Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves

Andreas Fuchs, Ole De Backer, Matthew Brooks, Martina C. De Knegt, Gintautas Bieliauskas, Masanori Yamamoto, Ryo Yanagisawa, Kentaro Hayashida, Lars Søndergaard, Klaus F. Kofoed

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Aims: This study aimed to assess the potential relationship between subclinical leaflet thickening and stent frame geometry in patients who underwent aortic valve replacement with a self-expanding transcatheter heart valve (THV). Methods and results: Seventy-five patients with a self-expanding THV were studied with 4D-computed tomography and analysed for leaflet thickening. There was no difference in THV size, overall THV expansion, eccentricity or implantation depth between patients with and those without leaflet thickening. Moderate-to-severe regional THV underexpansion (≤90°) more frequently occurred at the non-coronary and right coronary cusps with a significantly higher incidence of leaflet thickening than in cases of full regional THV expansion (24% vs. 3%, p<0.01). Regional THV underexpansion at the inflow level more often translated into the same issue at the valvular level in THV with intra-annular as compared to supra-annular valve position (54% vs. 17%; p=0.04). In case of post-dilatation, regional THV underexpansion occurred less frequently as compared to THV that were not post-dilated (18% vs. 43%, p=0.028). A similar but nonsignificant trend was found for leaflet thickening. Conclusions: Regional THV stent frame underexpansion is associated with an increased risk of leaflet thickening. Post-dilatation of self-expanding THV as well as a supra-annular valve position seem to reduce the occurrence of this phenomenon.

Original languageEnglish
Pages (from-to)e1067-e1075
JournalEuroIntervention
Volume13
Issue number9
DOIs
Publication statusPublished - 2017 Oct 1

Keywords

  • Computed tomography (CT)
  • Leaflet thickening
  • Stent frame geometry
  • Transcatheter aortic valve replacement (TAVR)
  • Transcatheter heart valve (THV)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves'. Together they form a unique fingerprint.

  • Cite this

    Fuchs, A., De Backer, O., Brooks, M., De Knegt, M. C., Bieliauskas, G., Yamamoto, M., Yanagisawa, R., Hayashida, K., Søndergaard, L., & Kofoed, K. F. (2017). Subclinical leaflet thickening and stent frame geometry in self-expanding transcatheter heart valves. EuroIntervention, 13(9), e1067-e1075. https://doi.org/10.4244/EIJ-D-17-00373