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Tnay TD, Kang L, Mekhail A, Galvin SD. Case Series of Early Structural Valve Deterioration of Trifecta Bioprosthesis - New Zealand Experience. Ann Thorac Cardiovasc Surg 2023; 29:233-240. [PMID: 36935120 PMCID: PMC10587479 DOI: 10.5761/atcs.oa.23-00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/14/2023] [Indexed: 03/19/2023] Open
Abstract
PURPOSE Structural valve deterioration (SVD) remains a limitation on the use of bioprosthetic valves, with patient and valve-related factors contributing to early SVD. The Trifecta valve has been reported to have excellent hemodynamics but studies have highlighted early failure. We present a review and case series at a New Zealand tertiary hospital defining early SVD as failure within 3 years of implant. METHODS A retrospective review from January 2015 to July 2019 included 525 patients undergoing surgical aortic valve replacement with 263 patients receiving an Abbott Trifecta or Trifecta Glide Technology (GT) valve. Our review found an acceptable safety profile for the valve with excellent hemodynamics, with a low mortality, stroke, and permanent pacemaker rate. RESULTS Three patients out of 263 were identified from the study period as having early SVD requiring reintervention within 3 years of valve implantation leading to a 1.14% failure rate. One of the valves that had early SVD was a new generation Trifecta GT. An additional four patients were identified to have valves implanted prior to the study period and had valve failure at greater than 3 years post implantation. Five cases had cusp tears as their mechanism of failure, raising concerns about durability. CONCLUSION The Trifecta valve has an acceptable safety profile and offers good hemodynamics due to the externally mounted leaflets. However, our experience of early SVD and failure is concerning for valve durability. Further comparison to other bioprosthetic valves and longer term follow-up are required to characterize the mechanism of failures.
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Affiliation(s)
- Trevor D Tnay
- Department of Cardiothoracic Surgery, Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand
- Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, St Vincent's Health Australia, Melbourne, Australia
| | - Lily Kang
- Department of Cardiothoracic Surgery, St Vincent's Hospital Melbourne, St Vincent's Health Australia, Melbourne, Australia
| | - Andrew Mekhail
- Department of Cardiothoracic Surgery, Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand
| | - Sean D Galvin
- Department of Cardiothoracic Surgery, Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand
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2
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Kwon MH, Baird CW. Surgical Valve Choices for Pulmonary Valve Replacement. Semin Thorac Cardiovasc Surg 2023; 35:94-104. [PMID: 35139432 DOI: 10.1053/j.semtcvs.2022.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/05/2022] [Accepted: 01/25/2022] [Indexed: 11/11/2022]
Abstract
The range of valve choices available to the cardiac surgeon for placement in the pulmonary position continues to expand. This article will provide a brief compendium of the most clinically relevant among these choices and review the contemporary literature regarding their relative durability as well as risk factors for structural valve deterioration and reintervention. The unique advantages and disadvantages of each of these valve choices will be discussed as they pertain to unique patient-specific factors, including patient size and the anatomy of the right ventricular outflow tract, that inform the choice of one prosthesis over another. Finally, general principles regarding the approach to valve choice, and future directions will be discussed.
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Affiliation(s)
- Michael H Kwon
- Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Christopher W Baird
- Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
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3
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Tnay TD, Shell D, Lui A. Review of bioprosthetic structural valve deterioration: Patient or valve? J Card Surg 2022; 37:5243-5253. [PMID: 36317394 DOI: 10.1111/jocs.17081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 08/22/2022] [Accepted: 09/17/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND With guidelines progressively recommending bioprosthetic aortic valves in younger patients, a greater emphasis is placed on structural valve deterioration (SVD) as an important clinical endpoint for both transcatheter and surgically implanted valves. However, SVD of bioprosthetic valves is a complex entity with varying definitions in the literature and a multifaceted pathogenesis. AIM This review first aims to establish the most updated definitions of SVD as per the literature. We then explore the patient- and valve-related factors that play the greatest roles in facilitating early SVD. METHODS A PubMed literature review was conducted to identify the relevant research in this field within the past two decades. CONCLUSION Increasing rates of obesity and metabolic syndrome pose a significant risk to the longevity of bioprosthetic valves. Additionally, externally mounted valves have proven to sacrifice durability for superior haemodynamics. Bioprosthetic SVD continues to be a multifactorial issue that will require various patient- and valve-related factors to be addressed.
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Affiliation(s)
- Trevor D Tnay
- Department of Cardiothoracic Surgery, St Vincent's Hospital - Melbourne St Vincent's Health Australia, Melbourne, Australia
| | - Daniel Shell
- Department of Cardiothoracic Surgery, St Vincent's Hospital - Melbourne St Vincent's Health Australia, Melbourne, Australia
| | - Adrienne Lui
- Department of Cardiothoracic Surgery, St Vincent's Hospital - Melbourne St Vincent's Health Australia, Melbourne, Australia
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4
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Bui HT, Ishrat A, James SP, Dasi LP. Design consideration of a novel polymeric transcatheter heart valve through computational modeling. J Mech Behav Biomed Mater 2022; 135:105434. [PMID: 36116342 DOI: 10.1016/j.jmbbm.2022.105434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/28/2022] [Indexed: 11/29/2022]
Abstract
Transcatheter heart valve replacement is becoming a more routine procedure, and this is further supported by positive outcomes from studies involving low-risk patients. Nevertheless, the lack of long-term transcatheter heart valve (TAV) durability is still one of the primary concerns. As a result, more research has been focused on improving durability through various methods such as valve design, computational modeling, and material selection. Recent advancements in polymeric valve fabrication showed that linear low-density polyethylene (LLDPE) could be used as leaflet material for transcatheter heart valves. In this paper, a parametric study of computational simulations showed stress distribution on the leaflets of LLDPE-TAV under diastolic load, and the results were used to improve the stent design. The in silico experiment also tested the effect of shock absorbers in terms of valve durability. The results demonstrated that altering specific stent angles can significantly lower peak stress on the leaflets (13.8 vs. 6.07 MPa). Implementing two layers of shock absorbers further reduces the stress value to 4.28 MPa. The pinwheeling index was assessed, which seems to correlate with peak stress. Overall, the parametric study and the computational method can be used to analyze and improve valve durability.
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Affiliation(s)
- Hieu T Bui
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA
| | - Amina Ishrat
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA
| | - Susan P James
- School of Advanced Materials Discovery, Colorado State University, 700 Meridian Ave, Fort Collins, CO, 80523, USA
| | - Lakshmi Prasad Dasi
- Department of Biomedical Engineering, Georgia Institute of Technology, 387 Technology Cir NW, Atlanta, GA, 30313, USA.
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5
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Malvindi PG, Kattach H, Luthra S, Ohri S. Modes of failure of Trifecta aortic valve prosthesis. Interact Cardiovasc Thorac Surg 2022; 35:6554752. [PMID: 35348698 PMCID: PMC9297516 DOI: 10.1093/icvts/ivac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 03/23/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Pietro Giorgio Malvindi
- Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK
| | - Hassan Kattach
- Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK
| | - Suvitesh Luthra
- Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK
- University of Southampton , Southampton, UK
| | - Sunil Ohri
- Wessex Cardiothoracic Centre, Department of Cardiac Surgery, University Hospital Southampton, Southampton, UK
- University of Southampton , Southampton, UK
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Preliminary Results with a Novel expanded Polytetrafluoroethylene-based Pulmonary Valved Conduit. Ann Thorac Surg 2021; 114:2314-2321. [PMID: 34838744 DOI: 10.1016/j.athoracsur.2021.10.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND A novel polymeric pulmonary valved conduit, resistant to calcification and structural valve deterioration, may provide a more durable therapy option for the pediatric population by preventing loss of right ventricular function and increasing freedom from valve-related reintervention and mortality. METHODS This was a prospective, multicenter, single-arm study evaluating safety and performance of an investigational novel ePTFE-based valve. Patients met study inclusion/exclusion criteria, had a signed informed consent, had pre- and post-operative evaluation via transthoracic echocardiography and six-month cardiac magnetic resonance imaging (cMRI). RESULTS Seventeen patients were enrolled from 3 sites. Median age was 12 years (range, 6-17) with 52.9% male. BSA ranged from 0.82 to 1.57 m2. There has been no mortality and 100% freedom from device related reinterventions. Baseline compared to six-month cMRI (in 11 of 16 patients with available data) suggests favorable right ventricular remodeling (RVEDV 123±37 to 94±25 mL/m2) with no significant change in ejection fraction. Through current follow-up, no patient has an RVOT gradient > 20 mmHg, (mean 11.2 ± 4.3 mmHg). No evidence of worsening valvular insufficiency was observed throughout postoperative serial TTE evaluations. No pulmonary regurgitation above baseline (≤ mild) was observed. No patient developed endocarditis. No thrombus or calcification was identified. CONCLUSIONS This preliminary evaluation of a novel ePTFE-based valved conduit suggests promising valve function with no thromboembolic or infectious complications, no valve related reinterventions, no valve-related adverse events or unexpected findings, improved right ventricular volumes, and encouraging hemodynamic performance through current follow-up.
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Della Barbera M, Valente M, Basso C, Pettenazzo E, Thiene G. The pathology of early failure in Mitroflow pericardial valve bioprosthesis (12A/LX). Cardiovasc Pathol 2021; 55:107373. [PMID: 34333132 DOI: 10.1016/j.carpath.2021.107373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Limited mid-term durability of 12A/LX Mitroflow bioprosthesis has been reported. Aim of the study was to ascertain the pathologic substrates and possible mechanisms of structural valve deterioration in explants from animals and humans. METHODS Nine aortic 12A/LX Mitroflow bioprostheses preserved in hypotonic solution and three aortic 12A/LX bioprostheses, preserved in isotonic solution, were explanted from juvenile sheep, mean time from implant 95.66 ± 36.04 days and 132.33 ± 28.88 days from implant respectively. One stented unimplanted 12A/LX Mitroflow preserved in isotonic colution before glutaraldeyde fixation served as control. Ten aortic 12A/LX Mitroflow bioprostheses were explanted from humans because of severe dysfunction: five children, (3 females and 2 males, mean age 14.19 ± 4.77 years, range 11-21), 26 ± 8.24 months from implant and 5 adults (4 females and 1 male, mean age 57.4 ± 19.85 years, range 31-72), 64.4 ± 26.94 months from implant. X-ray, histology, and transmission electron microscopy were carried out as well as spectroscopy for calcium (Ca++) and phosphorus (P) content in human explants. RESULTS Explants, from both animals and humans, showed cusp folding and stiffness, with coarse calcific deposits at gross examination and X-ray. Severe collagen denaturation, plasma insudation and massive calcification, involving both collagen and cell debris, were observed microscopically. Mean Ca++ content of 183.27 ± 62.48 and P content of 94.35 ±33.76 mg/g dry weight was found in children and Ca++ content of 205.49 ± 2.23 and P content of 99.75 ± 0.11 mg/g dry weight in adults. Obstructive fibrous tissue overgrowth was detected in 6 human cases. CONCLUSIONS Collagen denaturation was observed in pericardial Mitroflow 12A/LX bioprosthesis with premature structural valve deterioration. Optimal collagen fixation and preservation as well as phospholipids reduction by removing cell debris, as employed in the novel CROWN PRT Mitroflow bioprosthesis, are expected to solve the flaw and achieve long-term durability.
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Affiliation(s)
- Mila Della Barbera
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiovascular Pathology, University of Padua Medical School, Padua, Italy
| | - Marialuisa Valente
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiovascular Pathology, University of Padua Medical School, Padua, Italy
| | - Cristina Basso
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiovascular Pathology, University of Padua Medical School, Padua, Italy
| | - Elena Pettenazzo
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiovascular Pathology, University of Padua Medical School, Padua, Italy
| | - Gaetano Thiene
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, Cardiovascular Pathology, University of Padua Medical School, Padua, Italy.
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Matsuzaki Y, Wiet MG, Boe BA, Shinoka T. The Real Need for Regenerative Medicine in the Future of Congenital Heart Disease Treatment. Biomedicines 2021; 9:478. [PMID: 33925558 PMCID: PMC8145070 DOI: 10.3390/biomedicines9050478] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/19/2021] [Accepted: 04/24/2021] [Indexed: 11/23/2022] Open
Abstract
Bioabsorbable materials made from polymeric compounds have been used in many fields of regenerative medicine to promote tissue regeneration. These materials replace autologous tissue and, due to their growth potential, make excellent substitutes for cardiovascular applications in the treatment of congenital heart disease. However, there remains a sizable gap between their theoretical advantages and actual clinical application within pediatric cardiovascular surgery. This review will focus on four areas of regenerative medicine in which bioabsorbable materials have the potential to alleviate the burden where current treatment options have been unable to within the field of pediatric cardiovascular surgery. These four areas include tissue-engineered pulmonary valves, tissue-engineered patches, regenerative medicine options for treatment of pulmonary vein stenosis and tissue-engineered vascular grafts. We will discuss the research and development of biocompatible materials reported to date, the evaluation of materials in vitro, and the results of studies that have progressed to clinical trials.
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Affiliation(s)
- Yuichi Matsuzaki
- Center for Regenerative Medicine, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, T2294, Columbus, OH 43205, USA; (Y.M.); (M.G.W.)
| | - Matthew G. Wiet
- Center for Regenerative Medicine, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, T2294, Columbus, OH 43205, USA; (Y.M.); (M.G.W.)
| | - Brian A. Boe
- Department of Cardiology, The Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, T2294, Columbus, OH 43205, USA;
| | - Toshiharu Shinoka
- Center for Regenerative Medicine, The Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, T2294, Columbus, OH 43205, USA; (Y.M.); (M.G.W.)
- Department of Cardiothoracic Surgery, The Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, T2294, Columbus, OH 43205, USA
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9
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Baird CW, Chávez M, Sleeper LA, Borisuk MJ, Bacha EA, Burchill L, Guleserian K, Ilbawi M, Nguyen K, Razzouk A, Shinkawa T, Lu M, Fuller SM. Reintervention rates after bioprosthetic pulmonary valve replacement in patients younger than 30 years of age: A multicenter analysis. J Thorac Cardiovasc Surg 2021; 161:345-362.e2. [DOI: 10.1016/j.jtcvs.2020.06.157] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/23/2022]
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10
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Marro M, Kossar AP, Xue Y, Frasca A, Levy RJ, Ferrari G. Noncalcific Mechanisms of Bioprosthetic Structural Valve Degeneration. J Am Heart Assoc 2021; 10:e018921. [PMID: 33494616 PMCID: PMC7955440 DOI: 10.1161/jaha.120.018921] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Bioprosthetic heart valves (BHVs) largely circumvent the need for long‐term anticoagulation compared with mechanical valves but are increasingly susceptible to deterioration and reduced durability with reoperation rates of ≈10% and 30% at 10 and 15 years, respectively. Structural valve degeneration is a common, unpreventable, and untreatable consequence of BHV implantation and is frequently characterized by leaflet calcification. However, 25% of BHV reoperations attributed to structural valve degeneration occur with minimal leaflet mineralization. This review discusses the noncalcific mechanisms of BHV structural valve degeneration, highlighting the putative roles and pathophysiological relationships between protein infiltration, glycation, oxidative and mechanical stress, and inflammation and the structural consequences for surgical and transcatheter BHVs.
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Affiliation(s)
- Matteo Marro
- Department of Surgery Columbia University New York NY.,Division of Cardiac Surgery, Department of Surgical Sciences Città della Salute e della Scienza di Torino/University of Turin Italy
| | | | - Yingfei Xue
- Department of Surgery Columbia University New York NY
| | | | - Robert J Levy
- Department of Pediatrics The Children's Hospital of Philadelphia PA
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11
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12
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Theologou T, Harky A, Shaw M, Harrington D, Kuduvalli M, Oo A, Field M. Mitroflow and Perimount Magna 10 years outcomes a direct propensity match analysis to assess reintervention rates and long follow‐up mortality. J Card Surg 2019; 34:1279-1287. [DOI: 10.1111/jocs.14250] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Thomas Theologou
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
| | - Amer Harky
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
| | - Matthew Shaw
- Department of Clinical Audit and Clinical QualityThe Liverpool Heart and Chest HospitalLiverpool UK
| | - Deborah Harrington
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
| | - Manoj Kuduvalli
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
| | - Aung Oo
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
| | - Mark Field
- Department of Cardiac SurgeryLiverpool Heart and Chest HospitalLiverpool UK
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13
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Shahanavaz S, Asnes JD, Grohmann J, Qureshi AM, Rome JJ, Tanase D, Crystal MA, Latson LA, Morray BH, Hellenbrand W, Balzer DT, Gewillig M, Love JC, Berdjis F, Gillespie MJ, McElhinney DB. Intentional Fracture of Bioprosthetic Valve Frames in Patients Undergoing Valve-in-Valve Transcatheter Pulmonary Valve Replacement. Circ Cardiovasc Interv 2019; 11:e006453. [PMID: 30354783 DOI: 10.1161/circinterventions.118.006453] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Percutaneous transcatheter pulmonary valve replacement (TPVR) has good clinical and hemodynamic outcomes in treating dysfunctional bioprosthetic valves (BPV) in the pulmonary position. Valve-in-valve therapy can further decrease the inner diameter (ID), potentially resulting in patient-prosthesis mismatch in patients with smaller BPVs. METHODS AND RESULTS To evaluate feasibility and outcomes of intentional BPV fracture to enlarge the pulmonary valve orifice with TPVR, 37 patients from 13 centers who underwent TPVR with intended BPV fracture were evaluated. A control cohort (n=70) who underwent valve-in-valve TPVR without attempted fracture was evaluated. BPV was successfully fractured in 28 patients and stretched in 5 while fracture was unsuccessful in 4. A Melody valve was implanted in 25 patients with fractured/stretched frame and a Sapien (XT 3) valve in 8. Among patients whose BPV was fractured/stretched, the final ID was a median of 2 mm larger (0-6.5 mm) than the valve's true ID. The narrowest diameter after TPVR in controls was a median of 2 mm smaller ( P<0.001) than true ID. Right ventricular outflow tract gradient decreased from median 40 to 8 mm Hg in the fracture group. Cases with fracture/stretching were matched 1:1 (weight, true ID) to controls. Post-TPVR peak gradient was lower but not significant (8.3±5.2 versus 11.8±9.2 mm Hg; P=0.070). There were no fracture-related adverse events. CONCLUSIONS Preliminary experience shows intentional fracture of BPV frame can be useful for achieving larger ID and better hemodynamics after valve-in-valve TPVR.
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Affiliation(s)
- Shabana Shahanavaz
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, MO (S.S., D.T.B.)
| | | | - Jochen Grohmann
- Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Germany (J.G.)
| | - Athar M Qureshi
- The Lillie Frank Abercrombie Section of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston (A.M.Q.)
| | - Jonathan J Rome
- The Children's Hospital of Philadelphia, PA (J.J.R., M.J.G.)
| | - Daniel Tanase
- Department of Paediatric Cardiology and Congenital Heart Defects, German Heart Centre, Munich (D.T.)
| | - Matthew A Crystal
- Division of Pediatric Cardiology, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY (M.A.C.)
| | - Larry A Latson
- Department of Cardiology, Joe DiMaggio Children's Hospital, Hollywood, FL (L.A.L.)
| | - Brian H Morray
- Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine (B.H.M.)
| | | | - David T Balzer
- Division of Cardiology, Department of Pediatrics, Washington University in St. Louis School of Medicine, MO (S.S., D.T.B.)
| | - Marc Gewillig
- Department of Pediatric Cardiology, University Hospitals Leuven, Belgium (M.G.)
| | - Jon C Love
- Division of Pediatric Cardiology, University of New Mexico, Albuquerque (J.C.L.)
| | | | | | - Doff B McElhinney
- Departments of Pediatrics and Cardiothoracic Surgery, Lucile Packard Children's Hospital Heart Center, Stanford University School of Medicine, Palo Alto, CA (D.B.M.)
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14
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Kitahara H, Edelman JJ, Thourani VH. Invited Commentary. Ann Thorac Surg 2019; 109:93. [PMID: 31344345 DOI: 10.1016/j.athoracsur.2019.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/12/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Hiroto Kitahara
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Georgetown University, 110 Irving St, Ste 6D15G, Washington, DC 20010
| | - J James Edelman
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Georgetown University, 110 Irving St, Ste 6D15G, Washington, DC 20010
| | - Vinod H Thourani
- Department of Cardiac Surgery, MedStar Heart and Vascular Institute, Georgetown University, 110 Irving St, Ste 6D15G, Washington, DC 20010.
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15
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Kaneyuki D, Nakajima H, Asakura T, Yoshitake A, Tokunaga C, Tochii M, Hayashi J, Takazawa A, Izumida H, Iguchi A. Early First-Generation Trifecta Valve Failure: A Case Series and a Review of the Literature. Ann Thorac Surg 2019; 109:86-92. [PMID: 31336064 DOI: 10.1016/j.athoracsur.2019.05.073] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 05/16/2019] [Accepted: 05/21/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Trifecta valve (Abbott, St Paul, MN) has excellent hemodynamic performance with acceptable rates of freedom from structural valve degeneration. However, some recent studies have reported early Trifecta valve failure. Here, we report a case series of seven Trifecta valve failures with a review of the literature. METHODS Of 107 implantations of Trifecta bioprostheses between 2012 and 2014, we encountered seven Trifecta valve failures (6.5%). Failure of a 19-mm Trifecta valve occurred in 1 patient, failure of a 21-mm Trifecta valve occurred in 5 patients, and failure of a 23-mm Trifecta valve occurred in 1 patient. The mean duration of valve durability was 51 ± 16 months. The mean effective orifice area index on the first echocardiogram after Trifecta valve implantation was 0.96 ± 0.26. The mode of presentation was prosthetic valve stenosis in 3 patients and severe aortic regurgitation in 4 patients. RESULTS Six patients underwent redo surgical aortic valve replacement. The common pathologic findings were circumferential pannus formation with noncoronary cusp tear and leaflet calcification. The rates of preoperative end-renal stage disease and postoperative prosthesis-patient mismatch were higher in patients with Trifecta valve failure. The incidence of early Trifecta valve failure was 3.1% at 48 months and 13.1% at 72 months. CONCLUSIONS In our experience, early Trifecta valve failure was caused by cusp tears or leaflet calcification. Patients with end-renal stage disease and prosthesis-patient mismatch should be closely followed. Some patients with cusp tears may require urgent surgery.
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Affiliation(s)
- Daisuke Kaneyuki
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan.
| | - Hiroyuki Nakajima
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Toshihisa Asakura
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akihiro Yoshitake
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Chiho Tokunaga
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masato Tochii
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Jun Hayashi
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akitoshi Takazawa
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Hiroaki Izumida
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsushi Iguchi
- Division of Cardiovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
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Michel E, Malaisrie SC. Not All Bioprosthetic Valves Are Created Equal. Semin Thorac Cardiovasc Surg 2019; 31:359-360. [PMID: 30735712 DOI: 10.1053/j.semtcvs.2019.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 02/01/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Eriberto Michel
- Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - S Christopher Malaisrie
- Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Fatima B, Mohananey D, Khan FW, Jobanputra Y, Tummala R, Banerjee K, Krishnaswamy A, Mick S, Tuzcu EM, Blackstone E, Svensson L, Kapadia S. Durability Data for Bioprosthetic Surgical Aortic Valve. JAMA Cardiol 2019; 4:71-80. [DOI: 10.1001/jamacardio.2018.4045] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Benish Fatima
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Divyanshu Mohananey
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Fazal W. Khan
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Yash Jobanputra
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ramyashree Tummala
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kinjal Banerjee
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Amar Krishnaswamy
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Stephanie Mick
- Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - E. Murat Tuzcu
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Eugene Blackstone
- Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Lars Svensson
- Department of Cardiothoracic Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Samir Kapadia
- Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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18
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Ruvolo G, Pisano C, Balistreri CR, Maresi E, Triolo OF, Argano V, Bassano C, Vacirca SR, Nardi P, Orlandi A. Early structural degeneration of Mitroflow aortic valve: another issue in addition to the mismatch? J Thorac Dis 2018; 10:E270-E274. [PMID: 29850167 DOI: 10.21037/jtd.2018.03.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We reported two cases of early structural valve degeneration (SVD) with Mitroflow prosthesis in aortic position in patients above the age of 65 years. Microscopic aspects have been analysed to investigate the intrinsic mechanism of SVD. New techniques to improve the structure and the preservation of this prosthesis are needed in order to reduce potential dangerous early complications.
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Affiliation(s)
- Giovanni Ruvolo
- Cardiac Surgery Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Carmela Rita Balistreri
- Department of Pathobiology and Medical and Forensic Biotechnologies, University of Palermo, Palermo, Italy
| | | | | | | | - Carlo Bassano
- Cardiac Surgery Unit, Tor Vergata University Hospital, Rome, Italy
| | | | - Paolo Nardi
- Cardiac Surgery Unit, Tor Vergata University Hospital, Rome, Italy
| | - Augusto Orlandi
- Anatomic Pathology, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy
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Ahmad T, Ludhani P, Gurvitch R, Goldblatt J, Tatoulis J. Surgical Aortic Valve Replacement Following Early Sapien-XT Valve Failure: A First. Heart Lung Circ 2018; 27:513-516. [DOI: 10.1016/j.hlc.2017.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 03/19/2017] [Accepted: 04/06/2017] [Indexed: 11/15/2022]
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Malvindi PG, Carbone C, Labriola C, Paparella D. Surgical retrieval of a degenerated Sapien 3 valve after 29 months. Interact Cardiovasc Thorac Surg 2017; 25:155-156. [PMID: 28379465 DOI: 10.1093/icvts/ivx057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 02/01/2017] [Indexed: 11/14/2022] Open
Abstract
A 70-year-old man developed heart failure due to severe mixed disease of a degenerated transcatheter aortic valve prosthesis. The patient underwent retrieval of the transcatheter aortic valve and implantation of a 25-mm bioprosthesis through a redo sternotomy.
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Affiliation(s)
- Pietro Giorgio Malvindi
- Department of Cardiovascular Surgery, GVM Care and Research, Santa Maria Hospital, Bari, Italy
| | - Carmine Carbone
- Department of Cardiovascular Surgery, GVM Care and Research, Santa Maria Hospital, Bari, Italy
| | - Cataldo Labriola
- Department of Cardiovascular Surgery, GVM Care and Research, Santa Maria Hospital, Bari, Italy
| | - Domenico Paparella
- Department of Cardiovascular Surgery, GVM Care and Research, Santa Maria Hospital, Bari, Italy.,Department of Emergency and Organ Transplant, University of Bari Aldo Moro, Bari, Italy
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21
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Mariathas M, Rawlins J, Curzen N. Transcatheter aortic valve implantation: where are we now? Future Cardiol 2017; 13:551-566. [DOI: 10.2217/fca-2017-0056] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Transcatheter aortic valve implantation (TAVI) was first used in clinical practice in 2002. Since 2002, there has been a rapid increase in TAVI activity in patients with symptomatic severe aortic stenosis. This has been supported by systematic randomized data comparing TAVI against the gold standard treatment for the last 50 years’ surgical aortic valve replacement. TAVI is now currently a recommended therapeutic intervention in the treatment of severe aortic stenosis patients who are deemed either high risk or inoperable. The indications for TAVI continue to expand. Within this review we will focus on the current guidelines for TAVI, the evidence for it, the complications of TAVI, postprocedure care, the technology available to clinicians now and finally the future perspectives for TAVI.
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Affiliation(s)
- Mark Mariathas
- Coronary Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK
| | - John Rawlins
- Coronary Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
| | - Nick Curzen
- Coronary Research Group, University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD, UK
- Faculty of Medicine, University of Southampton, Southampton, SO16 6YD, UK
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22
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Abstract
PURPOSE OF REVIEW Our review is intended to provide readers with an overview of disease processes involving the pulmonic valve, highlighting recent outcome studies and guideline-based recommendations; with focus on the two most common interventions for treating pulmonic valve disease, balloon pulmonary valvuloplasty and pulmonic valve replacement. RECENT FINDINGS The main long-term sequelae of balloon pulmonary valvuloplasty, the gold standard treatment for pulmonic stenosis, remain pulmonic regurgitation and valvular restenosis. The balloon:annulus ratio is a major contributor to both, with high ratios resulting in greater degrees of regurgitation, and small ratios increasing risk for restenosis. Recent studies suggest that a ratio of approximately 1.2 may provide the most optimal results. Pulmonic valve replacement is currently the procedure of choice for patients with severe pulmonic regurgitation and hemodynamic sequelae or symptoms, yet it remains uncertain how it impacts long-term survival. Transcatheter pulmonic valve replacement is a rapidly evolving field and recent outcome studies suggest short and mid-term results at least equivalent to surgery. The Melody valve® was FDA approved for failing pulmonary surgical conduits in 2010 and for failing bioprosthetic surgical pulmonic valves in 2017 and has been extensively studied, whereas the Sapien XT valve®, offering larger diameters, was approved for failing pulmonary conduits in 2016 and has been less extensively studied. Patients with pulmonic valve disease deserve lifelong surveillance for complications. Transcatheter pulmonic valve replacement is a novel and attractive therapeutic option, but is currently only FDA approved for patients with failing pulmonary conduits or dysfunctional surgical bioprosthetic valves. New advances will undoubtedly increase the utilization of this rapidly expanding technology.
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Lee S, Levy RJ, Christian AJ, Hazen SL, Frick NE, Lai EK, Grau JB, Bavaria JE, Ferrari G. Calcification and Oxidative Modifications Are Associated With Progressive Bioprosthetic Heart Valve Dysfunction. J Am Heart Assoc 2017; 6:JAHA.117.005648. [PMID: 28483776 PMCID: PMC5524104 DOI: 10.1161/jaha.117.005648] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background Bioprosthetic heart valves (BHVs), fabricated from glutaraldehyde‐pretreated bovine pericardium or porcine aortic valves, are widely used for the surgical or interventional treatment of heart valve disease. Reoperation becomes increasingly necessary over time because of BHV dysfunction. Methods and Results Forty‐seven explanted BHV aortic valve replacements were retrieved at reoperation for clinically severe BHV dysfunction over the period 2010–2016. Clinical explant analyses of BHV leaflets for calcium (atomic absorption spectroscopy) and oxidized amino acids, per mass spectroscopy, were primary end points. Comorbidities for earlier BHV explant included diabetes mellitus and coronary artery bypass grafting. Mean calcium levels in BHV leaflets were significantly increased compared with unimplanted BHV (P<0.001); however, time to reoperation did not differ comparing calcified and noncalcified BHV. BHV dityrosine, an oxidized amino acid cross‐link, was significantly increased in the explants (227.55±33.27 μmol/mol [dityrosine/tyrosine]) but was undetectable in unimplanted leaflets (P<0.001). BHV regional analyses revealed that dityrosine, ranging from 57.5 to 227.8 μmol/mol (dityrosine/tyrosine), was detectable only in the midleaflet samples, indicating the site‐specific nature of dityrosine formation. 3‐Chlorotyrosine, an oxidized amino acid formed by myeloperoxidase‐catalyzed chlorinating oxidants, correlated with BHV calcium content in leaflet explant analyses from coronary artery bypass graft patients (r=0.62, P=0.01) but was not significantly correlated with calcification in non–coronary artery bypass graft explanted BHV. Conclusions Both increased BHV leaflet calcium levels and elevated oxidized amino acids were associated with bioprosthesis dysfunction necessitating reoperation; however, BHV calcium levels were not a determinant of implant duration, indicating a potentially important role for oxidized amino acid formation in BHV dysfunction.
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Affiliation(s)
| | | | | | | | | | - Eric K Lai
- University of Pennsylvania, Philadelphia, PA
| | - Juan B Grau
- Ottawa Heart Institute, Ottawa, Ontario, Canada
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Zhu MZL, Newman MA, Joshi P, Passage J. Acute Structural Failure of the Trifecta Aortic Valve Bioprosthesis. Heart Lung Circ 2017; 26:e82-e85. [PMID: 28506647 DOI: 10.1016/j.hlc.2017.03.157] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 01/27/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
Advancements in bioprosthetic valve technology have greatly enhanced the haemodynamic performance and long-term durability of tissue valves. These features, along with the key advantage of avoiding lifelong anticoagulation, have made bioprosthetic valves increasingly attractive for clinicians and patients alike. The St Jude Trifecta valve is a novel, bovine pericardial bioprosthesis with promising early data for performance and safety. However, no prosthetic valve is perfect and prosthesis failure can occur with even the most reliable and well-designed devices. We report a case of early and acute structural deterioration (stent-post leaflet rupture) of the Trifecta valve, explanted after 33 months, in a 76-year-old male.
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Affiliation(s)
- Michael Z L Zhu
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Mark A Newman
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Pragnesh Joshi
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia; School of Medicine, The University of Notre Dame, Fremantle, WA, Australia; The Baird Institute, Sydney, NSW, Australia
| | - Jurgen Passage
- Department of Cardiothoracic Surgery, Sir Charles Gairdner Hospital, Perth, WA, Australia; School of Medicine, The University of Notre Dame, Fremantle, WA, Australia; The Baird Institute, Sydney, NSW, Australia.
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25
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Callahan R, Bergersen L, Baird CW, Porras D, Esch JJ, Lock JE, Marshall AC. Mechanism of valve failure and efficacy of reintervention through catheterization in patients with bioprosthetic valves in the pulmonary position. Ann Pediatr Cardiol 2017; 10:11-17. [PMID: 28163423 PMCID: PMC5241839 DOI: 10.4103/0974-2069.197049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Surgical and transcatheter bioprosthetic valves (BPVs) in the pulmonary position in patients with congenital heart disease may ultimately fail and undergo transcatheter reintervention. Angiographic assessment of the mechanism of BPV failure has not been previously described. AIMS The aim of this study was to determine the mode of BPV failure (stenosis/regurgitation) requiring transcatheter reintervention and to describe the angiographic characteristics of the failed BPVs and report the types and efficacy of reinterventions. MATERIALS AND METHODS This is a retrospective single-center review of consecutive patients who previously underwent pulmonary BPV placement (surgical or transcatheter) and subsequently underwent percutaneous reintervention from 2005 to 2014. RESULTS Fifty-five patients with surgical (41) and transcutaneous pulmonary valve (TPV) (14) implantation of BPVs underwent 66 catheter reinterventions. The surgically implanted valves underwent fifty reinterventions for indications including 16 for stenosis, seven for regurgitation, and 27 for both, predominantly associated with leaflet immobility, calcification, and thickening. Among TPVs, pulmonary stenosis (PS) was the exclusive failure mode, mainly due to loss of stent integrity (10) and endocarditis (4). Following reintervention, there was a reduction of right ventricular outflow tract gradient from 43 ± 16 mmHg to 16 ± 10 mmHg (P < 0.001) and RVp/AO ratio from 0.8 ± 0.2 to 0.5 ± 0.2 (P < 0.001). Reintervention with TPV placement was performed in 45 (82%) patients (34 surgical, 11 transcatheter) with no significant postintervention regurgitation or paravalvular leak. CONCLUSION Failing surgically implanted BPVs demonstrate leaflet calcification, thickness, and immobility leading to PS and/or regurgitation while the mechanism of TPV failure in the short- to mid-term is stenosis, mainly from loss of stent integrity. This can be effectively treated with a catheter-based approach, predominantly with the valve-in-valve technique.
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Affiliation(s)
- Ryan Callahan
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Lisa Bergersen
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Christopher W Baird
- Department of Cardiac Surgery, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Diego Porras
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Jesse J Esch
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - James E Lock
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
| | - Audrey C Marshall
- Department of Cardiology, Harvard Medical School, Boston Children's Hospital, Boston, MA, USA
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26
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Nomoto R, Sleeper LA, Borisuk MJ, Bergerson L, Pigula FA, Emani S, Fynn-Thompson F, Mayer JE, del Nido PJ, Baird CW. Outcome and performance of bioprosthetic pulmonary valve replacement in patients with congenital heart disease. J Thorac Cardiovasc Surg 2016; 152:1333-1342.e3. [DOI: 10.1016/j.jtcvs.2016.06.064] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 06/23/2016] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
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Dysregulation of ossification-related miRNAs in circulating osteogenic progenitor cells obtained from patients with aortic stenosis. Clin Sci (Lond) 2016; 130:1115-24. [PMID: 27129184 PMCID: PMC4876482 DOI: 10.1042/cs20160094] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/13/2016] [Indexed: 11/17/2022]
Abstract
CAVD (calcific aortic valve disease) is the defining feature of AS (aortic stenosis). The present study aimed to determine whether expression of ossification-related miRNAs is related to differentiation intro COPCs (circulating osteogenic progenitor cells) in patients with CAVD. The present study included 46 patients with AS and 46 controls. Twenty-nine patients underwent surgical AVR (aortic valve replacement) and 17 underwent TAVI (transcatheter aortic valve implantation). The number of COPCs was higher in the AS group than in the controls (P<0.01). Levels of miR-30c were higher in the AS group than in the controls (P<0.01), whereas levels of miR-106a, miR-148a, miR-204, miR-211, miR-31 and miR-424 were lower in the AS group than in the controls (P<0.01). The number of COPCs and levels of osteocalcin protein in COPCs were positively correlated with levels of miR-30a and negatively correlated with levels of the remaining miRNAs (all P<0.05). The degree of aortic valve calcification was weakly positively correlated with the number of COPCs and miR-30c levels. The number of COPCs and miR-30c levels were decreased after surgery, whereas levels of the remaining miRNAs were increased (all P<0.05). Changes in these levels were greater after AVR than after TAVI (all P<0.05). In vitro study using cultured peripheral blood mononuclear cells transfected with each ossification-related miRNA showed that these miRNAs controlled levels of osteocalcin protein. In conclusion, dysregulation of ossification-related miRNAs may be related to the differentiation into COPCs and may play a significant role in the pathogenesis of CAVD.
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Nielsen PH, Hjortdal V, Modrau IS, Jensen H, Kimose HH, Terp K, Poulsen SH, Smerup M, Nielsen SL. Durability after aortic valve replacement with the Mitroflow versus the Perimount pericardial bioprosthesis: a single-centre experience in 2393 patients. Eur J Cardiothorac Surg 2016; 49:1705-10. [PMID: 26984983 DOI: 10.1093/ejcts/ezv432] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 11/12/2015] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study compares the durability and risk of reoperation in patients undergoing aortic valve replacement (AVR) with either a Mitroflow or a Carpentier-Edwards (CE) pericardial bioprosthesis. Since AVR with bioprosthetic valves has increased progressively in recent years as compared to mechanical valves, especially in patients aged 60-70 years, there has been renewed interest in the long-term durability of current pericardial bioprostheses. METHODS We compared 440 AVR with Mitroflow valves with 1953 AVR with CE pericardial valves implanted from 1999 to 2014 with regard to reoperation, reoperation for structural valve deterioration (SVD) and all-cause mortality. RESULTS Ten-year freedom from explant of any cause was higher for CE Perimount (98 ± 0.7%) than for Mitroflow (95 ± 1.4%, P < 0.01). Reasons for explant for CE Perimount were SVD (n = 2), endocarditis (n = 8) and paraprosthetic leak (n = 10). The reasons for explant for Mitroflow were SVD (n = 11), endocarditis (n = 3) SVD and pericarditis (n = 1) and paraprosthetic leak (n = 2). Ten-year freedom from explant due to SVD was higher for CE Perimount (100%) than for Mitroflow (96%) (P < 0.01). In small aortic annuli (bioprosthesis size 19-21 mm), freedom from SVD at 10 years for CE Perimount and Mitroflow was 100 versus 96%, respectively. By multivariate analysis, it was found that bioprosthesis size was not a risk factor for SVD. The choice of valve type could not be demonstrated to influence long-term survival. CONCLUSIONS The Mitroflow pericardial bioprosthesis provides less than optimal mid- and long-term durability compared with the CE Perimount pericardial valve, especially for small aortic diameter implants (19 and 21 mm). This study hereby confirms the existence of a real risk of valvular deterioration of the Mitroflow valve that might compromise the prognosis of the patients.
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Affiliation(s)
- Per Hostrup Nielsen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Vibeke Hjortdal
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Ivy Susanne Modrau
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Jensen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Hans-Henrik Kimose
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Kim Terp
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Steen Hvitfelt Poulsen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Smerup
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Sten Lyager Nielsen
- Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
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Early Bioprosthetic Valve Failure: Mechanistic Insights via Correlation between Echocardiographic and Operative Findings. J Am Soc Echocardiogr 2015; 28:1131-48. [DOI: 10.1016/j.echo.2015.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Indexed: 11/22/2022]
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31
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Anantha Narayanan M, Suri RM, Ugur M, Greason KL, Stulak JM, Dearani JA, Joyce LD, Pochettino A, Li Z, Schaff HV. Predictors of Survival and Modes of Failure After Mitroflow Aortic Valve Replacement in 1,003 Adults. Ann Thorac Surg 2015; 100:560-7. [DOI: 10.1016/j.athoracsur.2015.03.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/24/2015] [Accepted: 03/02/2015] [Indexed: 02/04/2023]
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Luk A, Cusimano RJ, Butany J. Pathologic Evaluation of 28 Mitroflow Pericardial Valves: A 12-Year Experience. Ann Thorac Surg 2015; 99:48-54. [DOI: 10.1016/j.athoracsur.2014.07.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/12/2014] [Accepted: 07/15/2014] [Indexed: 10/24/2022]
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Sénage T, Le Tourneau T, Foucher Y, Pattier S, Cueff C, Michel M, Serfaty JM, Mugniot A, Périgaud C, Carton HF, Al Habash O, Baron O, Roussel JC. Early Structural Valve Deterioration of Mitroflow Aortic Bioprosthesis. Circulation 2014; 130:2012-20. [DOI: 10.1161/circulationaha.114.010400] [Citation(s) in RCA: 160] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Thomas Sénage
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Thierry Le Tourneau
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Yohann Foucher
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Sabine Pattier
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Caroline Cueff
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Magali Michel
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Jean-Michel Serfaty
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Antoine Mugniot
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Christian Périgaud
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Hubert François Carton
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Ousama Al Habash
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Olivier Baron
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
| | - Jean Christian Roussel
- From the Department of Thoracic and Cardiovascular Surgery (T.S., S.P., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Institut du Thorax (T.S., T.L.T., S.P., C.C., M.M., A.M., C.P., H.F.C., O.A.H., O.B., J.C.R.), Department of Cardiology (T.L.T., C.C.), and Department of Radiology (J.S.), University Hospital, Nantes, France; Member of Translink European Network (dedicated to structural valve deterioration) (T.S., T.L.T., C.C., J.C.R.); INSERM UMR1087, Nantes, France (T.L.T.); and EA 4275 SPHERE
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Piñón M, Durán D, Pazos P, Pradas G. Leaflet tear in a Trifecta aortic bioprosthesis 34 months after implantation. Interact Cardiovasc Thorac Surg 2014; 20:281-2. [DOI: 10.1093/icvts/ivu384] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Avanzini A, Battini D. Structural analysis of a stented pericardial heart valve with leaflets mounted externally. Proc Inst Mech Eng H 2014; 228:985-95. [PMID: 25252695 DOI: 10.1177/0954411914552309] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our aim was to understand the structural and functional behaviour of a pericardial heart valve with biological leaflets attached externally to a stent. To our knowledge, there is little if any literature concerning these kinds of bioprosthetic heart valves, while there is more concerning bioprosthetic heart valves with leaflets mounted internally. We studied the problem using a finite element approach considering leaflets and stent interaction, the influence of leaflet anisotropy and stent stiffness, by comparing quasi-static and dynamic loadings. Although we considered the problem to be symmetric and fluid-structure interaction was not implemented, we believe that our results could be a solid basis for valve optimization. We found regions of high stress concentration at the commissure near the stent tip and at the base of the leaflet cusp. The structural behaviour in the first region was complex, while the stress in the second region acted radially because of high bending. Although leaflet tissue anisotropy and stent stiffness exerted a significant influence on the structural and functional behaviours, they had a contrasting effect on leaflet stress state, coaptation and valve opening. Therefore, a good optimization should take into account both structural and functional requirements when tuning tissue properties and stent stiffness.
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Affiliation(s)
- Andrea Avanzini
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
| | - Davide Battini
- Department of Mechanical and Industrial Engineering, University of Brescia, Brescia, Italy
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Saleeb SF, Newburger JW, Geva T, Baird CW, Gauvreau K, Padera RF, del Nido PJ, Borisuk MJ, Sanders SP, Mayer JE. Accelerated Degeneration of a Bovine Pericardial Bioprosthetic Aortic Valve in Children and Young Adults. Circulation 2014; 130:51-60. [DOI: 10.1161/circulationaha.114.009835] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Susan F. Saleeb
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Jane W. Newburger
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Tal Geva
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Christopher W. Baird
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Kimberlee Gauvreau
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Robert F. Padera
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Pedro J. del Nido
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Michele J. Borisuk
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - Stephen P. Sanders
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
| | - John E. Mayer
- From the Departments of Cardiology (S.F.S., J.W.N., T.G., K.G., S.P.S.) and Cardiac Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), Boston Children’s Hospital, Boston, MA; Departments of Pediatrics (S.F.S., J.W.N., T.G., K.G., S.P.S.), Surgery (C.W.B., P.J.d.N., M.J.B., J.E.M.), and Pathology (R.F.P.), Harvard Medical School, Boston, MA; and Department of Pathology, Brigham and Women’s Hospital, Boston, MA (R.F.P)
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Joshi V, Prosser K, Richens D. Early prosthetic valve degeneration with Mitroflow aortic valves: determination of incidence and risk factors. Interact Cardiovasc Thorac Surg 2014; 19:36-40. [DOI: 10.1093/icvts/ivu033] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rahimtoola SH. The year in valvular heart disease. J Am Coll Cardiol 2013; 61:1290-1301. [PMID: 23500330 DOI: 10.1016/j.jacc.2012.12.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 11/28/2012] [Accepted: 12/04/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Shahbudin H Rahimtoola
- Griffith Center, Division of Cardiovascular Medicine, Department of Medicine, LAC+USC Medical Center, Keck School of Medicine at University of Southern California, Los Angeles, CA 90033, USA.
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Singhal P, Luk A, Butany J. Bioprosthetic Heart Valves: Impact of Implantation on Biomaterials. ACTA ACUST UNITED AC 2013. [DOI: 10.5402/2013/728791] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Prosthetic heart valves are commonly used in the treatment of valvular heart disease. Mechanical valves are more durable than the bioprosthetic valves; however, the need for long-term anticoagulant therapy renders them unsuitable for some patient groups. In this paper we discuss the different types and models of bioprosthesis, and in particular, pericardial bioprosthesis. We also discuss the preimplantation preparation processes, as well as their postimplantation changes and modes of failure.
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Affiliation(s)
- Pooja Singhal
- Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4
| | - Adriana Luk
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jagdish Butany
- Department of Pathology, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
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Lazar HL. The year in review: the surgical treatment of valvular disease-2011. J Card Surg 2012; 27:493-510. [PMID: 22784204 DOI: 10.1111/j.1540-8191.2012.01494.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This review highlights important advances in techniques, guidelines, outcomes and innovations in valve surgery during 2011.
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Affiliation(s)
- Harold L Lazar
- Department of Cardiothoracic Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA.
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Invited commentary. Ann Thorac Surg 2011; 92:1627-8. [PMID: 22051258 DOI: 10.1016/j.athoracsur.2011.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2011] [Revised: 08/08/2011] [Accepted: 08/11/2011] [Indexed: 11/20/2022]
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