Image-Based Analysis of Correlation Between Valve Stent Deformation and Valve Function in Transcatheter Aortic Valve Replacement

IF 1.9 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2025-01-26 DOI:10.1002/ccd.31421

Min Jin, Qing Zhou, Shuchun li, Haitao Zhang, Dongjin Wang

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Abstract

Background and Objectives

Currently, there remains a paucity of research on the deformation and valve function of transcatheter heart valves (THV) in patients with aortic regurgitation (AR) following transcatheter aortic valve replacement (TAVR). This study aimed to thoroughly explore the correlation between THV deformation and postoperative hemodynamics in these patients.

Methods

In this study, we assessed 39 AR patients treated with the J-Valve THV system during TAVR. We utilized postoperative cardiac-enhanced computed tomography angiography (CTA) to examine the extent of stent deformation, correlating these measurements with concurrent echocardiographic data.

Results

Among patients with AR, the J-Valve exhibited three distinct configurations: rectangular, trapezoidal, and inverted trapezoidal shapes. The rectangular configuration showed a trend toward a larger effective orifice area (EOA) compared to the trapezoidal and inverted trapezoidal configurations (rectangular: 2.20 ± 0.11 cm², trapezoidal: 1.88 ± 0.08 cm², inverted trapezoidal: 2.04 ± 0.08 cm²; p = 0.068). Stratified analysis of the degree of inclined commissural posts indicated that THVs with all three commissural angles < 5° exhibited the highest standard EOA (sEOA). An increase in the number and degree of inclined commissural posts correlated with a decrease in sEOA. Furthermore, a higher EOA was observed when the expansion in the mid and transition level exceeded 80%.

Conclusions

During the TAVR procedure, ensuring sufficient expansion in the mid and transition level of the stent, maintaining the stent in a rectangular configuration, and avoiding tilting of the commissural posts contribute to achieving favorable postoperative hemodynamics.

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经导管主动脉瓣置换术中瓣膜支架变形与瓣膜功能相关性的影像学分析。

背景与目的：目前，关于经导管主动脉瓣置换术（TAVR）后主动脉瓣反流（AR）患者经导管心脏瓣膜（THV）变形及瓣膜功能的研究尚缺乏。本研究旨在深入探讨这些患者THV变形与术后血流动力学的关系。方法：在本研究中，我们评估了39例在TAVR期间接受J-Valve THV系统治疗的AR患者。我们利用术后心脏增强计算机断层血管造影（CTA）检查支架变形的程度，并将这些测量结果与并发超声心动图数据相关联。结果：在AR患者中，j型瓣膜呈现出三种不同的构型：矩形、梯形和倒梯形。与梯形和倒梯形构型相比，矩形构型的有效孔面积（EOA）有更大的趋势(矩形：2.20±0.11 cm²，梯形：1.88±0.08 cm²，倒梯形：2.04±0.08 cm²；p = 0.068)。结论：在TAVR手术过程中，保证支架中间和过渡层的充分扩张，保持支架的矩形构型，避免支架的倾斜，有助于获得良好的术后血流动力学。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.