Key result
In an in vitro model, Sapien S3 prostheses had significantly more thrombus-like formations than XT prostheses, particularly in the wall area, with distinct morphological patterns.
Why the study?
Does the Sapien S3 prosthesis compared to the Sapien XT prosthesis have different patterns of thrombus-like formations in an in vitro valve-in-valve model?
Does the Sapien S3 prosthesis compared to the Sapien XT prosthesis have different patterns of thrombus-like formations in an in vitro valve-in-valve model?
In an in vitro model, Sapien S3 prostheses exhibited significantly more thrombus-like formations at the wall area compared to XT prostheses, highlighting potential differences in flow properties and thrombosis risk.
Answers are grounded in this paper and cite their sources.
May indicate higher thrombosis risk with Sapien S3 in valve-in-valve settings; leaves open clinical relevance pending in vivo validation.
OBJECTIVES: Transcatheter aortic valve implantation is a treatment strategy for degenerated aortic valve prostheses, but there is some concern regarding valve thrombosis. The optimal anticoagulation strategy for implantation of a transcatheter aortic valve prosthesis remains unclear. METHODS: Aortic root models with the Sapien-XT and S3 prostheses (sizes 23 and 26) fixed in a Perimount Magna Ease bioprosthesis (sizes 23 and 25) were constructed. The haemodynamics of the left ventricle were imitated in a proved in vitro model. Milk was used for coagulation after 90s. Different areas of the leaflets (W: wall coagulation, C: commissure coagulation left/right and S: sinus coagulation) were examined and the number of thrombus-like formations was counted. RESULTS: A total of 54% of the thrombus-like formations were found in the sinus, 28% at the wall area, 13% at the right commissure and 10% at the left commissure. Significant differences were detected at the wall area. S3 prostheses had significantly more thrombus-like formations than the XT prostheses. Additionally, in the S3 prostheses, the thrombus-like formation resembled a film whereas in the XT prostheses, the thrombus-like formation was like the crumbs of a cake. We noted exactly the same pattern in explanted prostheses from patients. CONCLUSIONS: The Sapien prostheses tend to form thromboses due to their flow properties. More than half of the thrombus-like formations were seen in the sinus. The S3 prostheses had significantly more thrombus-like formations than the XT prostheses in the wall area. There are different patterns of thrombus-like formations in XT and S3 prostheses used for transcatheter aortic valve implantation both in vivo and in vitro.
No takes yet. Share an insight, caveat, or question.
Richardt et al. (2018) studied Degenerated aortic valve prostheses. Sapien S3 prosthesis vs. Sapien XT prosthesis was evaluated on Number and location of thrombus-like formations. In an in vitro model, Sapien S3 prostheses had significantly more thrombus-like formations than XT prostheses, particularly in the wall area, with distinct morphological patterns.
Synapse has enriched 10 related papers. Consider them for comparative context: