Document Type
Article
Publication Date
3-2022
Department
Department of Biomedical Engineering
Abstract
Objective: In this study we aimed to understand the role of interaction of the Medtronic Evolut R transcatheter aortic valve with the ascending aorta (AA) by evaluating the performance of the valve and the pressure recovery in different AA diameters with the same aortic annulus size. Methods: A 26-mm Medtronic Evolut R valve was tested using a left heart simulator in aortic root models of different AA diameter (D): small (D = 23 mm), medium (D = 28 mm), and large (D = 34 mm) under physiological conditions. Measurements of pressure from upstream to downstream of the valve were performed using a catheter at small intervals to comprehensively assess pressure gradient and pressure recovery. Results: In the small AA, the measured peak and mean pressure gradient at vena contracta were 11.5 ± 0.5 mm Hg and 7.8 ± 0.4 mm Hg, respectively, which was higher (P < .01) compared with the medium (8.1 ± 0.4 mm Hg and 5.2 ± 0.4 mm Hg) and large AAs (7.4 ± 1.0 mm Hg and 5.4 ± 0.6 mm Hg). The net pressure gradient was lower for the case with the medium AA (4.1 ± 1.2 mm Hg) compared with the small AA (4.7 ± 0.8 mm Hg) and large AA (6.1 ± 1.4 mm Hg; P < .01). Conclusions: We have shown that small and large AAs can increase net pressure gradient, because of the direct interaction of the Medtronic Evolut R stent with the AA (in small AA) and introducing higher level of turbulence (in large AA). AA size might need to be considered in the selection of an appropriate device for transcatheter aortic valve replacement.
Publication Title
JTCVS Open
Recommended Citation
Samaee, M.,
Hatoum, H.,
Biersmith, M.,
Yeats, B.,
Gooden, S.,
Thourani, V.,
Hahn, R.,
Lilly, S.,
Yoganathan, A.,
&
Dasi, L.
(2022).
Gradient and pressure recovery of a self-expandable transcatheter aortic valve depends on ascending aorta size: In vitro study.
JTCVS Open,
9, 28-38.
http://doi.org/10.1016/j.xjon.2022.01.003
Retrieved from: https://digitalcommons.mtu.edu/michigantech-p/15862
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Version
Publisher's PDF
Publisher's Statement
© 2022 The Author(s). Published by Elsevier Inc. on behalf of The American Association for Thoracic Surgery. Publisher’s version of record: https://doi.org/10.1016/j.xjon.2022.01.003