Mitral valve-in-valve hemodynamic performance: An in vitro study

The Journal of Thoracic and Cardiovascular Surgery
M EvinPhilippe Pibarot

Abstract

The valve-in-valve (VinV) procedure may be used in high-risk patients with failed mitral surgical bioprostheses. The objective of this in vitro study was to assess the hemodynamic function of different VinV configurations. A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VinV configurations (Sapien [Edwards Lifesciences, Irvine, Calif] implanted within the surgical bioprosthesis) under 8 different hemodynamic conditions. The internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor Measuring Instruments, Singapore). The VinV procedure was associated with significant deterioration in antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 ± 0.21 cm(2) vs 1.65 ± 0.37 cm(2); P < .001 and regurgitant fraction, 11.5% ± 7.2% vs 4.8% ± 3.8%; P < .001). Among the 120 tested experimental VinV situations, moderate or greater mitral stenosis occurred in 52 situations and mild or greater regurgitation occurred in 28 situations. The IOD of the surgical bioprosthesis was the main independent determinant of effective orifice area and regurgitant fraction. An IOD < 22 mm was associated with ...Continue Reading

References

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Jan 4, 2013·Current Opinion in Cardiology·Anson Cheung, Ala Al-Lawati

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Citations

Feb 15, 2016·The Journal of Thoracic and Cardiovascular Surgery·William M DeCampli
Mar 15, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Anne-Sophie ZensesRégis Rieu
Jun 29, 2021·Frontiers in Cardiovascular Medicine·Ming-Chon HsiungJeng Wei

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