Standardized Bench Test Evaluation of Biomechanical Characteristics of Stents Used in Right Ventricular Outflow Tract Revalvulation.
Bench test
Biomechanical characteristics
Percutaneous pulmonary valve implantation
Right ventricular outflow tract
Stent
Journal
Cardiovascular engineering and technology
ISSN: 1869-4098
Titre abrégé: Cardiovasc Eng Technol
Pays: United States
ID NLM: 101531846
Informations de publication
Date de publication:
11 Mar 2024
11 Mar 2024
Historique:
received:
28
08
2023
accepted:
26
02
2024
medline:
12
3
2024
pubmed:
12
3
2024
entrez:
12
3
2024
Statut:
aheadofprint
Résumé
Pre-stenting of the right ventricular outflow tract (RVOT) is commonly performed before percutaneous pulmonary valve implantation (PPVI), to relieve obstruction, prevent valved stent fractures, and provide a landing zone. This study aimed to evaluate the biomechanical characteristics of the stents currently used to perform pre-stenting of the RVOT. We assessed five commercially available stents: Cheatham-Platinum Stent ("CP Stent"), AndraStent XL, AndraStent XXL, Optimus XL, and Optimus XXL. Following stent deployment at nominal pressure, radial and longitudinal elastic recoils and radial resistance were measured. The bending stiffness of the stents crimped onto the balloons was also evaluated. Three samples were tested for each stent. Our study showed no significant difference between the stent platforms in terms of radial elastic recoil, which was relatively low (< 10%). The longitudinal elastic recoil was also low for all the devices (< 5%). Significant differences were observed in radial resistance (P < 0.001). CP Stent and AndraStent XL exhibited the highest radial resistances. The bending stiffnesses of the stents crimped on their balloons were significantly different (P < 0.00001). Optimus XL and XXL were more flexible than the other stents. This study highlights the significant differences between the stents currently used in RVOT pre-stenting. Stents with good radial resistance are preferred, especially for calcified vessels, and flexibility is crucial for tortuous vessels. We proposed an algorithm for selecting the most suitable stent according to the need for radial force and flexibility, which will help inform clinicians considering RVOT revalvulation.
Identifiants
pubmed: 38468115
doi: 10.1007/s13239-024-00726-1
pii: 10.1007/s13239-024-00726-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s) under exclusive licence to Biomedical Engineering Society.
Références
Bonhoeffer, P., Y. Boudjemline, Z. Saliba, et al. Percutaneous replacement of pulmonary valve in a right-ventricle to pulmonary-artery prosthetic conduit with valve dysfunction. Lancet. 356:1403–1405, 2000. https://doi.org/10.1016/S0140-6736(00)02844-0 .
doi: 10.1016/S0140-6736(00)02844-0
pubmed: 11052583
Plessis, J., S. Hascoët, A. Baruteau, et al. Edwards SAPIEN transcatheter pulmonary valve implantation: results from a French registry. JACC. 11:1909–1916, 2018. https://doi.org/10.1016/j.jcin.2018.05.050 .
doi: 10.1016/j.jcin.2018.05.050
pubmed: 30219326
Kenny, D., Z. M. Hijazi, S. Kar, et al. Percutaneous implantation of the Edwards SAPIEN transcatheter heart valve for conduit failure in the pulmonary position: early phase 1 results from an international multicenter clinical trial. J. Am. Coll. Cardiol. 58:2248–2256, 2011. https://doi.org/10.1016/j.jacc.2011.07.040 .
doi: 10.1016/j.jacc.2011.07.040
pubmed: 22078433
Haas, N. A., A. Moysich, U. Neudorf, et al. Percutaneous implantation of the Edwards SAPIEN
doi: 10.1007/s00392-012-0503-8
pubmed: 22932954
McElhinney, D. B., A. C. Marshall, and S. Schievano. Fracture of cardiovascular stents in patients with congenital heart disease: theoretical and empirical considerations. Cardiovasc. Interv. 6:575–585, 2013. https://doi.org/10.1161/CIRCINTERVENTIONS.113.000148 .
doi: 10.1161/CIRCINTERVENTIONS.113.000148
Cools, B., S. Brown, M. Wevers, et al. Right ventricle outflow tract prestenting: in vitro testing of rigidity and corrosion properties. Catheter. Cardiovasc. Interv. 91:285–291, 2018. https://doi.org/10.1002/ccd.27320 .
doi: 10.1002/ccd.27320
pubmed: 28895283
Cabalka, A. K., W. E. Hellenbrand, A. Eicken, et al. Relationships among conduit type, pre-stenting, and outcomes in patients undergoing transcatheter pulmonary valve replacement in the prospective north American and European melody valve trials. JACC. 10:1746–1759, 2017. https://doi.org/10.1016/j.jcin.2017.05.022 .
doi: 10.1016/j.jcin.2017.05.022
pubmed: 28823778
Peng, L. F., D. B. McElhinney, A. W. Nugent, et al. Endovascular stenting of obstructed right ventricle–to–pulmonary artery conduits: a 15-year experience. Circulation. 113:2598–2605, 2006. https://doi.org/10.1161/CIRCULATIONAHA.105.607127 .
doi: 10.1161/CIRCULATIONAHA.105.607127
pubmed: 16735676
Karsenty, C., S. Malekzadeh-Milani, A. Fraisse, et al. Right ventricular outflow tract prestenting with AndraStent XXL before percutaneous pulmonary valve implantation. Arch. Cardiovasc. Dis. 113:113–120, 2020. https://doi.org/10.1016/j.acvd.2019.12.004 .
doi: 10.1016/j.acvd.2019.12.004
pubmed: 32081640
Schievano, S., L. Petrini, F. Migliavacca, et al. Finite element analysis of stent deployment: understanding stent fracture in percutaneous pulmonary valve implantation. J. Interv. Cardiol. 20:546–554, 2007. https://doi.org/10.1111/j.1540-8183.2007.00294.x .
doi: 10.1111/j.1540-8183.2007.00294.x
pubmed: 18042059
Schievano, S., A. M. Taylor, C. Capelli, et al. Patient specific finite element analysis results in more accurate prediction of stent fractures: application to percutaneous pulmonary valve implantation. J. Biomech. 43:687–693, 2010. https://doi.org/10.1016/j.jbiomech.2009.10.024 .
doi: 10.1016/j.jbiomech.2009.10.024
pubmed: 19896668
Nordmeyer, J., S. Khambadkone, L. Coats, et al. Risk stratification, systematic classification, and anticipatory management strategies for stent fracture after percutaneous pulmonary valve implantation. Circulation. 115:1392–1397, 2007. https://doi.org/10.1161/CIRCULATIONAHA.106.674259 .
doi: 10.1161/CIRCULATIONAHA.106.674259
pubmed: 17339542
Nordmeyer, J., P. Lurz, S. Khambadkone, et al. Pre-stenting with a bare metal stent before percutaneous pulmonary valve implantation: acute and 1-year outcomes. Heart. 97:118–123, 2011. https://doi.org/10.1136/hrt.2010.198382 .
doi: 10.1136/hrt.2010.198382
pubmed: 20965979
Haddad, R. N., D. Bonnet, I. A. Abu Zahira, et al. A new solution for stenting large right ventricular outflow tracts before transcatheter pulmonary valve replacement. Can. J. Cardiol. 38:31–40, 2022. https://doi.org/10.1016/j.cjca.2021.08.021 .
doi: 10.1016/j.cjca.2021.08.021
pubmed: 34520811
Guerin, P., K. W. Fresse, and O. Razafimahatratra. Traitement percutané de la valve pulmonaire. Ann. Cardiol. Angéiol. 68:474–479, 2019. https://doi.org/10.1016/j.ancard.2019.10.003 .
doi: 10.1016/j.ancard.2019.10.003
Mori, K., and T. Saito. Effects of stent structure on stent flexibility measurements. Ann. Biomed. Eng. 33:733–742, 2005. https://doi.org/10.1007/s10439-005-2807-6 .
doi: 10.1007/s10439-005-2807-6
pubmed: 16078613
Jorge, C., and C. Dubois. Clinical utility of platinum chromium bare-metal stents in coronary heart disease. Med. Devices (Auckl). 8:359–367, 2015. https://doi.org/10.2147/MDER.S69415 .
doi: 10.2147/MDER.S69415
pubmed: 26345228
Houeijeh, A., C. Karsenty, N. Combes, et al. A modified technique for transcatheter pulmonary valve implantation of SAPIEN 3 valves in large right ventricular outflow tract: a matched comparison study. J. Clin. Med. 12:7656, 2023. https://doi.org/10.3390/jcm12247656 .
doi: 10.3390/jcm12247656
pubmed: 38137725
pmcid: 10743789
Lim, D. S., D. Kim, J. Aboulhosn, et al. Congenital pulmonic valve dysfunction treated with SAPIEN 3 transcatheter heart valve (from the COMPASSION S3 trial). Am. J. Cardiol. 190:102–109, 2023. https://doi.org/10.1016/j.amjcard.2022.12.010 .
doi: 10.1016/j.amjcard.2022.12.010
pubmed: 36608435
Law, M. A., and A. Chatterjee. Transcatheter pulmonic valve implantation: techniques, current roles, and future implications. World J. Cardiol. 13:117–129, 2021. https://doi.org/10.4330/wjc.v13.i5.117 .
doi: 10.4330/wjc.v13.i5.117
pubmed: 34131475
pmcid: 8173335
Sivakumar, K., P. Sagar, S. Qureshi, et al. Outcomes of Venus P-valve for dysfunctional right ventricular outflow tracts from Indian Venus P-valve database. Ann. Pediatr. Cardiol. 14:281–292, 2021. https://doi.org/10.4103/apc.APC_175_20 .
doi: 10.4103/apc.APC_175_20
pubmed: 34667398
pmcid: 8457277
Sivaprakasam, M. C., J. R. V. Reddy, S. Gunasekaran, et al. Early multicenter experience of a new balloon expandable MyVal transcatheter heart valve in dysfunctional stenosed right ventricular outflow tract conduits. Ann. Pediatr. Cardiol. 14:293–301, 2021. https://doi.org/10.4103/apc.apc_242_20 .
doi: 10.4103/apc.apc_242_20
pubmed: 34667399
pmcid: 8457297