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Transcatheter Pulmonary Valve Replacement from Autologous Pericardium with a Self-Expandable Nitinol Stent in an Adult Sheep Model
Published on: June 8, 2022
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Updates on bioprosthetic valve fracture
Shiv Bagga1, Adnan K Chhatriwalla1
1Department of Cardiology, Saint. Luke's Mid America Heart Institute and University of Missouri, Kansas City, MO, USA.
Expert Review of Cardiovascular Therapy
|May 24, 2023
Summary
Bioprosthetic valve fracture (BVF) and remodeling (BVR) enhance transcatheter valve-in-valve replacement outcomes. These techniques optimize transcatheter heart valve expansion, improving hemodynamics and potentially durability.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Valve-in-valve (VIV) transcatheter valve replacement is a viable option for failed bioprosthetic surgical valves (BSVs).
- Prosthesis-patient mismatch (PPM) is a risk in VIV procedures.
- Bioprosthetic valve fracture (BVF) and bioprosthetic valve remodeling (BVR) aim to improve transcatheter heart valve (THV) expansion.
Purpose of the Study:
- To provide an overview of BVF and BVR techniques for VIV transcatheter aortic valve replacement (TAVR).
- To discuss lessons learned from bench testing and clinical application of BVF/BVR.
- To review current evidence for BVF/BVR in non-aortic positions.
Main Methods:
- Review of bench testing studies on BVF and BVR.
- Analysis of procedural techniques and clinical outcomes.
- Synthesis of up-to-date evidence and expert experience.
Main Results:
- BVF and BVR improve valve hemodynamics after VIV-TAVR.
- The timing of BVF is crucial for safety and efficacy.
- Longer-term data are needed to assess clinical outcomes and durability.
Conclusions:
- BVF and BVR are beneficial for VIV-TAVR, improving hemodynamics.
- Further research is required for long-term outcomes and application in new valve generations.
- The role of BVF/BVR in pulmonic, mitral, and tricuspid positions needs further definition.
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