Effect of severe bioprosthetic valve tissue ingrowth and inflow calcification on valve-in-valve performance

Journal of Biomechanics
Hoda HatoumLakshmi P Dasi

Abstract

While in vivo studies clearly demonstrate that supra-annular Valve-in-Valve (ViV) implantation provides the highest probability for optimal post-ViV pressure gradients (PG), there is still no physical insight into explaining anomalies where some supra-annular ViV implantations yield high pressure gradients while some sub-annular implantations yield low pressure gradients. The aim of this study is to explain how severe tissue ingrowth and calcification (TIC) in a surgical aortic valve (SAV) can be one physical mechanism leading to anomalous ViV performance characteristic. The ViV hemodynamic performance was evaluated as a function of axial positioning -9.8, -6.2, 0, and +6 mm in SAVs with and without TIC. Effective orifice area (EOA) and PG were compared. Leaflet high-speed imaging and particle image velocimetry were performed to elucidate flutter and forward jet characteristics. ViV without TIC showed significantly lower PG and greater EOA (p < 0.01). EOA and PG improve with supra-annular deployment (p < 0.01) while for ViV with TIC, EOA and PG worsen as the deployment varies from -9.8 mm to 0 mm (p < 0.01) only to recover at + 6 mm (p < 0.01). Separated jet flow at the TIC site, and consequently induced stronger TAV leaflet fl...Continue Reading

Citations

Jul 22, 2018·Annals of Biomedical Engineering·Hoda HatoumLakshmi Prasad Dasi
Oct 16, 2018·Expert Review of Medical Devices·Oren M RotmanDanny Bluestein
Feb 3, 2019·Annals of Biomedical Engineering·Hoda Hatoum, Lakshmi Prasad Dasi
Aug 29, 2018·Annals of Biomedical Engineering·Hoda HatoumLakshmi Prasad Dasi
Sep 14, 2018·Annals of Biomedical Engineering·Hoda Hatoum, Lakshmi P Dasi
Dec 7, 2020·Interactive Cardiovascular and Thoracic Surgery·Georg LutterThomas Puehler
Dec 2, 2019·Journal of the Mechanical Behavior of Biomedical Materials·Hoda HatoumLakshmi Prasad Dasi
Jul 8, 2018·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi Prasad Dasi
Mar 25, 2019·The Journal of Thoracic and Cardiovascular Surgery·Hoda HatoumLakshmi Prasad Dasi

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