| Geometry and degree of apposition of the CoreValve ReValving system with multislice computed tomography after implantation in patients with aortic stenosis. | |
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MedLine Citation:
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PMID: 19712801 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Using multislice computed tomography (MSCT), we sought to evaluate the geometry and apposition of the CoreValve ReValving System (CRS, Medtronic, Luxembourgh, Luxembourgh) in patients with aortic stenosis. BACKGROUND: There are no data on the durability of percutaneous aortic valve replacement. Geometric factors may affect durability. METHODS: Thirty patients had MSCT at a median 1.5 months (interquartile range [IQR] 0 to 7 months) after percutaneous aortic valve replacement. Axial dimensions and apposition of the CRS were evaluated at 4 levels: 1) the ventricular end; 2) the nadir; 3) central coaptation of the CRS leaflets; and 4) commissures. Orthogonal smallest and largest diameters and cross-sectional surface area were measured at each level. RESULTS: The CRS (26-mm: n = 14, 29-mm: n = 16) was implanted at 8.5 mm (IQR 5.2 to 11.0 mm) below the noncoronary sinus. None of the CRS frames reached nominal dimensions. The difference between measured and nominal cross-sectional surface area at the ventricular end was 1.6 cm(2) (IQR 0.9 to 2.6 cm(2)) and 0.5 cm(2) (IQR 0.2 to 0.7 cm(2)) at central coaptation. At the level of central coaptation the CRS was undersized relative to the native annulus by 24% (IQR 15% to 29%). The difference between the orthogonal smallest and largest diameters (degree of deformation) at the ventricular end was 4.4 mm (IQR 3.3 to 6.4 mm) and it decreased progressively toward the outflow. Incomplete apposition of the CRS frame was present in 62% of patients at the ventricular end and was ubiquitous at the central coaptation and higher. CONCLUSIONS: Dual-source MSCT demonstrated incomplete and nonuniform expansion of the CRS frame, but the functionally important mid-segment was well expanded and almost symmetrical. Undersizing and incomplete apposition were seen in the majority of patients. |
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Authors:
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Carl J Schultz; Annick Weustink; Nicolo Piazza; Amber Otten; Nico Mollet; Gabriel Krestin; Robert J van Geuns; Pim de Feyter; Patrick W J Serruys; Peter de Jaegere |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 54 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-28 Completed Date: 2009-09-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 911-8 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aortic Valve / radiography*, surgery Aortic Valve Stenosis / physiopathology, radiography, surgery* Blood Flow Velocity Echocardiography Female Heart Catheterization Heart Valve Prosthesis* Heart Valve Prosthesis Implantation* Humans Male Prosthesis Design Tomography, X-Ray Computed* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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