However, the sutureless group had a mean operation time of 164.7 ± 37.3 min, while the sutured group had a mean operation time of 197.7 ± 45.6 min (p = 0.044). Again, the difference in cardiopulmonary bypass times between the two groups was statistically significant (p = 0.039). And again, four (14.2%) patients in the sutureless group underwent reoperation due to bleeding, while eight (26.6%) patients in the sutured group underwent postoperative bleeding control (p = 0.048). Conclusions: Our study suggests that sutureless aortic valve replacement may offer advantages in terms of operative efficiency and postoperative recovery compared to conventional sutured valves, with some significant differences in terms of some complications.

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Prosthetic Valve Function after Aortic Valve Replacement for Severe Aortic Stenosis by Transcatheter Procedure versus Surgery

Cited by 2 publications

References 35 publications

Mild Paravalvular Leak May Pose an Increased Thrombogenic Risk in Transcatheter Aortic Valve Replacement (TAVR) Patients-Insights from Patient Specific In Vitro and In Silico Studies

Mild Paravalvular Leak May Pose an Increased Thrombogenic Risk in Transcatheter Aortic Valve Replacement (TAVR) Patients-Insights from Patient Specific In Vitro and In Silico Studies

Comparison of Sutureless and Sutured Aortic Valve Replacements in Patients with Redo Infective Endocarditis

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