Adnan K Chhatriwalla1,2, John T Saxon3,4, David J Cohen3,4, Keith B Allen3,4. 1. Saint Luke's Mid America Heart Institute, Kansas City, MO, USA. achhatriwalla@saint-lukes.org. 2. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. achhatriwalla@saint-lukes.org. 3. Saint Luke's Mid America Heart Institute, Kansas City, MO, USA. 4. University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.
Abstract
PURPOSE OF REVIEW: This review aims to summarize data regarding bioprosthetic valve fracture (BVF), a novel technique that involves fracturing the surgical valve sewing ring to allow for further expansion of the transcatheter heart valve in patients undergoing valve in valve transcatheter aortic valve replacement (VIV TAVR). RECENT FINDINGS: Bench testing and clinical experience have demonstrated that most, but not all, bioprosthetic surgical valves can be fractured. BVF in patients with small- and intermediate-sized surgical valves results in a lower residual valve gradient and larger final valve effective orifice area as compared with standard VIV TAVR. However, whether patients with larger bioprothetic valves benefit from BVF, and whether the hemodynamic benefits of BVF translate into improved clinical outcomes, is unknown. BVF improves the hemodynamic results of VIV TAVR in small surgical valves. However, further research is needed to determine whether BVF is beneficial for patients with larger surgical valves, and whether the hemodynamic benefits of BVF result in improved clinical outcomes.
PURPOSE OF REVIEW: This review aims to summarize data regarding bioprosthetic valve fracture (BVF), a novel technique that involves fracturing the surgical valve sewing ring to allow for further expansion of the transcatheter heart valve in patients undergoing valve in valve transcatheter aortic valve replacement (VIV TAVR). RECENT FINDINGS: Bench testing and clinical experience have demonstrated that most, but not all, bioprosthetic surgical valves can be fractured. BVF in patients with small- and intermediate-sized surgical valves results in a lower residual valve gradient and larger final valve effective orifice area as compared with standard VIV TAVR. However, whether patients with larger bioprothetic valves benefit from BVF, and whether the hemodynamic benefits of BVF translate into improved clinical outcomes, is unknown. BVF improves the hemodynamic results of VIV TAVR in small surgical valves. However, further research is needed to determine whether BVF is beneficial for patients with larger surgical valves, and whether the hemodynamic benefits of BVF result in improved clinical outcomes.
Authors: Peter Johansen; Henrik Engholt; Mariann Tang; Rasmus F Nybo; Per D Rasmussen; Jens Erik Nielsen-Kudsk Journal: EuroIntervention Date: 2017-10-13 Impact factor: 6.534
Authors: Keith B Allen; Adnan K Chhatriwalla; David J Cohen; John T Saxon; Sanjeev Aggarwal; Anthony Hart; Suzanne Baron; J Russell Davis; Alex F Pak; Danny Dvir; A Michael Borkon Journal: Ann Thorac Surg Date: 2017-06-29 Impact factor: 4.330
Authors: Adnan K Chhatriwalla; Keith B Allen; John T Saxon; David J Cohen; Sanjeev Aggarwal; Anthony J Hart; Suzanne J Baron; Danny Dvir; A Michael Borkon Journal: Circ Cardiovasc Interv Date: 2017-07 Impact factor: 6.546
Authors: Jens Erik Nielsen-Kudsk; Asger Andersen; Christian Juhl Therkelsen; Evald Høj Christensen; Kaare Troels Jensen; Lars Romer Krusell; Mariann Tang; Kim Allan Terp; Kaj-Erik Klaaborg; Jacob Raben Greisen; Bjarne Linde Nørgaard; Henning Rud Andersen Journal: EuroIntervention Date: 2017-10-13 Impact factor: 6.534
Authors: John G Webb; Michael J Mack; Jonathon M White; Danny Dvir; Philipp Blanke; Howard C Herrmann; Jonathon Leipsic; Susheel K Kodali; Raj Makkar; D Craig Miller; Philippe Pibarot; Augusto Pichard; Lowell F Satler; Lars Svensson; Maria C Alu; Rakesh M Suri; Martin B Leon Journal: J Am Coll Cardiol Date: 2017-05-09 Impact factor: 24.094
Authors: Danny Dvir; John G Webb; Sabine Bleiziffer; Miralem Pasic; Ron Waksman; Susheel Kodali; Marco Barbanti; Azeem Latib; Ulrich Schaefer; Josep Rodés-Cabau; Hendrik Treede; Nicolo Piazza; David Hildick-Smith; Dominique Himbert; Thomas Walther; Christian Hengstenberg; Henrik Nissen; Raffi Bekeredjian; Patrizia Presbitero; Enrico Ferrari; Amit Segev; Arend de Weger; Stephan Windecker; Neil E Moat; Massimo Napodano; Manuel Wilbring; Alfredo G Cerillo; Stephen Brecker; Didier Tchetche; Thierry Lefèvre; Federico De Marco; Claudia Fiorina; Anna Sonia Petronio; Rui C Teles; Luca Testa; Jean-Claude Laborde; Martin B Leon; Ran Kornowski Journal: JAMA Date: 2014-07 Impact factor: 56.272