PMID- 37899719
OWN - NLM
STAT- MEDLINE
DCOM- 20231219
LR  - 20231219
IS  - 1969-6213 (Electronic)
IS  - 1774-024X (Print)
IS  - 1774-024X (Linking)
VI  - 19
IP  - 11
DP  - 2023 Dec 18
TI  - Deformation of transcatheter heart valves with mitral valve-in-valve.
PG  - e937-e947
LID - EIJ-D-23-00614 [pii]
LID - 10.4244/EIJ-D-23-00614 [doi]
AB  - BACKGROUND: The use of oversizing in mitral valve-in-valve (MViV) procedures can 
      lead to non-uniform expansion of transcatheter heart valves (THV). This may have 
      implications for THV durability. AIMS: The objective of this study was to assess 
      the extent and predictors of THV deformation in MViV procedures. METHODS: We 
      examined 33 patients who underwent MViV with SAPIEN prostheses. The extent of THV 
      deformation (deformation index, eccentricity, neosinus volume, asymmetric leaflet 
      expansion and vertical deformation) and hypoattenuating leaflet thickening (HALT) 
      were assessed using cardiac computed tomography (CT), performed prospectively at 
      30 days post-procedure. For descriptive purposes, the THV deformation index was 
      calculated, with values >1.00 representing a more hourglass shape. RESULTS: 
      Non-uniform underexpansion of THV was common after MViV implantation, with a 
      median expansion area of 74.0% (interquartile range 68.1-84.1) at the narrowest 
      level and a THV deformation index of 1.21 (1.13-1.29), but circularity was 
      maintained with eccentricity ranging from 0.24 to 0.28. The degree of oversizing 
      was a key factor associated with greater underexpansion and a higher deformation 
      index (beta=-0.634; p<0.001; beta=0.594; p<0.001, respectively). Overall, the incidence 
      of HALT on the 30-day postprocedural CT was 27.3% (9 of 33). Most patients (32 of 
      33) were on anticoagulation therapy, but the prothrombin time and international 
      normalised ratio (PT-INR) at the time of the CT scan was <2.5 in 23 of 32 
      patients. Among patients with a PT-INR of <2.5, HALT was predominantly observed 
      with a high THV deformation index of >/=1.18. CONCLUSIONS: THV deformation, i.e., 
      underexpansion and an hourglass shape, commonly occurs after MViV implantation 
      and is negatively affected by excessive oversizing. Optimising THV expansion 
      during MViV could potentially prevent HALT.
FAU - Fukui, Miho
AU  - Fukui M
AD  - Cardiovascular Imaging Research Center and Core Lab, Minneapolis Heart Institute 
      Foundation, Minneapolis, MN, USA.
FAU - Okada, Atsushi
AU  - Okada A
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
FAU - Burns, Marcus R
AU  - Burns MR
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
FAU - Sato, Hirotomo
AU  - Sato H
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
FAU - Thao, Kiahltone R
AU  - Thao KR
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
FAU - Wang, Cheng
AU  - Wang C
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
FAU - Koike, Hideki
AU  - Koike H
AD  - Cardiovascular Imaging Research Center and Core Lab, Minneapolis Heart Institute 
      Foundation, Minneapolis, MN, USA.
FAU - Hamid, Nadira
AU  - Hamid N
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
FAU - Enriquez-Sarano, Maurice
AU  - Enriquez-Sarano M
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
FAU - Lesser, John R
AU  - Lesser JR
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
FAU - Cavalcante, Joao L
AU  - Cavalcante JL
AD  - Cardiovascular Imaging Research Center and Core Lab, Minneapolis Heart Institute 
      Foundation, Minneapolis, MN, USA.
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
FAU - Sorajja, Paul
AU  - Sorajja P
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
FAU - Bapat, Vinayak N
AU  - Bapat VN
AD  - Valve Science Center, Minneapolis Heart Institute Foundation, Minneapolis, MN, 
      USA.
AD  - Allina Health Minneapolis Heart Institute - Minneapolis, Abbott Northwestern 
      Hospital, Minneapolis, MN, USA.
LA  - eng
PT  - Journal Article
DEP - 20231218
PL  - France
TA  - EuroIntervention
JT  - EuroIntervention : journal of EuroPCR in collaboration with the Working Group on 
      Interventional Cardiology of the European Society of Cardiology
JID - 101251040
SB  - IM
MH  - Humans
MH  - *Aortic Valve Stenosis/surgery
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - *Heart Valve Prosthesis
MH  - *Transcatheter Aortic Valve Replacement
MH  - Prosthesis Design
MH  - Aortic Valve/surgery
PMC - PMC10719737
COIS- J.L. Cavalcante has received consulting fees from 4C Medical, Abbott Structural, 
      Anteris, Aria CV, Boston Scientific, Edwards Lifesciences, HighLife, Medtronic, 
      VDyne, W.L. Gore & Associates, and Xylocor; and has received research grant 
      support from Abbott Northwestern Hospital Foundation. P. Sorajja has received 
      consulting fees from 4C Medical, Abbott Structural, Anteris, Boston Scientific, 
      Edwards Lifesciences, Evolution Medical, Foldax, GLG, Medtronic, Philips, 
      Siemens, Shifamed, W.L. Gore & Associates, VDyne, and xDot Medical; and has 
      received institutional research grant support from Abbott Structural, Medtronic, 
      and Boston Scientific. M. Enriquez-Sarano has received consulting fees from 
      CryoLife, Edwards Lifesciences, HighLife, and ChemImage. V.N. Bapat has received 
      consulting fees from Abbott Structural, Medtronic, Boston Scientific, Edwards 
      Lifesciences, 4C Medical, and Anteris. The other authors have no conflicts of 
      interest to declare.
EDAT- 2023/10/30 06:47
MHDA- 2023/12/19 06:41
PMCR- 2024/12/18
CRDT- 2023/10/30 04:14
PHST- 2024/12/18 00:00 [pmc-release]
PHST- 2023/12/19 06:41 [medline]
PHST- 2023/10/30 06:47 [pubmed]
PHST- 2023/10/30 04:14 [entrez]
AID - EIJ-D-23-00614 [pii]
AID - 10.4244/EIJ-D-23-00614 [doi]
PST - epublish
SO  - EuroIntervention. 2023 Dec 18;19(11):e937-e947. doi: 10.4244/EIJ-D-23-00614.