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Native Valve and Native Neo-Sinus Remodeling Following Transcatheter Aortic Valve Replacement.
Circ Cardiovasc Interv
December 2024
Cardiovascular Translational Laboratory, Providence Research and Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada (J.Y., H.G., J.J., A.L., J.G.W., J.S., D.M., S.L.S.).
Background: Transcatheter aortic valve replacement (TAVR) pushes aside the diseased native aortic valve and creates a native neo-sinus bordered by the aortic root wall and the displaced native valve. There are limited data on the progression of native valve disease post-TAVR and no previous analysis of the native neo-sinus.
Methods: Native aortic valves and native neo-sinus explants obtained post-TAVR were evaluated histologically (hematoxylin and eosin, Movat pentachrome, and Martius Scarlet Blue stains) and by immunohistochemistry (TGF-β1 [transforming growth factor-beta 1], FAP [fibroblast activation protein], and ALP [alkaline phosphatase]) to assess disease mechanisms.
Benchtop Flow Stasis Quantification: In Vitro Methods and In Vivo Possibilities.
Cardiovasc Eng Technol
December 2024
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Technology Enterprise Park, Suite 200, 387 Technology Circle, Atlanta, GA, 30313-2412, USA.
Article Synopsis
- Neo-sinus flow stasis has been linked to the severity of transcatheter heart valve thrombosis, and traditional assessment methods often face challenges due to limited optical access.
- This study introduces and compares laser-enhanced video densitometry (LEVD) and fluoroscopic video densitometry (FVD) to evaluate flow stasis, proposing a new metric called contrast attenuation ratio (CAR) as an effective measure.
- Results show strong correlation between CAR and traditional measures, indicating CAR's practicality for assessing flow stasis from routine clinical fluoroscopic data.
The relation between aortic morphology and transcatheter aortic heart valve thrombosis: Particle tracing and platelet activation in larger aortic roots with and without neo-sinus.
Comput Biol Med
September 2024
ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, Bern, 3010, Switzerland.
Transcatheter aortic heart valve thrombosis (THVT) affects long-term valve durability, transvalvular pressure gradient and leaflet mobility. In this study, we conduct high-fidelity fluid-structure interaction simulations to perform Lagrangian particle tracing in a generic model with larger aortic diameters (THVT model) with and without neo-sinus which is compared to a model of unaffected TAVI patients (control model). Platelet activation indices are computed for each particle to assess the risk of thrombus formation induced by high shear stresses followed by flow stagnation.
View Article and Find Full Text PDFSubclinical leaflet thrombus in patients with severe aortic stenosis and atrial fibrillation -ENRICH-AF TAVI study.
Sci Rep
June 2024
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo Chuo-ku, Kumamoto, 860-8556, Japan.
Article Synopsis
- Subclinical leaflet thrombosis (SLT) can lead to failure of transcatheter heart valves (THV) after TAVI, prompting this study to investigate its formation and related thrombotic factors.
- In a study of 26 patients treated with edoxaban for atrial fibrillation undergoing TAVI, SLT was observed in 16.7% of patients at one week, decreasing to 5.9% by three months.
- It was found that patients with SLT at one week had reduced maximal leaflet thickness, while thrombogenicity initially dropped but began to rise again by three months post-TAVI, indicating complex dynamics in thrombus formation in the early recovery phase.
Effect of Ascending Aortic Curvature on Flow in the Sinus and Neo-sinus Following TAVR: A Patient-Specific Study.
Ann Biomed Eng
February 2024
Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
Article Synopsis
- The study investigates how the unique shape of a patient's aorta affects blood flow around Transcatheter Aortic Valves (TAV) using various testing methods, including a left heart simulator.
- Six patient-specific aorta models were analyzed with a focus on the impact of aortic curvature on blood circulation in the ascending aorta and valve cusps.
- The results indicate that a curved ascending aorta enhances circulation and reduces stagnation risk, promoting effective blood flow back into heart areas known as the sinus and neo-sinus.
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