Bioprosthetic Valve Fracturing: In vitro Testing of Edwards PERIMOUNT Model P 2900

Frontiers in Cardiovascular Medicine

Hector A. Alvarez-Covarrubias¹  Zahra Alalawi²  Hendrik Ruge⁴  Rüdiger Lange⁴  Keti Vitanova⁴  Oliver Deutsch⁴ 

[1] Centro Medico Nacional Siglo XXI, Hospital de Cardiologia, IMSS, Ciudad de México, Mexico;Department of Cardiovascular Surgery, German Heart Center, INSURE (Institute for Translational Cardiac Surgery), TUM, Munich, Germany;German Heart Center Munich, Department of Cardiology, TUM, Munich, Germany;German Heart Center Munich, Department of Cardiovascular Surgery, TUM, Munich, Germany;

关键词: bioprosthetic valve fracturing;    valve-in-valve transcatheter aortic valve replacement;    in-vitro;    balloon rupture;    transprosthetic gradient;   

DOI  :  10.3389/fcvm.2022.859088

来源: DOAJ

【 摘 要 】

BackgroundBioprosthetic valve fracturing (BVF) results in low gradients following valve-in-valve transcatheter aortic valve replacement (ViV-TAVR). For the commonly used Edwards PERIMOUNT valve data from bench-testing are lacking to provide technical specifications for successful BVF during ViV-TAVR.MethodsUsing four Perimount 19- and 21-mm valves, in-vitro high-pressure balloon valvuloplasty with the True Dilatation Balloon Valvuloplasty Catheter and Atlas Gold PTA Dilatation Catheter was performed to analyze balloon-oversizing and pressure-thresholds to successfully achieve BVF.ResultsHigh-pressure balloons one millimeter larger than the labeled valve size and pressure rates of 20 atm (for Perimount 19-mm) and > 22 atm (for Perimount 21-mm) were required to achieve BVF. Caliper measurements demonstrated 2.5 mm (Perimount 19-mm) and 1.5 mm (Perimount 21-mm) enlarged inner prosthetic diameters after BVF. The Atlas TM Gold PTA Dilatation Catheter achieved BVF with the Perimount 21-mm, whereas the True TM Dilatation Balloon Valvuloplasty Catheter failed in the Perimount 21-mm either for balloon-rupture or pinhole-defect.ConclusionBoth 19-mm and 21-mm Perimount P 2900 are amendable to BVF, thereby increasing the inner prosthetic diameter. High-pressure balloons 1 mm larger than the labeled valves are essential for this purpose, and the Atlas Gold PTA Dilatation Catheter alone should ensure success in the 21-mm prosthetics.

【 授权许可】

Unknown