Aortic regurgitation after transcatheter aortic valve replacement

Influence of valve prosthesis implantation depth inside the aortic annulus on paravalvular regurgitation in in vitro steady flow conditions

Abstract

The assessment of hydrodynamic performance of transcatheter aortic valve prostheses in vitro is essential for the develosepment and approval of novel devices. Therefore, this study aims to investigate the correlation of target implantation depth and paravalvular regurgitation in a controlled in vitro test situation. We designed a test setup with retrograde steady flow conditions measuring paravalvular regurgitation as a function of increasing pressure on the closed valve ranging from 0 mmHg to 200 mmHg. Our future aim is to benchmark different valve prosthesis designs and describe the correlation between target implantation depth, paravalvular regurgitation and prosthesis design aspects. The current study describes the developed test setup, validation experiments as well as first results for a selfexpanding valve prosthesis. The highest regurgitation was measured at an implantation depth of 2 mm. In fact, regurgitation increases from 26.1 ± 8.2 ml/min at 0 mmHg to 1,490.7 ± 182.7 ml/min at 160 mmHg. The slightest regurgitation, however, was measured for an implantation depth of 6 mm ranging from 2.2 ± 0.6 ml/min at 0 mmHg to 605.8 ± 18.9 ml/min at 200 mmHg.

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Current Directions in Biomedical Engineering is an open access journal and closely related to the journal Biomedical Engineering - Biomedizinische Technik. CDBME is a forum for the exchange of knowledge in the fields of biomedical engineering, medical information technology and biotechnology/bioengineering for medicine and addresses engineers, natural scientists, and clinicians working in research, industry, or clinical practice.

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