Outcome of transcatheter aortic valve replacement in bicuspid aortic valve stenosis with new-generation devices.
Bicuspid aortic valve
Computational simulation
New-generation devices
Transcatheter aortic valve replacement
Journal
Interactive cardiovascular and thoracic surgery
ISSN: 1569-9285
Titre abrégé: Interact Cardiovasc Thorac Surg
Pays: England
ID NLM: 101158399
Informations de publication
Date de publication:
01 01 2021
01 01 2021
Historique:
received:
14
05
2020
revised:
05
08
2020
accepted:
03
09
2020
pubmed:
18
11
2020
medline:
17
7
2021
entrez:
17
11
2020
Statut:
ppublish
Résumé
To compare device success and paravalvular leak rates of 3 new-generation transcatheter aortic valve replacement devices in patients with bicuspid aortic valve stenosis and to test their biomechanical performance in a computer-based simulation model of aortic root with increasing ellipticity. This retrospective multicentre study included 56 bicuspid aortic valve patients undergoing transcatheter aortic valve replacement with new-generation devices: Lotus/Lotus Edge (N = 15; 27%), Evolut-R (N = 20; 36%) and ACURATE neo (N = 21; 37%). Three virtual simulation models of aortic root with increasing index of eccentricity (0-0.25-0.5) were implemented. Stress distribution, stent-root contact area and paravalvular orifice area were computed. Device success was achieved in 43/56 patients (77%) with comparable rates among Lotus (87%), Evolut-R (60%) and ACURATE neo (86%; P = 0.085). Moderate paravalvular leak rate was significantly lower in the Lotus group as compared to Evolut-R group (0% vs 30%; P = 0.027) and comparable to the ACURATE neo group (0% vs 10%; P = 0.33). By index of eccentricity = 0.5, Lotus showed a uniform and symmetric pattern of stress distribution with absent paravalvular orifice area, ACURATE neo showed a mild asymmetry with small paravalvular orifice area (1.1 mm2), whereas a severely asymmetric pattern was evident with Evolut-R, resulting in a large paravalvular orifice area (12.0 mm2). Transcatheter aortic valve replacement in bicuspid aortic valve patients with new-generation devices showed comparable device success rates. Lotus showed moderate paravalvular leak rate comparable to that of ACURATE neo and significantly lower than Evolut-R. On simulation, Lotus and ACURATE neo showed optimal adaptability to elliptic anatomies as compared to Evolut-R.
Identifiants
pubmed: 33201993
pii: 5986649
doi: 10.1093/icvts/ivaa231
pmc: PMC8906794
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
20-28Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
Références
J Am Coll Cardiol. 2017 May 30;69(21):2579-2589
pubmed: 28330793
Catheter Cardiovasc Interv. 2018 Dec 1;92(7):1374-1379
pubmed: 29521464
N Engl J Med. 2019 May 2;380(18):1695-1705
pubmed: 30883058
JACC Cardiovasc Interv. 2015 May;8(6):837-846
pubmed: 25999108
J Biomech. 2014 Aug 22;47(11):2547-55
pubmed: 24998989
Med Eng Phys. 2013 Jan;35(1):125-30
pubmed: 22640661
EuroIntervention. 2016 Sep 18;12(Y):Y42-5
pubmed: 27640030
EuroIntervention. 2018 Dec 20;14(12):e1269-e1275
pubmed: 30375336
J Am Coll Cardiol. 2014 Dec 9;64(22):2330-9
pubmed: 25465419
Circ Cardiovasc Interv. 2019 Jan;12(1):e007107
pubmed: 30626202
Catheter Cardiovasc Interv. 2019 May 1;93(6):1116-1123
pubmed: 30773838
Circ Cardiovasc Interv. 2013 Jun;6(3):284-91
pubmed: 23756698
EuroIntervention. 2013 Sep 10;9 Suppl:S95-6
pubmed: 24025968
EuroIntervention. 2019 Jun 12;15(3):e231-e238
pubmed: 31147305
EuroIntervention. 2018 Feb 02;13(15):e1764-e1770
pubmed: 29131801
J Am Coll Cardiol. 2012 Oct 9;60(15):1438-54
pubmed: 23036636
Interact Cardiovasc Thorac Surg. 2009 Aug;9(2):301-8
pubmed: 19414489
J Am Coll Cardiol. 2012 Mar 27;59(13):1200-54
pubmed: 22300974
EuroIntervention. 2016 Sep 18;12(Y):Y22-7
pubmed: 27640026
Med Eng Phys. 2017 Sep;47:2-12
pubmed: 28728867
Med Eng Phys. 2013 Dec;35(12):1721-30
pubmed: 24001692
J Am Coll Cardiol. 2016 Sep 13;68(11):1195-1205
pubmed: 27609682
J Am Coll Cardiol. 2012 Apr 3;59(14):1275-86
pubmed: 22365424
EuroIntervention. 2020 Apr 03;15(18):e1588-e1591
pubmed: 31186219
Front Cardiovasc Med. 2018 Jul 19;5:91
pubmed: 30073170
Interv Cardiol. 2018 May;13(2):62-65
pubmed: 29928309