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Sensor-Enabled 3D Printed Tissue-Mimicking Phantoms: Application in Pre-Procedural Planning for Transcatheter Aortic Valve Replacement
Published in Ayman El-Baz, Jasjit S. Suri, Cardiovascular Imaging and Image Analysis, 2018
Kan Wang, Chuck Zhang, Ben Wang, Mani A Vannan, Zhen Qian
Patients with severe aortic stenosis may be asymptomatic for many years. However, once the symptoms appear and are only treated medically, the condition of the symptomatic AS patient declines quickly. Mortality rates from the onset of symptoms are approximately 25% at 1 year and 50% at 2 years. Aortic valve replacement where the diseased aortic valve is replaced with a mechanical or tissue valve during a surgical procedure, is a viable treatment option for symptomatic AS patients. Conventional aortic replacement surgery requires sternotomy, cardioplegic arrest, and cardiopulmonary bypass. For severe AS patients with inoperable conditions or who are designated as high risk for surgery, transcatheter aortic valve replacement (TAVR), also known as transcatheter aortic valve implantation (TAVI) or percutaneous aortic valve replacement (PAVR), has been established as the treatment of choice. In this procedure, an aortic valve is implanted using a transcatheter technique and the sternotomy and cardiopulmonary bypass procedures are avoided.
Study the design parameters of 3D printing surgical guide deformation quantity by disinfection and sterilization
Published in Journal of Industrial and Production Engineering, 2021
Man-Yee Chan, Liang Gie Huang, Pei-Jhen Wu, Chia-Hung Yeh
By using the medical image processing CT, CAD technology, 3D model reconstruction, data design and other tools, Liu et al. [4] repaired the obvious damage of the model step by step, turning it into a complete squat model and completed the repair of the guided surgery for humeral defects by surgical catheter and forming plate. With continuously communicating between engineers and surgeons and with the use of software to design the best surgical solution, this program became 20% shorter than the previous traditional surgery, and the results show that the accuracy of this method has significantly improved and both the feasibility and the effectiveness have been verified. In addition, the patient itself was satisfied with the degree of functional recovery and appearance of the oral cavity. Ripley et al. [5] applied 3D printing technology to surgery to determine the feasibility of cardiac computed tomography (CT) for Transcatheter Aortic Valve Replacement (TAVR) and to predict valvular aortic regurgitation and the ability of Paravalvular Aortic Regurgitation (PAR). It was found that the 3D model of TAVR has high accuracy, and the measurement on the 3D model has very little error with the measurement result of 2D data.
Device profile of the SAPIEN 3 transcatheter heart valve in low-risk patients with aortic stenosis: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Alberto Alperi, Jules Mesnier, Vassili Panagides, Josep Rodés-Cabau
Transcatheter aortic valve replacement (TAVR) has become a broadly used approach for the treatment of patients with symptomatic severe aortic stenosis (AS). While this technique was initially conceived for patients with a prohibitive surgical risk, the good clinical outcomes achieved in this subset of patients compared to medical management [1] prompted the expansion of TAVR toward the treatment of operable patients. Several randomized trials in patients with high and intermediate surgical risk showed the non-inferiority of TAVR compared to surgical aortic valve replacement (SAVR) in such patients [2–4]. Lately, TAVR has progressively expanded toward the treatment of low-risk patients, defined as those exhibiting a Society of Thoracic Surgeons (STS) predicted risk of mortality (PROM) score < 4%. In fact, recent data from the STS-ACC TVT registry showed that more than 8,000 TAVR procedures were performed in low-risk patients in North America during the year 2019 [5].
The WATCHMAN left atrial appendage closure device for patients with atrial fibrillation: current status and future perspectives
Published in Expert Review of Medical Devices, 2020
Lisette I.S. Wintgens, Moniek Maarse, Martin J. Swaans, Benno J.W.M. Rensing, Vincent F. Van Dijk, Lucas V.A. Boersma
Finally, structural heart disease (e.g. coronary atherosclerosis, hypertrophic cardiomyopathy, valvular heart disease) is an independent risk factor for AF. The presence of structural heart disease in AF patients is very common, although these patients have been underrepresented in most clinical trials. Percutaneous catheter-based interventions have led to a revolution and evolution in clinical care, especially in patients with extensive comorbidities or frailty, who are deemed ineligible to undergo conventional cardiac surgery. Transcatheter aortic valve replacement (TAVR) has become the preferred strategy of patients with severe aortic stenosis (AS) and high surgery risk. In patients planned for TAVR, the prevalence of AF is estimated at 40–50% [48]. The number of patients with mitral valve regurgitation (MR) that suffers from AF may be even higher. Small feasibility registries have described patients with MR or AS who have undergone combined LAAC with mitral valve clipping and transcatheter aortic valve replacement, respectively [49–51]. WATCH-TAVR is an RCT currently enrolling 312 patients with TAVR indication who are eligible for OAC with VKA or NOAC. Patients will be randomized in a 1:1 ratio between WM and medical treatment. The primary endpoint will be a composite of all-cause mortality, stroke, and bleeding at 1 year. There may be a number of other catheter-based procedures, such as alcohol septal ablation or percutaneous coronary interventions, that may also be combined with LAAC, either in one single procedure or as separate staged procedures.