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Grubb KJ, Lisko JC, O'Hair D, Merhi W, Forrest JK, Mahoney P, Van Mieghem NM, Windecker S, Yakubov SJ, Williams MR, Chetcuti SJ, Deeb GM, Kleiman NS, Althouse AD, Reardon MJ. Reinterventions After CoreValve/Evolut Transcatheter or Surgical Aortic Valve Replacement for Treatment of Severe Aortic Stenosis. JACC Cardiovasc Interv 2024; 17:1007-1016. [PMID: 38573257 DOI: 10.1016/j.jcin.2024.01.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 12/26/2023] [Accepted: 01/20/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Data on valve reintervention after transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) are limited. OBJECTIVES The authors compared the 5-year incidence of valve reintervention after self-expanding CoreValve/Evolut TAVR vs SAVR. METHODS Pooled data from CoreValve and Evolut R/PRO (Medtronic) randomized trials and single-arm studies encompassed 5,925 TAVR (4,478 CoreValve and 1,447 Evolut R/PRO) and 1,832 SAVR patients. Reinterventions were categorized by indication, timing, and treatment. The cumulative incidence of reintervention was compared between TAVR vs SAVR, Evolut vs CoreValve, and Evolut vs SAVR. RESULTS There were 99 reinterventions (80 TAVR and 19 SAVR). The cumulative incidence of reintervention through 5 years was higher with TAVR vs SAVR (2.2% vs 1.5%; P = 0.017), with differences observed early (≤1 year; adjusted subdistribution HR: 3.50; 95% CI: 1.53-8.02) but not from >1 to 5 years (adjusted subdistribution HR: 1.05; 95% CI: 0.48-2.28). The most common reason for reintervention was paravalvular regurgitation after TAVR and endocarditis after SAVR. Evolut had a significantly lower incidence of reintervention than CoreValve (0.9% vs 1.6%; P = 0.006) at 5 years with differences observed early (adjusted subdistribution HR: 0.30; 95% CI: 0.12-0.73) but not from >1 to 5 years (adjusted subdistribution HR: 0.61; 95% CI: 0.21-1.74). The 5-year incidence of reintervention was similar for Evolut vs SAVR (0.9% vs 1.5%; P = 0.41). CONCLUSIONS A low incidence of reintervention was observed for CoreValve/Evolut R/PRO and SAVR through 5 years. Reintervention occurred most often at ≤1 year for TAVR and >1 year for SAVR. Most early reinterventions were with the first-generation CoreValve and managed percutaneously. Reinterventions were more common following CoreValve TAVR compared with Evolut TAVR or SAVR.
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Affiliation(s)
- Kendra J Grubb
- Division of Cardiothoracic Surgery, Emory University, Atlanta, Georgia, USA.
| | - John C Lisko
- Division of Cardiology, Emory University, Atlanta, Georgia, USA
| | - Daniel O'Hair
- Cardiovascular Service Line, Boulder Community Health, Boulder, Colorado, USA
| | - William Merhi
- Department of Interventional Cardiology, Corewell Health, Grand Rapids, Michigan, USA; Department of Cardiothoracic Surgery, Corewell Health, Grand Rapids, Michigan, USA
| | - John K Forrest
- Yale University School of Medicine, New Haven, Connecticut, USA
| | - Paul Mahoney
- University of Pittsburgh Medical Center Harrisburg, Harrisburg, Pennsylvania, USA
| | | | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | | | | | - Stanley J Chetcuti
- University of Michigan Health Systems-University Hospital, Ann Arbor, Michigan, USA
| | - G Michael Deeb
- University of Michigan Health Systems-University Hospital, Ann Arbor, Michigan, USA
| | - Neal S Kleiman
- Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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Hayek A, Prieur C, Dürrleman N, Chatelain Q, Ibrahim R, Asgar A, Modine T, Ben Ali W. Clinical considerations and challenges in TAV-in-TAV procedures. Front Cardiovasc Med 2024; 11:1334871. [PMID: 38440208 PMCID: PMC10910030 DOI: 10.3389/fcvm.2024.1334871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024] Open
Abstract
Transcatheter aortic valve replacement (TAVR) has emerged as a viable treatment for aortic valve disease, including low-risk patients. However, as TAVR usage increases, concerns about long-term durability and the potential for addition interventions have arisen. Transcatheter aortic valve (TAV)-in-TAV procedures have shown promise in selected patients in numerous registries, offering a less morbid alternative to TAVR explantation. In this review, the authors aimed to comprehensively review the experience surrounding TAV-in-TAV, summarize available data, discuss pre-procedural planning, highlight associated challenges, emphasize the importance of coronary obstruction assessment and provide insights into the future of this technique.
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Affiliation(s)
- Ahmad Hayek
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
- Department of Interventional Cardiology, Hospices Civils de Lyon, Lyon, France
| | - Cyril Prieur
- Department of Interventional Cardiology, Hospices Civils de Lyon, Lyon, France
| | - Nicolas Dürrleman
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
| | - Quentin Chatelain
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
| | - Reda Ibrahim
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
| | - Anita Asgar
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
| | - Thomas Modine
- Service Médico-Chirurgical: Valvulopathies-Chirurgie Cardiaque-Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, CHU Bordeaux, Bordeaux, France
| | - Walid Ben Ali
- Structural Heart Intervention Program, Montreal Heart Institute, Montreal, QC, Canada
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Ochiai T, Yamanaka F, Yamabe T, Miyashita H, Moriyama N, Shishido K, Iwasaki K, Saito S. Late Sinus Sequestration After TAVR-in-TAVR Rescued by Coronary Artery Bypass Grafting. JACC Cardiovasc Interv 2024:S1936-8798(24)00314-5. [PMID: 38456881 DOI: 10.1016/j.jcin.2024.01.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/04/2024] [Accepted: 01/09/2024] [Indexed: 03/09/2024]
Affiliation(s)
- Tomoki Ochiai
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan; Cooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women's Medical University and Waseda University, Waseda University, Shinjuku-ku, Tokyo, Japan.
| | - Futoshi Yamanaka
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Tsuyoshi Yamabe
- Department of Cardiothoracic and Vascular Surgery, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Hirokazu Miyashita
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Noriaki Moriyama
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Koki Shishido
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
| | - Kiyotaka Iwasaki
- Cooperative Major in Advanced Biomedical Sciences, Joint Graduate School of Tokyo Women's Medical University and Waseda University, Waseda University, Shinjuku-ku, Tokyo, Japan
| | - Shigeru Saito
- Department of Cardiology, Shonan Kamakura General Hospital, Kamakura, Kanagawa, Japan
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Sakakibara S, Maeda K, Shimamura K, Yamashita K, Kawamura A, Yoshioka D, Miyagawa S. A Case of CABG in a Patient with High Risk of Coronary Obstruction during TAV-in-TAV. Ann Thorac Cardiovasc Surg 2024; 30:22-00038. [PMID: 35732432 PMCID: PMC10851442 DOI: 10.5761/atcs.cr.22-00038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/26/2022] [Indexed: 11/16/2022] Open
Abstract
A 94-year-old man who underwent transcatheter aortic valve (TAV) replacement 6 years ago was admitted because of exertional dyspnea. Transthoracic echocardiography revealed severe aortic regurgitation owing to TAV dysfunction. The patient was considered to have a high risk of occlusion of the sinus of Valsalva during TAV-in-TAV. Therefore, we performed TAV-in-TAV concomitant with coronary artery bypass grafting (CABG). The postoperative course was uneventful, and computed tomography 9 months later revealed patency of both the grafts. Concomitant CABG could be considered as one of the options in patients with a high risk of coronary occlusion during TAV-in-TAV.
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Affiliation(s)
- Satoshi Sakakibara
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Koichi Maeda
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Kazuo Shimamura
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Kizuku Yamashita
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Ai Kawamura
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Daisuke Yoshioka
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
| | - Shigeru Miyagawa
- Department of Cardiovascular Surgery, Osaka University Hospital, Suita, Osaka, Japan
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Taramasso M, Tagliari AP, Fischman DL. TAV-in-TAV and Beyond: How Far Can We Go? JACC Case Rep 2023; 22:101974. [PMID: 37790778 PMCID: PMC10544083 DOI: 10.1016/j.jaccas.2023.101974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Affiliation(s)
- Maurizio Taramasso
- HerzZentrum Hirslanden Zurich Clinic of Cardiac Surgery, Zurich, Switzerland
| | - Ana Paula Tagliari
- Cardiac Surgery Department, Hospital Mãe de Deus, Porto Alegre, Brazil
- Cardiac Surgery Department, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - David L. Fischman
- Cardiology Department. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
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Hatab T, Zaid S, Wessly P, Reardon MJ, Atkins MD, Faza N, Little SH, Kleiman NS, Goel SS. TAV-in-TAV in Failed Homograft: Redo TAVI in a Patient With 3 Previous Sternotomies. JACC Case Rep 2023; 22:101973. [PMID: 37790767 PMCID: PMC10544086 DOI: 10.1016/j.jaccas.2023.101973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 10/05/2023]
Abstract
A 59-year-old male patient with history of rheumatic heart disease with 3 previous surgical aortic valve replacements with the last one being homograft followed by transcatheter aortic valve implantation in failed homograft presented with severe aortic regurgitation and cardiogenic shock requiring urgent TAV-in-TAV-in homograft. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Taha Hatab
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Syed Zaid
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Priscilla Wessly
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Michael J. Reardon
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Marvin D. Atkins
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, Texas, USA
| | - Nadeen Faza
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Stephen H. Little
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Neal S. Kleiman
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
| | - Sachin S. Goel
- Houston Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA
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Sato S, Ninomiya R, Tosaka K, Koeda Y, Fusazaki T, Kin H, Morino Y. Risk of Coronary Occlusion Due to Sinus Sequestration by Redo Transcatheter Aortic Valve Implantation in Japanese Patients With SAPIEN 3. Circ Rep 2023; 5:217-224. [PMID: 37180474 PMCID: PMC10166666 DOI: 10.1253/circrep.cr-23-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Background: Transcatheter aortic valve (TAV)-in-TAV is an attractive treatment for degenerated TAV. The risk of coronary artery occlusion due to sequestration of the sinus of Valsalva (SOV) in TAV-in-TAV has been reported, but the risk in Japanese patients is unknown. This study aimed to investigate the proportion of Japanese patients who are expected to experience difficulty with the second TAV implantation (TAVI) and evaluate the possibility of reducing the risk of coronary artery occlusion. Methods and Results: Patients (n=308) with an implanted SAPIEN 3 were divided into 2 groups: a high-risk group, which included patients with a TAV-sinotubular junction (STJ) distance <2 mm and a risk plane above the STJ (n=121); and a low-risk group, which included all other patients (n=187). The preoperative SOV diameter, mean STJ diameter, and STJ height were significantly larger in the low-risk group (P<0.05). The cut-off value for predicting the risk of SOV sequestration due to TAV-in-TAV in the difference between the mean STJ diameter and area-derived annulus diameter was 3.0 mm (sensitivity 70%; specificity 68%; area under the curve 0.74). Conclusions: Japanese patients may have a higher risk for sinus sequestration caused by TAV-in-TAV. The risk of sinus sequestration should be assessed before the first TAVI in young patients who are likely to require TAV-in-TAV, and whether TAVI is the best aortic valve therapy must be carefully decided.
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Affiliation(s)
- Sayaka Sato
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
| | - Ryo Ninomiya
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
| | - Kengo Tosaka
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
| | - Yorihiko Koeda
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
| | - Tetsuya Fusazaki
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
| | - Hajime Kin
- Department of Cardiovascular Surgery, Iwate Medical University Iwate Japan
| | - Yoshihiro Morino
- Division of Cardiology, Department of Internal Medicine, Iwate Medical University Iwate Japan
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De Marco F, Casenghi M, Spagnolo P, Popolo Rubbio A, Brambilla N, Testa L, Bedogni F. A patient-specific algorithm to achieve commissural alignment with Acurate Neo: The sextant technique. Catheter Cardiovasc Interv 2021; 98:E847-E854. [PMID: 33960624 PMCID: PMC9292557 DOI: 10.1002/ccd.29737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/07/2022]
Abstract
Aims The aim of this proof‐of‐concept study was to investigate safety and efficacy of a CT‐scan based patient‐specific algorithm to maximize coronary clearance and secondarily to achieve anatomically correct commissural alignment with the Acurate Neo device. Method and results A total of 45 consecutive patients undergoing TAVR with the Acurate Neo THV were prospectively enrolled in the study. Mean age was 81.6 ± 5.5 years, mean STS score was 6.1 ± 3.7. Device success rate was 100%. Aim of the technique was to rotationally deploy the TAVR device with a commissure lying on the bisector between the coronary ostia as calculated on the pre‐procedural CT‐scan. At post‐TAVR CT‐scan, coronary clearance was achieved in 98% of patients with no cases of severe coronary artery overlap. In 42 out of 45 patients, THV was aligned or, at most, mildly misaligned; there were 2 cases of moderate misalignment without any case of severe misalignment. Post‐TAVR selective coronary artery engagement was attempted and succeeded in all patients (100%). Conclusion Our CT‐scan based patient‐specific algorithm is safe and proven to be effective in avoiding coronary artery overlap and providing commissural alignment with Acurate Neo in all treated patients.
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Affiliation(s)
- Federico De Marco
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Matteo Casenghi
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy.,Department of Clinical and Molecular Medicine, School of Medicine and Psychology, University of Rome "Sapienza", Rome, Italy
| | - Pietro Spagnolo
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Antonio Popolo Rubbio
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Nedy Brambilla
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Luca Testa
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Francesco Bedogni
- Clinical and Interventional Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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Pirelli L, Basman CL, Brinster DR, Wang D, Patel N, Scheinerman SJ, Kliger CA. Surgical Resection of Prosthetic Valve Leaflets Under Direct Vision (SURPLUS) for Redo TAVR. JACC Cardiovasc Interv 2021; 14:1036-1037. [PMID: 33865740 DOI: 10.1016/j.jcin.2021.02.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/11/2021] [Accepted: 02/16/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Luigi Pirelli
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA.
| | - Craig L Basman
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
| | - Derek R Brinster
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
| | - Denny Wang
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
| | - Nirav Patel
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
| | - S Jacob Scheinerman
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
| | - Chad A Kliger
- Department of Cardio & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York, USA
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Hatoum H, Lilly S, Maureira P, Crestanello J, Dasi LP. The hemodynamics of transcatheter aortic valves in transcatheter aortic valves. J Thorac Cardiovasc Surg 2021; 161:565-576.e2. [PMID: 31767355 DOI: 10.1016/j.jtcvs.2019.09.174] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/22/2019] [Accepted: 09/06/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND The durability of transcatheter aortic valves (TAVs) remains their greatest disadvantage, given that fixed tissue leaflets are not immune to structural degeneration from calcification and thrombosis. Therefore, a second intervention is necessary, especially given that TAV in low-risk patients has shown noninferior outcomes compared with surgery. This study aimed to assess the hemodynamic and turbulent properties of the flow downstream with different TAV-in-TAV configurations, to offer basic hemodynamic guidance for future interventions when currently implanted valves structurally degrade. METHODS Six TAV-in-TAV configurations were chosen: 23 mm Evolut-in-26 mm Evolut, 23 mm Evolut-in-23 mm SAPIEN 3, 26 mm Evolut-in-26 mm Evolut, 26 mm Evolut-in-23 mm SAPIEN 3, 23 mm SAPIEN3-in-26 mm Evolut, and 23 mm SAPIEN3-in-23 mm SAPIEN 3. Their hemodynamic performance was assessed in a pulse duplicator for 100 cycles. High-speed imaging and particle image velocimetry were performed to assess turbulence. Effective orifice area (EOA), pinwheeling index (PI), and Reynolds shear stress (RSS) were evaluated. RESULTS The largest mean EOA was obtained with 23 mm SAPIEN-in-26 mm Evolut (2.07 ± 0.06 cm2), and the smallest was obtained with 23 mm Evolut-in-23 mm SAPIEN (1.50 ± 0.04 cm2) (P < .001). The highest mean PI was obtained with SAPIEN-in-SAPIEN (26.5 ± 2.00%), and the lowest was obtained with 26 mm Evolut-in-26 mm Evolut (7.5 ± 1.6%) (P < .01). At peak systole, the least detrimental RSS range was obtained with 23 mm Evolut-in-26 mm Evolut (up to ∼340 Pa), and the most detrimental RSS range was obtained with 23 mm Evolut-in-SAPIEN (∼900 Pa) (P < .01). CONCLUSIONS This study shows that best hemodynamic parameters are TAV-specific (implanted and to be implanted). In addition, it shows that RSS levels, which are indicative of turbulence levels and associated with blood damage, are 2- to 3-fold higher after TAV-in-TAV.
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Yamashita K, Fukushima S, Shimahara Y, Yamasaki T, Matsumoto Y, Kawamoto N, Tadokoro N, Kakuta T, Hamatani Y, Okada A, Takahama H, Amaki M, Hasegawa T, Kanzaki H, Izumi C, Yasuda S, Kobayashi J, Fujita T. Study Protocol for Transcatheter Aortic Valve Replacement for a Degenerated Aortic Bioprosthesis in a Japanese Cohort. Circ Rep 2019; 1:102-106. [PMID: 33693120 PMCID: PMC7890281 DOI: 10.1253/circrep.cr-18-0023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background:
The valve-in-valve (VIV) procedure is being increasingly performed in high-risk patients with a degenerated bioprosthesis in an aortic position in Western countries. The early safety and efficacy of the VIV procedure, however, remain unclear in Japanese patients with a small aortic annulus. We present the protocol for a study designed to evaluate the early safety and efficacy of the VIV procedure in the aortic position in Japanese patients. Methods and Results:
The prospective, single-center, non-comparative, clinical study of the VIV procedure for the aortic position (AORTIC VIV study) commenced in August 2016 and will end in March 2020. Patients will be monitored for ≥1 month after the VIV procedure. The targeted number of patients is 11. Eligible patients are those who have undergone transcatheter aortic valve replacement for a surgical valve (including stented or stentless bioprosthetic valves), or for a transcatheter heart valve. The VIV procedure is performed in high-operative-risk patients with substantial prosthetic valve stenosis, and regurgitation and heart failure resistant to medical treatment (unless the patient meets an exclusion criterion). The safety and efficacy of the VIV procedure will be evaluated in accordance with the Valve Academic Research Consortium-2 initiative. Conclusions:
The AORTIC VIV study will clarify the early safety and efficacy of the VIV procedure in Japanese patients.
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Affiliation(s)
- Kizuku Yamashita
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan.,William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London London UK
| | - Satsuki Fukushima
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Yusuke Shimahara
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Takuma Yamasaki
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Yorihiko Matsumoto
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Naonori Kawamoto
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Naoki Tadokoro
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Takashi Kakuta
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Yasuhiro Hamatani
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Atsushi Okada
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Hiroyuki Takahama
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Makoto Amaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Takuya Hasegawa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Hideaki Kanzaki
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Chisato Izumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Suita Japan
| | - Junjiro Kobayashi
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
| | - Tomoyuki Fujita
- Department of Cardiac Surgery, National Cerebral and Cardiovascular Center Suita Japan
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