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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.
Imaging of Cardiovascular Disease
Published in George C. Kagadis, Nancy L. Ford, Dimitrios N. Karnabatidis, George K. Loudos, Handbook of Small Animal Imaging, 2018
Aleksandra Kalinowska, Lawrence W. Dobrucki
Moreover, although molecular imaging has a wide range of applications, there are some areas where conventional cardiovascular imaging has proven superior to the more novel technologies. Echocardiographic guidance, for instance, has long been used for valve replacement and repair. It has recently been extended to catheterization and electrophysiology lab procedures. Intraoperative echocardiography is used for procedures, such as closure of atrial and ventricular septal defects and paravalvular leaks, as well as pulmonary vein isolation. It has been proposed that a fusion of preoperative CT with transesophageal echocardiography could improve the safety margin for percutaneous aortic valve replacement. Unfortunately, this approach did not show promise of being used for these applications.
Therapeutic options for functional mitral regurgitation in chronic heart failure
Published in Expert Review of Medical Devices, 2018
Judith E. Lowry, Stephan Fichtlscherer, Klaus K. Witte
A fully percutaneous mitral valve replacement might provide a possible solution for patients with severe MR especially in the setting of mixed etiologies in people with prohibitive comorbidities. The major challenge over percutaneous aortic valve replacement is the great anatomical complexity and variability of the mitral valve including the subvalvular apparatus, and also the mobility of the mitral valve structure during the cardiac cycle. Due to difficulties of achieving access and positioning of a large valve, most systems to date have been transapical, but in the longer term, the greater morbidity associated with this route over a transfemoral approach is likely to be a limiting factor. A large number of TMVR systems are in clinical and preclinical trials [60], but with an average 30-day mortality of 23% (with half of these occurring periprocedurally) it is clear that a trial comparing sham with a TMVR approach is still far in the future.