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Prosthetic heart valve size and diameter

David Hasler, Dominik Obrist
The flow field past a prosthetic aortic valve comprises many details that indicate whether the prosthesis is functioning well or not. It is, however, not yet fully understood how an optimal flow scenario would look, i.e. which subtleties of the fluid dynamics in place are essential regarding the durability and compatibility of a prosthetic valve. In this study, we measured and analyzed the 3D flow field in the vicinity of a bio-prosthetic heart valve in function of the aortic root size. The measurements were conducted within aortic root phantoms of different size, mounted in a custom-built hydraulic setup, which mimicked physiological flow conditions in the aorta...
2018: PloS One
Noah Barka, Jason Bourgoin, Erin Grassl, John A St Cyr
OBJECTIVE: Prosthetic heart valve implantation is commonly performed in patients that have valvular heart disease. Prior to clinical evaluation of newly developed prostheses, preclinical animal studies are performed for the assessment of both acute and chronic valvular function. Commonly, one size of valve is used in these preclinical studies, which can present difficulties with the implantation procedure and assessing valve function. Due to these potential problems, we developed a preoperative screening assessment in potential ovine candidates for prosthetic aortic valve implantation...
August 2016: Therapeutic Advances in Cardiovascular Disease
Dominika Suchá, Ceranza G Daans, Petr Symersky, R Nils Planken, Willem P Th M Mali, Lex A van Herwerden, Ricardo P J Budde
The implanted prosthetic heart valve (PHV) size is vital for the evaluation of suspected PHV dysfunction and in case of reoperation or valve-in-valve transcatheter approaches. The labeled size is not always known, and discrepancies exist between manufacturers' labeled sizes and true sizes. Reproducible methods for noninvasive PHV size assessment are lacking. We determined the reliability and agreement of PHV size measurements using multidetector-row computed tomography (MDCT) and provide reference values of MDCT measurements compared with manufacturer specifications...
July 1, 2015: American Journal of Cardiology
L A Bokeria, O L Bokeria, A A Fadeev, O A Makhachev, T I Kosareva, I I Averina
The analysis of transprosthetic hemodynamics in adults after aortic valve replacement in the Bakoulev Center for Cardiovascular Surgery in 2007-2010 demonstrated the hemodynamic advantage of the concept of new full-flow mechanical aortic valve prosthesis "CorBeat". Having the same size of internal orifice and tissue annulus diameters, the values of transprosthetic parameters (peak and mean gradients, blood flow velocities) through "CorBeat" were close to physiological values of transvalvular native aortic parameters and had a tendency to be not dependent on the size of prosthesis (p = 0...
2013: Vestnik Rossiĭskoĭ Akademii Meditsinskikh Nauk
Wen Sheng Chen, Bing Ren Gao, Wen Qin Chen, Zhen Zhen Li, Zhi Yi Xu, Yan Hua Zhang, Kun Yang, Xin Qiang Guan
OBJECTIVE: To compare the efficacy of electrical versus pharmacological cardioversion following prosthetic cardiac valve replacement in patients with permanent atrial fibrillation (AF). METHODS: Patients with permanent AF who had undergone prosthetic cardiac valve replacement, who had a cardiothoracic ratio ≤ 0.5 and a left atrial diameter ≤ 50 mm for ≥ 6 months after surgery were randomly divided to receive either electrical or pharmacological cardioversion...
August 2013: Journal of International Medical Research
Rüdiger Lange, Catalin C Badiu, Manfred Vogt, Bernhard Voss, Jürgen Hörer, Zsolt Prodan, Christian Schreiber, Domenico Mazzitelli
OBJECTIVES: We aimed at evaluating the results of aortic valve-sparing root replacement (AVSRR) in children with aortic root aneurysm (ARA) due to genetic disorders in terms of mortality, reoperation and recurrent aortic valve regurgitation (AVR). METHODS: Thirteen patients (mean age 9.7 ± 6.5 years, 10 months-18 years) underwent AVSRR for ARA between 2002 and 2011. Six of the 13 patients had Marfan syndrome, 3 Loeys-Dietz syndrome (LDS), 2 bicuspid aortic valve syndrome and 2 an unspecified connective tissue disorder...
May 2013: European Journal of Cardio-thoracic Surgery
Katie L Losenno, Jill J Gelinas, Marjorie Johnson, Michael W A Chu
BACKGROUND: Aortic root enlargement (ARE) procedures are believed to allow implantation of larger valve prostheses; however, little evidence exists to support the specific efficacy of various techniques. METHODS: Using a cadaveric model, 20 adult (72.4 ± 15.3 years) hearts were stratified into 4 groups based on annular diameter: <20 mm, 20-22 mm, 22-24 mm, and >24 mm. Each heart underwent an aortic valve replacement following a Nicks, Manougian, aortoventriculoplasty and modified Bentall procedure, with appropriate reversals between procedures...
April 2013: Canadian Journal of Cardiology
Tadahisa Sugiura, Takeshi Hiramatsu, Yusuke Iwata, Toru Okamura, Takeshi Konuma, Hiromi Kurosawa
A 6-year-old girl with a diagnosis of aortic regurgitation with stenosis and mitral regurgitation because of short chordae was referred to us for surgery. Echocardiography revealed that the aortic and the mitral annular diameters were 16 and 23 mm, respectively. The Ross procedure and mitral valvuloplasty were scheduled. During the procedure, we were concerned that aggressive mitral valvuloplasty might result in mitral stenosis. We therefore converted the procedure to double-valve replacement using the Manouguian technique because it was necessary to enlarge both the aortic and mitral annuli...
November 2012: General Thoracic and Cardiovascular Surgery
Ninel Santos, José Alberto de Agustín, Carlos Almería, Alejandra Gonçalves, Pedro Marcos-Alberca, Covadonga Fernández-Golfín, Eulogio García, Rosana Hernández-Antolín, Leopoldo Pérez de Isla, Carlos Macaya, José Zamorano
AIMS: Paravalvular aortic regurgitation (AR) is common after transcatheter aortic valve implantation (TAVI). This study aimed to assess the prosthesis/aortic annulus discongruence by three-dimensional (3D) transoesophageal (TOE) planimetry of aortic annulus and its impact on the occurrence of significant AR after TAVI. METHODS AND RESULTS: We included 33 patients who underwent TAVI with a balloon expandable device for severe aortic stenosis. To appraise the prosthesis/annulus discongruence, we defined a 'mismatch index' expressed as: annulus area - prosthesis area...
November 2012: European Heart Journal Cardiovascular Imaging
Hikmet Selçuk Gedik, Kemal Korkmaz, Gökhan Lafçı, Adnan Yalçınkaya, Kerim Çağlı
OBJECTIVE: We aimed to study the effects of the valve sizes according to body surface area on aortic gradient and ventricular hypertrophy in the cases of aortic valve replacement due to isolated aortic stenosis. METHODS: Between January 2006 and April 2007, patients (12 men, 15 women; totally 27) followed up prospectively with echocardiography fourth and sixth month postoperatively. The patients were divided into two groups according to the prosthetic aortic valve diameters (19-21 mm vs 23-25 mm)...
March 2012: Anadolu Kardiyoloji Dergisi: AKD, the Anatolian Journal of Cardiology
Thomas Walther, Matthias Thielmann, Joerg Kempfert, Holger Schroefel, Gerhard Wimmer-Greinecker, Hendrik Treede, Thorsten Wahlers, Olaf Wendler
OBJECTIVES: Transapical (TA) aortic valve implantation (AVI) has evolved as an alternative procedure for high-risk patients. We evaluated the second-generation SAPIEN XT™ prosthesis in a prospective multicentre clinical trial. METHODS: A total of 150 patients (age: 81.6 ± 5.8 years; 40.7% female) were included. Prosthetic valves (diameter: 23 mm (n = 36), 26 mm (n = 57) and 29 mm (n = 57)) were implanted. The ASCENDRA-II™ modified delivery system was used in the smaller sizes...
August 2012: European Journal of Cardio-thoracic Surgery
Marie-Annick Clavel, Josep Rodés-Cabau, Éric Dumont, Rodrigo Bagur, Sébastien Bergeron, Robert De Larochellière, Daniel Doyle, Eric Larose, Jean G Dumesnil, Philippe Pibarot
OBJECTIVES: The objectives were to compare different Doppler echocardiographic methods for the measurement of prosthetic valve effective orifice area (EOA) following transcatheter aortic valve implantation (TAVI) and to determine the factors influencing the EOA of transcatheter balloon expandable valves. BACKGROUND: Previous studies have used different methods for the measurement of the valve EOA following TAVI. Factors influencing the EOA of transcatheter valves are unknown...
October 2011: JACC. Cardiovascular Imaging
Wenzhi Pan, Daxin Zhou, Cuizhen Pan, Junbo Ge
OBJECTIVES: The objective of the study was to describe the distribution and determine the predictors of aortic valve annulus diameter (AVAD) in Chinese patients with severe calcific aortic valve stenosis (CAS). BACKGROUND: AVAD in Chinese patients with CAS has not been reported. Predictors of AVAD in patients with CAS are unclear. METHODS: One hundred elderly patients (≥60 years) with severe CAS were included in the study. AVAD in all patients was measured by transthoracic echocardiograph (AVAD-TTE) and in 74 patients of them was measured intra-operatively (AVAD-intra)...
April 1, 2012: Catheterization and Cardiovascular Interventions
Faleh Al Rashidi, Misha Bhat, Peter Höglund, Carl Meurling, Anders Roijer, Bansi Koul
OBJECTIVE: Following the Ross operation, pulmonary autografts tend to dilate over time. This study researches the fate of the pulmonary autograft - at 4.5 years following the modified Ross operation - with special reference to the impact of the modification on (a) pulmonary autograft dilatation, (b) the neo-aortic root geometry, (c) neo-aortic valve function and (d) the coronary artery reserve. METHODS: A total of 26 patients who underwent the Ross operation were included in this study; of these, 13 consecutive patients underwent a modified Ross operation in which the free-standing autograft root was supported externally by a Dacron vascular prosthetic jacket (DVPJ)...
April 2010: European Journal of Cardio-thoracic Surgery
Francesco Onorati, Antonino Salvatore Rubino, Domenico Marturano, Eugenia Pasceri, Giuseppina Mascaro, Stefania Zinzi, Filiberto Serraino, Attilio Renzulli
BACKGROUND: Despite restrictive mitral annuloplasty (RMA) being considered effective for chronic ischaemic mitral regurgitation (CIMR), few data exist on mid-term echocardiographic results with different prosthetic rings. Therefore, comparative echocardiographic analysis has been performed. METHODS: Sixty-four consecutive coronary artery bypass graft surgery (CABG) + RMA (downsizing by two-ring sizes; median size: 26 mm) for CIMR with a follow-up of at least 6 months were prospectively followed-up with serial echocardiograms (preoperative, discharge, 6 months, follow-up ending)...
August 2009: European Journal of Cardio-thoracic Surgery
Narayanan Namboodiri, Othayoth Shajeem, Jaganmohan A Tharakan, R Sankarkumar, Thomas Titus, Ajitkumar Valaparambil, Sivasubramonian Sivasankaran, Kavassery Mahadevan Krishnamoorthy, Sivadasan Pillai Harikrishnan, Santosh Kumar Dora
AIMS: TTK Chitra heart valve prosthesis (CHVP), a tilting disc mechanical heart valve of low cost and proven efficacy, has been in use for the last 15 years. Although various studies substantiating its long-term safety and efficacy are available, no study had assessed its echocardiographic characteristics. The purpose of this study was to determine the normal Doppler parameters of CHVP in the mitral position and to assess whether derivation of mitral valve area (MVA) using the continuity equation (CE) and more commonly used pressure half-time (PHT) method is comparable in the functional assessment of this tilting disc mitral prosthesis...
September 2008: European Journal of Echocardiography
Maria Lengyel
Left-sided prosthetic valve thrombosis is a life-threatening complication of the mechanical valves. Prosthetic valve thrombosis has been divided into obstructive forms (OPVT) and nonobstructive forms (NOPVT). Clinical presentation of OPVT is heart failure and systemic embolism of OPVT and NOPVT, but it may be asymptomatic. Transesophageal echocardiography is the technique of choice for diagnosis and treatment guidance. There are three treatment options. Surgery carries a high hospital mortality risk in severely sick patients...
January 2008: Expert Review of Cardiovascular Therapy
A Tulga Ulus, Ufuk Tütün, Baran Budak, Sakine Erbaş, Nurcan Arat, Seher Bozboğa, Kenan Köse, Mustafa Seren, Ali Ihsan Parlar, Ayşen Aksöyek, Salih Fehmi Katircioğlu
OBJECTIVE: The aim of this study was to investigate the response of heart to stress according to the size of the prosthetic valve in patients who had undergone mitral valve replacement by using dobutamine stress echocardiography (DSE) and to evaluate the relationship between the size of the prosthetic valve and cardiac recovery-remodeling process. METHODS: Thirty-nine patients, who had undergone mitral valve replacement were compared in terms of left ventricular diameters, systolic functions and cardiac mass indexes in order to investigate the effect of the mechanical valve size on postoperative cardiac remodeling in this longitudinal study...
December 2007: Anadolu Kardiyoloji Dergisi: AKD, the Anatolian Journal of Cardiology
Benjamin A Youdelman, Hitoshi Hirose, Harsh Jain, J Yasha Kresh, John W C Entwistle, Andrew S Wechsler
OBJECTIVES: Proper valve selection is critical to ensure appropriate valve replacement for patients, because implantation of a small valve might place the patient at risk for persistent gradients. Labeled valve size is not the same as millimeter measure of prosthetic valve diameters or the annulus into which it will fit. Studies that use the labeled valve size in lieu of actual measured diameter in millimeters to compare different valves might be misleading. Using human cadaver hearts, we sized the aortic annulus with 8 commonly used prosthetic aortic valve sizers and compared the valves using geometric orifice area...
December 2007: Journal of Thoracic and Cardiovascular Surgery
Mourad Djebbi, Ali Walid Ben, Mehdi Chihaoui, Mourad Hakim, Faker Guedira, Raouf Denguir, Taoufik Kalfat, Adel Khayati, Abdelfatteh Abid
BACKGROUND: Konno procedure is used to enlarge the aortic root and increase the size of the aortic valve implanted. AIM: The aim of this study is to present the indications of the Konno procedure in congenital and acquired aortic lesions, in young patients with normal or hypoplastic aortic annulus or adults with small aortic annulus. METHODS: We reported our experience of this technique with a retrospective study of 13 patients operated on between 1998 and 2004...
March 2007: La Tunisie Médicale
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