Implantation Depth and Rotational Orientation Effect on Valve-in-Valve Hemodynamics and Sinus Flow

摘要

BackgroundThis study aims to evaluate the effect of transcatheter aortic valve (TAV) implantation depth and rotation on pressure gradient (PG), leakage fractions (LF), leaflet shear stress and sinus washout in an effort to understand factors that may dictate optimal positioning for valve-in-valve (ViV) procedures. Sinus flow stasis is often associated with prosthetic leaflet thrombosis. While recent ViV in-vitro studies highlighted transcatheter aortic valve (TAV) supra-annular implantation potential benefits to minimize pressure gradients, the relationship between TAV depth and other determinates of valve function remains unknown. Among these, LFs, shear stress and poor sinus washout have been associated with poorer valve outcomes.