Search results for "Cardiac skeleton"
showing 10 items of 10 documents
Transcatheter Heart Valve Implantation in Bicuspid Patients with Self-Expanding Device
2021
Bicuspid aortic valve (BAV) patients are conventionally not treated by transcathether aortic valve implantation (TAVI) because of anatomic constraint with unfavorable outcome. Patient-specific numerical simulation of TAVI in BAV may predict important clinical insights to assess the conformability of the transcathether heart valves (THV) implanted on the aortic root of members of this challenging patient population. We aimed to develop a computational approach and virtually simulate TAVI in a group of n.6 stenotic BAV patients using the self-expanding Evolut Pro THV. Specifically, the structural mechanics were evaluated by a finite-element model to estimate the deformed THV configuration in …
TAVI imaging: over the echocardiography
2020
Aortic valve stenosis (AS) is a common valvular heart disease. Recently, transcatheter aortic valve implantation (TAVI) has changed the treatment of severe AS in elderly patients with contraindications to traditional surgical replacement. Echocardiography is conventionally used as the first imaging modality to assess the presence and severity of AS and to provide anatomical and functional information. Nowadays, imaging techniques play a crucial role in the planning of TAVI to define suitable candidates. Computed tomography (CT) is essential to display the anatomy of the aortic valve complex (including aortic annulus, Valsalva sinuses, coronary arteries ostia, sinotubular junction), thoracoa…
Simulation study of transcatheter heart valve implantation in patients with stenotic bicuspid aortic valve
2019
Bicuspid aortic valve (BAV) anatomy has routinely been considered an exclusion in the setting of transcatheter aortic valve implantation (TAVI) because of the large dimension of the aortic annulus having a more calcified, bulky, and irregular shape. The study aims to develop a patient-specific computational framework to virtually simulate TAVI in stenotic BAV patients using the Edwards SAPIEN 3 valve (S3) and its improved version SAPIEN 3 Ultra and quantify stent frame deformity as well as the severity of paravalvular leakage (PVL). Specifically, the aortic root anatomy of n.9 BAV patients who underwent TAVI was reconstructed from pre-operative CT imaging. Crimping and deployment of S3 fram…
Modified Danielson Technique for Prosthetic Aortic Valve Endocarditis and Aortoventricular Discontinuity
2020
Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aor…
Valve prosthesis-patient mismatch: hemodynamic, echocardiographic and clinical consequences
2011
OBJECTIVES: The purpose is to evaluate in vivo at rest and under stress conditions hemodynamic performance of the small size St. Jude Medical Regent (SJMR) prosthetic valve in patients with a body surface area (BSA) of 1.8 ± 0.11 m(2) and to define the role of valve prosthesis- patient mismatch on left ventricular mass regression following aortic valve replacement. METHODS: We evaluated 25 cases (12 males and 13 females, mean age 65.2 ± 8 years) of aortic valve replacement (17 mm SJMR in three cases and 19 mm SJMR in 22 cases). All the patients underwent at rest Doppler echocardiography before and after surgery and both basal and dobutamine stress echocardiography (DSE) at follow-up. The me…
Reducing Patient Radiation Dose With Image Noise Reduction Technology in Transcatheter Aortic Valve Procedures
2015
X-ray radiation exposure is of great concern for patients undergoing structural heart interventions. In addition, a larger group of medical staff is required and exposed to radiation compared with percutaneous coronary interventions. This study aimed at quantifying radiation dose reduction with implementation of specific image noise reduction technology (NRT) in transcatheter aortic valve implantation (TAVI) procedures. We retrospectively analyzed 104 consecutive patients with TAVI procedures, 52 patients before and 52 after optimization of x-ray radiation chain, and implementation of NRT. Patients with 1-step TAVI and complex coronary intervention, or complex TAVI procedures, were excluded…
Aortic valve-sparing root replacement from inside the aorta using three Dacron skirts preserving the native Valsalva sinuses geometry and stabilizing…
2009
We present an alternative idea for valve-sparing technique combining the advantages of the reimplantation and the benefits of the remodeling techniques. We replace the sinuses of Valsalva using three Dacron skirts from inside of the aorta. The physiological anatomy of the Valsalva sinuses and their dynamic properties are preserved and the aortic commissures displacement avoided. The distal rim of each Dacron skirt was anchored to the aorto-ventricular junction using Ticron (2-0) U stitches placed from the ventricular side to the aortic side. We stabilize the base of the aortic annulus to prevent future dilation.
Implantation of Gore-Tex chordae on aortic valve leaflet to treat prolapse using "the chordae technique": surgical aspects and clinical results.
2008
Background Repair of prolapsed aortic valve leaflets has been considered a challenging technique for cardiac surgeons. In this paper we describe our surgical approach, "the chordae technique." It consists of the correction of aortic cusp prolapse by shortening the free margin length and of an adjustment of the leaflets coaptation height by anchoring the prolapsing cusp to the aortic wall at the sinotubular junction level. Methods Between February 2003 and December 2006, 26 patients with one or more prolapsed aortic leaflets underwent surgical repair using the new approach. The mean age of patients was 55 ± 10 years. There were 10 (38.5%) patients with grade II aortic valve regurgitation, 4 …
New Technique for Aortic Valve Functional Annulus Reshaping Using a Handmade Prosthetic Ring
2011
Background Despite a wide development in aortic leaflets repair techniques, aortic valve annuloplastic procedures are still poorly investigated. We present our aortic valve annuloplastic system consisting of a handmade prosthetic ring with 2 components for reshaping the aortic annulus and sinotubular junction (STJ) and illustrates our surgical approach and clinical results. Methods Since February 2003, 45 patients with aortic valve regurgitation underwent aortic annuloplasty using the new ring. Mean patient age was 58 ± 16 years (range, 46 to 76 years). The ring has 2 components: a circular ring used to undersize the circumference of the aortoventricular junction and 3-crown-like shape ring…
Aortic Annulus Stabilization Using Internal Rings
2017
The past 20 years have seen the growing range of valve lesion etiologies turn nonvalvular conditions into the primary causes of aortic regurgitation [1]. Valves present relatively small lesions of the leaflets and concomitant dilatation of the ascending aorta with aortic regurgitation that can be explained thanks to our improved knowledge of the functional aortic annulus’ role in valve function. The geometric relations and dynamic behavior of aortic root components have been seen to ensure valve competence when leaflets have no structural lesions [2].