TY - JOUR
T1 - Optimisation of transcatheter aortic balloon-expandable valve deployment: the two-step inflation technique
AU - Nijhoff, Freek
AU - Agostoni, Pierfrancesco
AU - Samim, Mariam
AU - Ramjankhan, Faiz Z.
AU - Kluin, Jolanda
AU - Doevendans, Pieter A.
AU - Stella, Pieter R.
PY - 2013
Y1 - 2013
N2 - Aims: To evaluate the two-step inflation technique aimed at achieving optimal valve implantation depth (defined as 40% of prosthesis height extending below the lower sinus border on angiography) during balloon-expandable transcatheter aortic valve implantation (TAVI). Methods and results: Between September 2010 and March 2013, 103 patients (67 females, mean age 80.9 +/- 5.6 years) were treated with the Edwards SAPIEN XT prosthesis using the two-step inflation technique. Implantation depth was measured on angiography. A historical control group (treated with Edwards SAPIEN) was used for comparison (n=20). Deviation from the defined optimum implantation depth (expressed as a percentage of stent frame height) was significantly less in the study group versus controls (7.0 [3.4-14.1]% vs. 13.9 [5.4-18.9]%; p=0.048). Valve placement was graded "as intended"/"within range"/"out of range" (defmed as <= 10%, >10% but <= 20% and >20% deviation, respectively) in 66%/22%/12% of the study group and 35%/40%/25% of historical controls (p=0.02). Corrections in valve position were made in 20 procedures (20%), resulting in placement as intended in 16 cases (80%), with highest efficacy in the transapical and direct aortic approaches. Conclusions: The two-step inflation technique improves valve placement towards optimal implantation depth and may thereby prevent adverse events due to malpositioning
AB - Aims: To evaluate the two-step inflation technique aimed at achieving optimal valve implantation depth (defined as 40% of prosthesis height extending below the lower sinus border on angiography) during balloon-expandable transcatheter aortic valve implantation (TAVI). Methods and results: Between September 2010 and March 2013, 103 patients (67 females, mean age 80.9 +/- 5.6 years) were treated with the Edwards SAPIEN XT prosthesis using the two-step inflation technique. Implantation depth was measured on angiography. A historical control group (treated with Edwards SAPIEN) was used for comparison (n=20). Deviation from the defined optimum implantation depth (expressed as a percentage of stent frame height) was significantly less in the study group versus controls (7.0 [3.4-14.1]% vs. 13.9 [5.4-18.9]%; p=0.048). Valve placement was graded "as intended"/"within range"/"out of range" (defmed as <= 10%, >10% but <= 20% and >20% deviation, respectively) in 66%/22%/12% of the study group and 35%/40%/25% of historical controls (p=0.02). Corrections in valve position were made in 20 procedures (20%), resulting in placement as intended in 16 cases (80%), with highest efficacy in the transapical and direct aortic approaches. Conclusions: The two-step inflation technique improves valve placement towards optimal implantation depth and may thereby prevent adverse events due to malpositioning
U2 - https://doi.org/10.4244/EIJV9I5A91
DO - https://doi.org/10.4244/EIJV9I5A91
M3 - Article
C2 - 24058073
SN - 1774-024X
VL - 9
SP - 555
EP - 563
JO - Eurointervention
JF - Eurointervention
IS - 5
ER -