Intentional Fracture of Bioprosthetic Valve Frames in Patients Undergoing Valve-in-Valve Transcatheter Pulmonary Valve Replacement
Key result
Intentional bioprosthetic valve fracture during TPVR yielded a lower but non-significant post-procedural peak gradient compared to controls without fracture (8.3 vs 11.8 mm Hg; P=0.070).
Why the study?
Does intentional bioprosthetic valve fracture improve hemodynamics and inner diameter in patients undergoing valve-in-valve transcatheter pulmonary valve replacement?
Population
107 patients with dysfunctional bioprosthetic valves in the pulmonary position undergoing valve-in-valve…
Comparison
Intentional bioprosthetic valve fracture to… vs Valve-in-valve TPVR without attempted fracture
Design
Cohort
Authors
Discussion
Loading...
Member takes
Implication
Post-TPVR narrowing may affect effective orifice area; leaves open optimal sizing and durability questions in feasibility data.
Study Design
Type
Cohort (n=107)
Multicenter
Yes
Structured PICO
Does intentional bioprosthetic valve fracture improve hemodynamics and inner diameter in patients undergoing valve-in-valve transcatheter pulmonary valve replacement?
P
Population
107 patients with dysfunctional bioprosthetic valves in the pulmonary position undergoing valve-in-valve transcatheter pulmonary valve replacement.
E
Exposure
Intentional bioprosthetic valve (BPV) fracture to enlarge the pulmonary valve orifice during TPVR
C
Comparator
Valve-in-valve TPVR without attempted fracture
O
Outcome
Final inner diameter (ID) and post-TPVR peak right ventricular outflow tract gradientsurrogate
Main Result
Absolute Event Rate: 8.3% vs 11.8%
p-value: p=0.070
Intentional fracture of bioprosthetic valve frames during pulmonary valve-in-valve TPVR is feasible, safe, and achieves a larger inner diameter with improved hemodynamics.
Cite This Study
Shahanavaz et al. (2018) conducted a cohort in Dysfunctional bioprosthetic valves in the pulmonary position (n=107). Intentional bioprosthetic valve fracture vs. Valve-in-valve TPVR without attempted fracture was evaluated on Post-TPVR peak gradient (p=0.070). Intentional bioprosthetic valve fracture during TPVR yielded a lower but non-significant post-procedural peak gradient compared to controls without fracture (8.3 vs 11.8 mm Hg; P=0.070).