The Effects of Transcatheter Valve Crimping on Pericardial Leaflets

Alavi, S. Hamed; Groves, Elliott M.; Kheradvar, Arash

doi:10.1016/j.athoracsur.2013.11.009

Cited by 123 publications

(88 citation statements)

References 22 publications

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“…The biological origin of the material cannot mask the feature of the material, single leather For Khoffi and Heim, the degradation of the tissue was aggravated in small diameter valves (19 and 21 mm) with a loss of mechanical characteristics of up to 50% [25]. Coupling sophisticated morphological examination (scanning electron microscopy and second harmonic generation microscopy) and mechanical measurements, Alavi et al were meritorious in focusing on crimping only [26]. Damages were observed on the flow surface with all crimping sizes and the deeper layers of the pericardium were affected more extensively in the 14F than in the 16F and 18F sizes.…”

Section: Injuries At Crimping and Deployment That Cannot Be Repaired mentioning

confidence: 99%

Transcatheter Heart Valve Crimping and Expansion: Commentary

Guidoin¹,

Mao²,

Zegdi³

et al. 2017

J Med Surg Pathol

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Bovine pericardium represents the material of choice to serve as leaflets but this material is fragile and mishandling might lead to dramatic consequences. The complete innocuousness of handling at implantation has not been reached as crimping and balloon inflation cause various degrees of injury. These can impair the physical characteristics and aggravate the thrombogenicity. The design of the device must promote the long-term durability of the pericardium. The role and selection of polyester fabrics as buffer between the metallic frame and the pericardium is likely to prevent major abrasion at implantation and in situ.

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Section: Injuries At Crimping and Deployment That Cannot Be Repaired mentioning

confidence: 99%

Transcatheter Heart Valve Crimping and Expansion: Commentary

Guidoin¹,

Mao²,

Zegdi³

et al. 2017

J Med Surg Pathol

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“…A recent study by Alavi et al showed that the aggressively crimped leaflets are severely damaged, suggesting either the leaflets should be placed outside the stent during crimping or they should not be aggressively compacted. 1 This study also recommends that the ambition for lower profile devices should be tempered to avoid leaflets damage. 1 …”

Section: Limitations and Challengesmentioning

confidence: 99%

“…1 This study also recommends that the ambition for lower profile devices should be tempered to avoid leaflets damage. 1 …”

Section: Limitations and Challengesmentioning

confidence: 99%

“…Furthermore, there are few recent quantitative data that evaluates leaflets in-jury due to crimping. 1,3,20,24,49,93 It has been shown that mechanical stresses affecting pericardial leaflets can cause disruption of collagen fiber orientation, 1 that may lead to calcification and possible early valve failure. 49,74,93 What effects this damage may have on the durability of transcatheter valves compared to surgical bioprosthetic valves is not yet known.…”

Section: Limitations and Challengesmentioning

confidence: 99%

“…49,74,93 What effects this damage may have on the durability of transcatheter valves compared to surgical bioprosthetic valves is not yet known. 1,84 The success of transcatheter technology would suggest that TAVR will see expanded indications in lower risk patients. As a result, leaflet durability will be of increased concern.…”

Section: Limitations and Challengesmentioning

confidence: 99%

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Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement

et al. 2014

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Abstract-The engineering of technologies for heart valve replacement (i.e., heart valve engineering) is an exciting and evolving field. Since the first valve replacement, technology has progressed by leaps and bounds. Innovations emerge frequently and supply patients and physicians with new, increasingly efficacious and less invasive treatment options. As much as any other field in medicine the treatment of heart valve disease has experienced a renaissance in the last 10 years. Here we review the currently available technologies and future options in the surgical and transcatheter treatment of aortic valve disease. Different valves from major manufacturers are described in details with their applications.

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Risk factors for infective endocarditis following transcatheter pulmonary valve replacement in patients with congenital heart disease

Sadeghi¹,

Wadia²,

Lluri³

et al. 2019

Cathet Cardio Intervent

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Objectives We sought to delineate the risk factors for infective endocarditis (IE) in patients undergoing transcatheter pulmonary valve replacement (TCPVR). Background Despite the therapeutic benefits of TCPVR for treatment of dysfunctional right ventricular outflow tracts, IE is a major complication of the approach. Specific hemodynamic gradients and patient immune status as predisposing factors for IE are largely unexplored. Methods We performed a retrospective review of patients who had undergone TCPVR at UCLA between October 2010 and October 2017. Cases of IE were diagnosed based on the modified Duke criteria. Results Two hundred and thirty‐five cases of TCPVR were performed with a mean follow‐up of 2.6 years (range 0.0–8.0 years). Sixteen distinct IE events developed in 13 patients (Melody™ n = 12, SAPIEN n = 1), with a median time from implant to IE of 3.3 years (range 2.0–7.2 years). Univariate Cox regression showed that immunocompromised status was significantly associated with the development of IE hazard ratios (HR 5.43 [1.80–16.4], p = .003). Kaplan–Meier curves show that the 5‐year freedom from IE among immunocompetent patients was 87% (95% CI 78–96%) versus 64% (95% CI 39–89%) among immunocompromised patients (log‐rank p = .02). Postimplant right ventricular systolic pressure was higher among immunocompromised patients (p = .03). The risk of IE post‐TCPVR in immunocompromised patients with residual pulmonary stenosis was 43%. Conclusions Among the risk factors examined in this study, immunocompromised status was the most significant predictor of IE development post‐TCPVR. Patients with the lowest risk of IE are those with competent immune systems, without a history of IE, and with minimal residual pulmonary valve gradients post‐TCPVR.

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The Effects of Transcatheter Valve Crimping on Pericardial Leaflets

Cited by 123 publications

References 22 publications

Transcatheter Heart Valve Crimping and Expansion: Commentary

Transcatheter Heart Valve Crimping and Expansion: Commentary

Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement

Risk factors for infective endocarditis following transcatheter pulmonary valve replacement in patients with congenital heart disease

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