Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device
The increasing incidence of calcific aortic valve disease necessitates the elaboration of new strategies to retard the progression of the pathology with an innovative solution. While the increasing diffusion of the transcatheter aortic valve replacements (TAVRs) allows a mini-invasive approach to ao...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.850393/full |
| _version_ | 1811275160632688640 |
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| author | Giacomo Bernava Enrico Fermi Guido Gelpi Stefano Rizzi Davide Benettin Marianna Barbuto Claudia Romagnoni Domenico Ventrella Maria Chiara Palmieri Marco Agrifoglio Gianluca Polvani Maria Laura Bacci Enrico Pasquino Maurizio Pesce |
| author_facet | Giacomo Bernava Enrico Fermi Guido Gelpi Stefano Rizzi Davide Benettin Marianna Barbuto Claudia Romagnoni Domenico Ventrella Maria Chiara Palmieri Marco Agrifoglio Gianluca Polvani Maria Laura Bacci Enrico Pasquino Maurizio Pesce |
| author_sort | Giacomo Bernava |
| collection | DOAJ |
| description | The increasing incidence of calcific aortic valve disease necessitates the elaboration of new strategies to retard the progression of the pathology with an innovative solution. While the increasing diffusion of the transcatheter aortic valve replacements (TAVRs) allows a mini-invasive approach to aortic valve substitution as an alternative to conventional surgical replacement (SAVR) in an always larger patient population, TAVR implantation still has contraindications for young patients. In addition, it is liable to undergo calcification with the consequent necessity of re-intervention with conventional valve surgery or repeated implantation in the so-called TAVR-in-TAVR procedure. Inspired by applications for non-cardiac pathologies or for vascular decalcification before stenting (i.e., coronary lithotripsy), in the present study, we show the feasibility of human valve treatment with a mini-invasive device tailored to deliver shockwaves to the calcific leaflets. We provide evidence of efficient calcium deposit ruptures in human calcified leaflets treated ex vivo and the safety of the treatment in pigs. The use of this device could be helpful to perform shockwaves valvuloplasty as an option to retard TAVR/SAVR, or as a pretreatment to facilitate prosthesis implantation and minimize the occurrence of paravalvular leak. |
| first_indexed | 2024-04-12T23:33:05Z |
| format | Article |
| id | doaj.art-c4c620131bea414da7c4d74bba41ed54 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-12T23:33:05Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-c4c620131bea414da7c4d74bba41ed542022-12-22T03:12:13ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-03-01910.3389/fcvm.2022.850393850393Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based DeviceGiacomo Bernava0Enrico Fermi1Guido Gelpi2Stefano Rizzi3Davide Benettin4Marianna Barbuto5Claudia Romagnoni6Domenico Ventrella7Maria Chiara Palmieri8Marco Agrifoglio9Gianluca Polvani10Maria Laura Bacci11Enrico Pasquino12Maurizio Pesce13Unità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyAorticLab S.r.l., Bioindustry Park, Colleretto Giacosa, ItalyASST Fatebenefratelli Sacco, Milan, ItalyUnità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyAorticLab S.r.l., Bioindustry Park, Colleretto Giacosa, ItalyUnità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyASST Fatebenefratelli Sacco, Milan, ItalyUniversità Degli Studi di Bologna, Bologna, ItalyAorticLab S.r.l., Bioindustry Park, Colleretto Giacosa, ItalyUniversità Degli Studi di Milano, Milan, ItalyUniversità Degli Studi di Milano, Milan, ItalyUniversità Degli Studi di Bologna, Bologna, ItalyAorticLab S.r.l., Bioindustry Park, Colleretto Giacosa, ItalyUnità di Ingegneria Tissutale Cardiovascolare, Centro Cardiologico Monzino, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, ItalyThe increasing incidence of calcific aortic valve disease necessitates the elaboration of new strategies to retard the progression of the pathology with an innovative solution. While the increasing diffusion of the transcatheter aortic valve replacements (TAVRs) allows a mini-invasive approach to aortic valve substitution as an alternative to conventional surgical replacement (SAVR) in an always larger patient population, TAVR implantation still has contraindications for young patients. In addition, it is liable to undergo calcification with the consequent necessity of re-intervention with conventional valve surgery or repeated implantation in the so-called TAVR-in-TAVR procedure. Inspired by applications for non-cardiac pathologies or for vascular decalcification before stenting (i.e., coronary lithotripsy), in the present study, we show the feasibility of human valve treatment with a mini-invasive device tailored to deliver shockwaves to the calcific leaflets. We provide evidence of efficient calcium deposit ruptures in human calcified leaflets treated ex vivo and the safety of the treatment in pigs. The use of this device could be helpful to perform shockwaves valvuloplasty as an option to retard TAVR/SAVR, or as a pretreatment to facilitate prosthesis implantation and minimize the occurrence of paravalvular leak.https://www.frontiersin.org/articles/10.3389/fcvm.2022.850393/fullcalcific aortic valve disease (CAVD)ultrasoundlithotripsy—methodsvalve leafletsvalvuloplastymedical device |
| spellingShingle | Giacomo Bernava Enrico Fermi Guido Gelpi Stefano Rizzi Davide Benettin Marianna Barbuto Claudia Romagnoni Domenico Ventrella Maria Chiara Palmieri Marco Agrifoglio Gianluca Polvani Maria Laura Bacci Enrico Pasquino Maurizio Pesce Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device Frontiers in Cardiovascular Medicine calcific aortic valve disease (CAVD) ultrasound lithotripsy—methods valve leaflets valvuloplasty medical device |
| title | Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device |
| title_full | Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device |
| title_fullStr | Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device |
| title_full_unstemmed | Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device |
| title_short | Lithotripsy of Calcified Aortic Valve Leaflets by a Novel Ultrasound Transcatheter-Based Device |
| title_sort | lithotripsy of calcified aortic valve leaflets by a novel ultrasound transcatheter based device |
| topic | calcific aortic valve disease (CAVD) ultrasound lithotripsy—methods valve leaflets valvuloplasty medical device |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.850393/full |
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