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• W2325157294 abstract "The SAPIEN XT aortic bioprosthesis is currently the balloon expandable valve of choice for transcatheter aortic valve replacement (TAVR) due to its lower profile delivery system. This has been made possible, in part, by design and material changes to the frame. Clinical evaluation of the effect of these design modifications on radial expansion and circularity is lacking. We assessed the geometry of the SAPIEN XT bioprosthesis with multidetector computed tomography (MDCT) and correlated these findings with early clinical events. MDCT was performed within one week of SAPIEN XT valve implantation. Geometry of the stent frame was assessed for circularity, minimum (Dmin) and maximum (Dmax) external diameter and expansion ratio at three stent levels: ventricular, mid and aortic. Circularity was defined as an eccentricity index (EI) of less than 0.1 (EI = 1-Dmin/Dmax) and expansion ratio as a percentage of the measured cross sectional stent area divided by the area for a fully expanded valve. Degree of stent annular apposition and grade of aortic regurgitation(AR) were assessed. 43 patients underwent MDCT. Stents were circular in 95.3% of cases (41/43). The mean expansion ratio was 105.6 ± 7.3% with no valves having an ER of less than 90%. The mean external diameter for the 20, 23, 26 and 29mm valves was 20.0 ± 1.0mm, 23.5 ± 1.0mm, 25.9 ± 0.8mm and 29.0 ± 1.0mm respectively. There was no difference in circularity or expansion ratio from the ventricular to aortic aspect of the stents (EI: 0.02 vs 0.02, P = 0.78, ER: 104.8% vs 106.5%, P = 0.28). There was no difference in expansion or circularity in patients with moderate to severe valvular AR compared to trace/mild AR (ER: 108.4% vs 105.3%, P = 0.37, EI: 0.05 vs 0.02, P = 0.40). Annular malapposition (12/43, 27.9%) on MDCT was associated with moderate to severe AR in 25%(3/12) compared with 6.5% (2/31) with circumferential annular apposition (P = 0.24). The early structural integrity of the SAPIEN XT valve is excellent as demonstrated by full expansion and circularity across all stent levels. Malapposition on MDCT may be associated with paravalvular aortic regurgitation." @default.
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• W2325157294 date "2011-09-01" @default.
• W2325157294 modified "2023-10-18" @default.
• W2325157294 title "594 Post implantation geometry of the edwards sapien XT valve as assessed by multidetector computed tomography" @default.
• W2325157294 doi "https://doi.org/10.1016/j.cjca.2011.07.494" @default.
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