Related Experiment Video

Updated: Feb 16, 2026

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement
09:57

Four-Dimensional Computed Tomography-Guided Valve Sizing for Transcatheter Pulmonary Valve Replacement

Published on: January 20, 2022

3.2K

Impact of Annular Size on Outcomes After Surgical or Transcatheter Aortic Valve Replacement

G Michael Deeb1, Stanley J Chetcuti2, Steven J Yakubov3

  • 1Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.

The Annals of Thoracic Surgery
|January 9, 2018
PubMed

Insights

Transcatheter aortic valve replacement (TAVR) offers better hemodynamics and less prosthesis-patient mismatch (PPM) than surgical aortic valve replacement (SAVR) in small and medium annuli. Annular size significantly impacts SAVR outcomes but not TAVR outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Prosthesis-patient mismatch (PPM) and hemodynamics are critical in aortic valve replacement.
  • Annular size is a key factor influencing outcomes in surgical aortic valve replacement (SAVR).
  • Transcatheter aortic valve replacement (TAVR) offers an alternative to SAVR, particularly for high-risk patients.

Purpose of the Study:

  • To evaluate the relationship between aortic annular size, hemodynamics, and PPM incidence.
  • To compare outcomes between SAVR and TAVR concerning annular size.
  • To determine optimal valve choice based on annular dimensions.

Main Methods:

  • Analysis of data from the CoreValve US Pivotal High Risk Trial.
  • Categorization of patients into large (≥26 mm), medium (23–26 mm), and small (<23 mm) annular size groups using multislice computed tomography.
  • Assessment of hemodynamics (mean gradients), PPM, and clinical outcomes post-procedure.

Main Results:

  • TAVR demonstrated significantly lower mean gradients than SAVR in small and medium annuli.
  • Annular size significantly affected SAVR gradients and PPM incidence, with smaller annuli showing higher gradients and PPM.
  • TAVR showed similar gradients across all annular sizes and significantly less PPM than SAVR in small and medium annuli.

Conclusions:

  • Annular size significantly impacts hemodynamics and PPM in SAVR but not in TAVR.
  • TAVR provides superior hemodynamic performance and reduced PPM in patients with small to medium aortic annuli (less than 26 mm).
  • TAVR should be strongly considered for patients with small and medium annuli requiring aortic valve replacement.
Abstract

More Related Videos

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.8K
Author Spotlight: Revolutionizing Remote Surgery with Augmented Reality and Robotics for Enhanced Precision and Accessibility07:46

Author Spotlight: Revolutionizing Remote Surgery with Augmented Reality and Robotics for Enhanced Precision and Accessibility

Published on: August 9, 2024

1.2K

Related Concept Videos

Heart Valves01:16

Heart Valves

The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
12.5K
Predicting Reaction Outcomes02:24

Predicting Reaction Outcomes

Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
11.0K
Impact of Groups on Groups01:19

Impact of Groups on Groups

Social psychologists analyze how groups influence one another, shaping social structures and interactions through both cooperation and competition. These dynamics manifest in various ways, ranging from economic partnerships to intergroup conflicts that shape societal structures and perceptions.Cooperation and Competition in Intergroup RelationsIntergroup relationships vary across contexts, sometimes fostering cooperation and mutual benefit while at other times leading to conflict and...
264
Outcomes of Glycolysis01:13

Outcomes of Glycolysis

Nearly all the energy used by cells comes from the bonds that make up complex organic compounds. These organic compounds are broken down into simpler molecules, such as glucose. As a result, cells extract energy from glucose over many chemical reactions—a process called cellular respiration.
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
107.8K
Cell Size01:22

Cell Size

Cell sizes vary widely among and within organisms. Bacterial cells range between 1-10 micrometers (μm)and are considerably smaller than most eukaryotic cells. The smallest bacteria are 0.1 μm in diameter—about a thousand times smaller than eukaryotic cells, which typically range from 10-100 μm.
Surface Area
Cells can take in nutrients and water via diffusion through the plasma membrane itself or through specific channels in the membrane. The area of the membrane surrounding...
132.6K
Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
1.2K