Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves
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Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves. / Fuchs, Andreas; De Backer, Ole; Brooks, Matthew; de Knegt, Martina C; Bieliauskas, Gintautas; Yamamoto, Masanori; Yanagisawa, Ryo; Hayashida, Kentaro; Søndergaard, Lars; Kofoed, Klaus F.
I: EuroIntervention, Bind 13, Nr. 9, 2017, s. e1067-e1075.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves
AU - Fuchs, Andreas
AU - De Backer, Ole
AU - Brooks, Matthew
AU - de Knegt, Martina C
AU - Bieliauskas, Gintautas
AU - Yamamoto, Masanori
AU - Yanagisawa, Ryo
AU - Hayashida, Kentaro
AU - Søndergaard, Lars
AU - Kofoed, Klaus F
PY - 2017
Y1 - 2017
N2 - AIMS: This study aimed to assess the potential relationship between subclinical leaflet thickening and stent frame geometry in patients who underwent aortic valve replacement with a self-expanding transcatheter heart valve (THV).METHODS AND RESULTS: Seventy-five patients with a self-expanding THV were studied with 4D-computed tomography and analysed for leaflet thickening. There was no difference in THV size, overall THV expansion, eccentricity or implantation depth between patients with and those without leaflet thickening. Moderate-to-severe regional THV underexpansion (≤90°) more frequently occurred at the non-coronary and right coronary cusps with a significantly higher incidence of leaflet thickening than in cases of full regional THV expansion (24% vs. 3%, p<0.01). Regional THV underexpansion at the inflow level more often translated into the same issue at the valvular level in THV with intra-annular as compared to supra-annular valve position (54% vs. 17%; p=0.04). In case of post-dilatation, regional THV underexpansion occurred less frequently as compared to THV that were not post-dilated (18% vs. 43%, p=0.028). A similar but non-significant trend was found for leaflet thickening.CONCLUSIONS: Regional THV stent frame underexpansion is associated with an increased risk of leaflet thickening. Post-dilatation of self-expanding THV as well as a supra-annular valve position seem to reduce the occurrence of this phenomenon.
AB - AIMS: This study aimed to assess the potential relationship between subclinical leaflet thickening and stent frame geometry in patients who underwent aortic valve replacement with a self-expanding transcatheter heart valve (THV).METHODS AND RESULTS: Seventy-five patients with a self-expanding THV were studied with 4D-computed tomography and analysed for leaflet thickening. There was no difference in THV size, overall THV expansion, eccentricity or implantation depth between patients with and those without leaflet thickening. Moderate-to-severe regional THV underexpansion (≤90°) more frequently occurred at the non-coronary and right coronary cusps with a significantly higher incidence of leaflet thickening than in cases of full regional THV expansion (24% vs. 3%, p<0.01). Regional THV underexpansion at the inflow level more often translated into the same issue at the valvular level in THV with intra-annular as compared to supra-annular valve position (54% vs. 17%; p=0.04). In case of post-dilatation, regional THV underexpansion occurred less frequently as compared to THV that were not post-dilated (18% vs. 43%, p=0.028). A similar but non-significant trend was found for leaflet thickening.CONCLUSIONS: Regional THV stent frame underexpansion is associated with an increased risk of leaflet thickening. Post-dilatation of self-expanding THV as well as a supra-annular valve position seem to reduce the occurrence of this phenomenon.
U2 - 10.4244/EIJ-D-17-00373
DO - 10.4244/EIJ-D-17-00373
M3 - Journal article
C2 - 28741579
VL - 13
SP - e1067-e1075
JO - EuroIntervention
JF - EuroIntervention
SN - 1774-024X
IS - 9
ER -
ID: 194525874