Key result
Perceval sutureless valve underexpansion shows no association with HALT.
Why the study?
Underexpansion of transcatheter heart valves and the Perceval sutureless aortic valve bioprosthesis has been suggested as an underlying mechanism for hypo-attenuated leaflet thickening.
Is underexpansion of the Perceval sutureless bioprosthesis associated with hypo-attenuated leaflet thickening (HALT) in patients undergoing surgical aortic valve replacement?
Observational (n=46)
No
Is underexpansion of the Perceval sutureless bioprosthesis associated with hypo-attenuated leaflet thickening (HALT) in patients undergoing surgical aortic valve replacement?
Absolute Event Rate: 74% vs 76.5%
p-value: p=0.11
In patients receiving the Perceval sutureless bioprosthetic valve, overall and regional underexpansion were not significantly associated with the development of hypo-attenuated leaflet thickening (HALT).
Underexpansion of transcatheter heart valves and the surgically implanted Perceval sutureless aortic valve bioprosthesis has been suggested as an underlying mechanism for hypo-attenuated leaflet thickening (HALT). This was a single-center prospective observational study that included 47 patients who underwent surgical aortic valve replacement with the Perceval sutureless bioprosthesis (LivaNova, London, United Kingdom) from 2012 to 2016 and were studied by four-dimensional cardiac computed tomography (CT). The association between overall and regional expansion and the prevalence of HALT was analyzed. In total 46 patients were included in the analysis. HALT was found in 39.1% of patients and the mean overall prosthesis expansion was 75.5 ± 5.2% (range 64.6-84.8%). Overall expansion did not differ between patients with HALT compared with patients without HALT (mean overall expansion 74.0 ± 5.2% vs. 76.5 ± 5.0%, P = 0.11). The prevalence of HALT was lower in patients with overall expansion > 80% compared to patients with expansion < 80% expansion though not significantly (20% vs. 44.4%, P = 0.16). None or trivial regional underexpansion was found in 94.7% of coronary cusps. There was no significant association between regional underexpansion and the prevalence of HALT (mean coronary cusp angle 120 ± 8° vs. 119 ± 10°, P = 0.53). The prevalence of HALT and overall underexpansion was high in the Perceval sutureless bioprosthetic valve. Overall underexpansion was not associated with HALT. Whether severe overall underexpansion increases the risk for HALT requires further study. Regional underexpansion was uncommon in the Perceval sutureless bioprosthetic valve and not associated with HALT.Clinical trial registration Unique identifier: NCT03753126 (http://www.clinicaltrials.gov).
No takes yet. Share an insight, caveat, or question.
Themudo et al. (2020) conducted an observational in Aortic stenosis (n=46). Overall and regional bioprosthetic valve underexpansion vs. Normal valve expansion was evaluated on Mean overall prosthesis expansion in patients with vs without hypo-attenuated leaflet thickening (HALT) (p=0.11). Overall and regional underexpansion of the Perceval sutureless bioprosthetic aortic valve were not significantly associated with the prevalence of hypo-attenuated leaflet thickening.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: