A virtual workshop identified a lack of standardization in assessing bioprosthetic aortic valve hemodynamics and reaffirmed echocardiography as the standard assessment methodology.
There is a critical need for standardized definitions and measurement techniques to accurately assess bioprosthetic aortic valve hemodynamics and guide clinical management.
A virtual workshop was organized by the Heart Valve Collaboratory to identify areas of expert consensus, areas of disagreement, and evidence gaps related to bioprosthetic aortic valve hemodynamics. Impaired functional performance of bioprosthetic aortic valve replacement is associated with adverse patient outcomes; however, this assessment is complicated by the lack of standardization for labelling, definitions, and measurement techniques, both after surgical and transcatheter valve replacement. Echocardiography remains the standard assessment methodology because of its ease of performance, widespread availability, ability to do serial measurements over time, and correlation with outcomes. Management of a high gradient after replacement requires integration of the patient's clinical status, physical examination, and multimodality imaging in addition to shared patient decisions regarding treatment options. Future priorities that are underway include efforts to standardize prosthesis sizing and labelling for both surgical and transcatheter valves as well as trials to characterize the consequences of adverse hemodynamics.
“Could one valve fail early compared to the other one? Sure. And there could be other things that influence outcomes other than hemodynamics [given that] there are competing variables for all of these outcomes. But I do expect hemodynamics to affect outcomes over time.”
Herrmann et al. (Mon,) conducted a review in Bioprosthetic aortic valve hemodynamics. Bioprosthetic aortic valve replacement was evaluated. A virtual workshop identified a lack of standardization in assessing bioprosthetic aortic valve hemodynamics and reaffirmed echocardiography as the standard assessment methodology.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: