Hoda Hatoum1, Atieh Yousefi1, Scott Lilly2, Pablo Maureira3, Juan Crestanello2, Lakshmi P Dasi4. 1. Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio. 2. Department of Surgery, The Ohio State University, Columbus, Ohio. 3. Department of Cardiovascular Surgery, CHU de Nancy, Nancy, France. 4. Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio; Department of Surgery, The Ohio State University, Columbus, Ohio. Electronic address: lakshmi.dasi@osumc.edu.
Abstract
BACKGROUND: This study aimed at assessment of post-transcatheter aortic valve (TAV) replacement hemodynamics and turbulence when a same-size SAPIEN 3 (Edwards Lifesciences Corp, Irvine, Calif) and Medtronic Evolut (Minneapolis, Minn) were implanted in a rigid aortic root with physiological dimensions and in a representative root with calcific leaflets obtained from patient computed tomography scans. METHODS: TAV hemodynamics were studied by placing a SAPIEN 3 26-mm and an Evolut 26-mm in rigid aortic roots and representative root with calcific leaflets under physiological conditions. Hemodynamics were assessed using high-fidelity particle image velocimetry and high-speed imaging. Transvalvular pressure gradients (PGs), pinwheeling indices, and Reynolds shear stress (RSS) were calculated. RESULTS: (1) PGs obtained with the Evolut and the SAPIEN 3 were comparable among the different models (10.5 ± 0.15 mm Hg vs 7.76 ± 0.083 mm Hg in the rigid model along with 13.9 ± 0.19 mm Hg vs 5.0 ± 0.09 mm Hg in representative root with calcific leaflets obtained from patient computed tomography scans respectively); (2) more pinwheeling was found in the SAPIEN 3 than the Evolut (0.231 ± 0.057 vs 0.201 ± 0.05 in the representative root with calcific leaflets and 0.366 ± 0.067 vs 0.122 ± 0.045 in the rigid model); (3) higher rates of RSS were found in the Evolut (161.27 ± 3.45 vs 122.84 ± 1.76 Pa in representative root with calcific leaflets and 337.22 ± 7.05 vs 157.91 ± 1.80 Pa in rigid models). More lateral fluctuations were found in representative root with calcific leaflets. CONCLUSIONS: (1) Comparable PGs were found among the TAVs in different models; (2) pinwheeling indices were found to be different between both TAVs; (3) turbulence patterns among both TAVs translated according to RSS were different. Rigid aortic models yield more conservative estimates of turbulence; (4) both TAVs exhibit peak maximal RSS that exceeds platelet activation 100 Pa threshold limit.
BACKGROUND: This study aimed at assessment of post-transcatheter aortic valve (TAV) replacement hemodynamics and turbulence when a same-size SAPIEN 3 (Edwards Lifesciences Corp, Irvine, Calif) and Medtronic Evolut (Minneapolis, Minn) were implanted in a rigid aortic root with physiological dimensions and in a representative root with calcific leaflets obtained from patient computed tomography scans. METHODS: TAV hemodynamics were studied by placing a SAPIEN 3 26-mm and an Evolut 26-mm in rigid aortic roots and representative root with calcific leaflets under physiological conditions. Hemodynamics were assessed using high-fidelity particle image velocimetry and high-speed imaging. Transvalvular pressure gradients (PGs), pinwheeling indices, and Reynolds shear stress (RSS) were calculated. RESULTS: (1) PGs obtained with the Evolut and the SAPIEN 3 were comparable among the different models (10.5 ± 0.15 mm Hg vs 7.76 ± 0.083 mm Hg in the rigid model along with 13.9 ± 0.19 mm Hg vs 5.0 ± 0.09 mm Hg in representative root with calcific leaflets obtained from patient computed tomography scans respectively); (2) more pinwheeling was found in the SAPIEN 3 than the Evolut (0.231 ± 0.057 vs 0.201 ± 0.05 in the representative root with calcific leaflets and 0.366 ± 0.067 vs 0.122 ± 0.045 in the rigid model); (3) higher rates of RSS were found in the Evolut (161.27 ± 3.45 vs 122.84 ± 1.76 Pa in representative root with calcific leaflets and 337.22 ± 7.05 vs 157.91 ± 1.80 Pa in rigid models). More lateral fluctuations were found in representative root with calcific leaflets. CONCLUSIONS: (1) Comparable PGs were found among the TAVs in different models; (2) pinwheeling indices were found to be different between both TAVs; (3) turbulence patterns among both TAVs translated according to RSS were different. Rigid aortic models yield more conservative estimates of turbulence; (4) both TAVs exhibit peak maximal RSS that exceeds platelet activation 100 Pa threshold limit.
Authors: Robert M A van der Boon; Nicolas M Van Mieghem; Dominic A Theuns; Rutger-Jan Nuis; Sjoerd T Nauta; Patrick W Serruys; Luc Jordaens; Ron T van Domburg; Peter P T de Jaegere Journal: Int J Cardiol Date: 2013-01-05 Impact factor: 4.164
Authors: María Del Trigo; Abdellaziz Dahou; John G Webb; Danny Dvir; Rishi Puri; Omar Abdul-Jawad Altisent; Francisco Campelo-Parada; Chris Thompson; Jonathon Leipsic; Dion Stub; Robert DeLarochellière; Jean-Michel Paradis; Eric Dumont; Daniel Doyle; Siamak Mohammadi; Sergio Pasian; Melanie Côté; Philippe Pibarot; Josep Rodés-Cabau Journal: Rev Esp Cardiol (Engl Ed) Date: 2015-12-29
Authors: Hoda Hatoum; Shelley Gooden; Megan Heitkemper; Kevin M Blum; Jason Zakko; Martin Bocks; Tai Yi; Yen-Lin Wu; Yadong Wang; Christopher K Breuer; Lakshmi Prasad Dasi Journal: Ann Biomed Eng Date: 2020-02-12 Impact factor: 3.934