Structural Valve Deterioration after Transcatheter Aortic Valve Implantation Using J-Valve: A Long-Term Follow-Up

Abstract

Purpose: Our study aimed to investigate the structural valve deterioration (SVD) after transcatheter aortic valve implantation (TAVI) using J-Valve. Methods: In all, 14 patients with aortic stenosis (AS) and 4 patients with pure aortic regurgitation (PAR) were available in the study. Four-year follow-up was performed in all patients, and the clinical data and echocardiographic findings were recorded and analyzed. Results: All patients survived at the 4-year follow-up. There was no evidence of morphological SVD or prosthetic valve thrombosis in enrolled patients. None of the hemodynamic SVD occurred in patients with PAR. Mean gradients decreased from 61.93 ± 15.42 mm Hg (pre-TAVI) to 19.64 ± 9.16 mm Hg (discharge) in patients with AS (p <0.001); subsequently, a slight increase was observed in the mean trans-aortic gradient throughout follow-up (p = 0.967). Overall, in patients with AS, six individuals suffered moderate (3/14, 21.4%) or severe (3/14, 21.4%) hemodynamic SVD at 4-year follow-up. Conclusions: The limited number of cases provides a preliminary indication of the longterm efficacy of TAVI using J-Valve in patients with PAR. In patients with AS, although the higher rate of SVD was observed, the overall transcatheter heart valve (THV) hemodynamics remained stable over time after prosthetic valve implantation and the longterm durability of J-Valve was convincing.

Comparison of Procedural and 1-Year Clinical Results of Transcatheter Aortic Valve Implantation Using Prostheses with Different Design of Support Frame

“…In the previous study, 20) we reported the long-term outcome of patients who underwent TAVI with J-Valve, and a convincing long-term outcome (4-year follow-up) was observed in these patients. Although the higher transaortic pressure gradient (!20 mmHg) was observed in 43% of patients, none of them suffered AS-related symp-toms or underwent redo TAVI or evolved to death.…”

“…In our previous study, 20) the possible reasons why J-Valve had a higher transaortic pressure gradient after TAVI were analyzed. We speculated that its frame design may be a possible reason because THV is not fully expanded after implantation ( Figure 5), which implies that its support frame cannot exert enough radial force on the calcified aortic valve.…”

Transapical mitral valve-in-valve implantation for failed bioprosthetic valve using the J-valve system with locator device: early and mid-term outcomes

“…The J-valve mainly includes five models: 21, 23, 25, 27, and 29 mm. At present, the J-valve has shown advantages in the application of non-calcified aortic regurgitation in several clinical studies (14)(15)(16)(17). In 2017, the China Food and Drug Administration (CFDA) approved the J-valve system for transcatheter aortic valve implantation with aortic stenosis and/or regurgitation.…”

Artificial Intelligence-Based Spiral CT 3D Reconstruction in Transcatheter Aortic Valve Implantation

“…In addition, the diameter of the aortic valve ring should be obtained through imaging examination before TAVI treatment and the appropriate valve type should be selected according to the examination results. Inappropriate valve type and size will lead to pathological changes of surrounding annulus and aortic regurgitation, which will seriously affect the prognosis of patients [ 29 , 30 ]. In this research, a 3D CT reconstruction model based on DCNN was proposed based on artificial intelligence and MBIR reconstruction model was introduced.…”