scholarly journals Patient-specific Computer Simulation: An Emerging Technology for Guiding the Transcatheter Treatment of Patients with Bicuspid Aortic Valve

2021 ◽  
Vol 16 ◽  
Author(s):  
Cameron Dowling ◽  
Robert Gooley ◽  
Liam McCormick ◽  
Sami Firoozi ◽  
Stephen J Brecker
Keyword(s):  
Computer Simulation ◽  
Aortic Valve ◽  
Clinical Outcomes ◽  
Bicuspid Aortic Valve ◽  
Patient Specific ◽  
Transcatheter Aortic Valve ◽  
Anatomical Basis ◽  
Transcatheter Heart Valve ◽  
Risk Patients ◽  
Valve Implantation

Transcatheter aortic valve implantation (TAVI) is increasingly being used to treat younger, lower-risk patients, many of whom have bicuspid aortic valve (BAV). As TAVI begins to enter these younger patient cohorts, it is critical that clinical outcomes from TAVI in BAV are matched to those achieved by surgery. Therefore, the identification of patients who, on an anatomical basis, may not be suitable for TAVI, would be desirable. Furthermore, clinical outcomes of TAVI in BAV might be improved through improved transcatheter heart valve sizing and positioning. One potential solution to these challenges is patient-specific computer simulation. This review presents the methodology and clinical evidence surrounding patient-specific computer simulation of TAVI in BAV.

scholarly journals Transcatheter Tricuspid Valve-In-Ring and Aortic Valve-In-Valve Implantation

2017 ◽  
Vol 06 (01) ◽  
pp. e29-e31 ◽  
Author(s):  
Daniel Reichart ◽  
Niklas Schofer ◽  
Florian Deuschl ◽  
Andreas Schaefer ◽  
Stefan Blankenberg ◽  
...  
Keyword(s):  
United States ◽  
Aortic Valve ◽  
Tricuspid Valve ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Risk Patients ◽  
Valve Position ◽  
Valve In Valve ◽  
Valve Implantation ◽  
Surgical Valve Replacement

Background Transcatheter heart valve (THV) therapies have shown to be an alternative to surgical valve replacement, especially in high-risk patients requiring redo surgery. However, reports of transcatheter-based interventions in tricuspid valve position are scarce. Case Description Here, we report a case of successful concomitant transcatheter aortic valve-in-valve (ViV) and tricuspid valve-in-ring (ViR) procedures using a 23-mm CoreValve Evolut R THV (Medtronic, Inc., Minneapolis, Minnesota, United States) in aortic position and a 29-mm SAPIEN3 (Edwards Lifesciences, Inc., Irvine, California, United States) THV in tricuspid position. Conclusion This case demonstrates feasibility of concomitant transcatheter aortic ViV and tricuspid ViR procedures.

Impact of Mitral Regurgitation on Clinical Outcomes After Transcatheter Aortic Valve Implantation

2016 ◽  
Vol 11 (1) ◽  
pp. 54
Author(s):  
Crochan J O’Sullivan ◽  
◽  
◽  
◽  
◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Clinical Outcomes ◽  
Transcatheter Aortic Valve Implantation ◽  
Severe Aortic Stenosis ◽  
Surgical Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Transcatheter Heart Valve ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Severe aortic stenosis (AS) and mitral regurgitation (MR) are the two most common valvular lesions referred for surgical intervention in Europe and frequently co-exist. In patients with both severe AS and significant MR referred for surgical aortic valve replacement (SAVR), a concomitant mitral valve intervention is typically performed if the MR is severe, despite the higher associated perioperative risk. The management of moderate MR among SAVR patients is controversial and depends on a number of factors including MR aetiology (i.e., organic versus functional MR), feasibility of repair and patient risk profile. Moderate or severe MR is present in up to one-third of patients undergoing transcatheter aortic valve implantation (TAVI), is mainly of functional aetiology and is typically left untreated. Although data are conflicting, a growing body of evidence suggests that significant MR exerts an adverse effect on both short- and long-term clinical outcomes after TAVI. Moderate or severe MR improves in just over half of patients following TAVI and recent data suggest MR is more likely to improve among patients receiving a balloon-expandable as compared with a self-expandable transcatheter heart valve.

scholarly journals Sealing Behavior in Transcatheter Bicuspid and Tricuspid Aortic Valves Replacement Through Patient-Specific Computational Modeling

2021 ◽  
Vol 8 ◽  
Author(s):  
Xianbao Liu ◽  
Jiaqi Fan ◽  
Peter Mortier ◽  
Yuxin He ◽  
Qifeng Zhu ◽  
...  
Keyword(s):  
Computer Simulation ◽  
Aortic Valve ◽  
Computational Modeling ◽  
Maximum Diameter ◽  
Patient Specific ◽  
Aortic Valves ◽  
Minimum Diameter ◽  
Transcatheter Aortic Valve ◽  
Patient Interaction ◽  
Transcatheter Heart Valve

Background: Patient-specific computer simulation of transcatheter aortic valve replacement (TAVR) can provide unique insights in device-patient interaction.Aims: This study was to compare transcatheter aortic valve sealing behavior in patients with bicuspid aortic valves (BAV) and tricuspid aortic valves (TAV) through patient-specific computational modeling.Methods: Patient-specific computer simulation was retrospectively performed with FEops HEARTguide for TAVR patients. Simulation output was compared with postprocedural computed tomography and echocardiography to validate the accuracy. Skirt malapposition was defined by a distance larger than 1 mm based on the predicted device-patient interaction by quantifying the distance between the transcatheter heart valve (THV) skirt and the surrounding anatomical regions.Results: In total, 43 patients were included in the study. Predicted and observed THV frame deformation showed good correlation (R2 ≥ 0.90) for all analyzed measurements (maximum diameter, minimum diameter, area, and perimeter). The amount of predicted THV skirt malapposition was strongly linked with the echocardiographic grading of paravalvular leakage (PVL). More THV skirt malapposition was observed for BAV cases when compared to TAV cases (22.7 vs. 15.5%, p < 0.05). A detailed analysis of skirt malapposition showed a higher degree of malapposition in the interleaflet triangles section for BAV cases as compared to TAV patients (11.1 vs. 5.8%, p < 0.05).Conclusions: Patient-specific computer simulation of TAVR can accurately predict the behavior of the Venus A-valve. BAV patients are associated with more malapposition of the THV skirt as compared to TAV patients, and this is mainly driven by more malapposition in the interleaflet triangle region.

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