Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses
Transcatheter aortic valve replacement (TAVR) has become a popular treatment option for severe aortic stenosis for patients with a high risk for mortality with surgical aortic valve replacement (SAVR). Coronary artery occlusion (CAO) following the implantation of the device is a potential and someti...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/12/413 |
| _version_ | 1797457165307346944 |
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| author | Michael A. Bielecki Amanda N. DeVos Francesco Bianchini Paul A. Iaizzo |
| author_facet | Michael A. Bielecki Amanda N. DeVos Francesco Bianchini Paul A. Iaizzo |
| author_sort | Michael A. Bielecki |
| collection | DOAJ |
| description | Transcatheter aortic valve replacement (TAVR) has become a popular treatment option for severe aortic stenosis for patients with a high risk for mortality with surgical aortic valve replacement (SAVR). Coronary artery occlusion (CAO) following the implantation of the device is a potential and sometimes devastating complication of this procedure, that provokes a sudden deterioration of hemodynamic status followed by cardiogenic shock and electrical instability. With patients that present a high risk for coronary obstruction, coronary protection with a chimney stenting technique is an effective strategy that can ensure coronary perfusion during TAVR in case of acute CAO. Utilizing Visible Heart<sup>®</sup> methodologies, a human heart was reanimated. A chimney stenting technique was implemented simultaneously with the deployment of a Medtronic Evolut<sup>™</sup> Pro+ valve (Medtronic PLC; Minneapolis, MN, USA). The entire procedure was recorded utilizing endoscopic cameras, fluoroscopy, optical coherence tomography, and echocardiography. In addition to these procedural visualizations, post-procedural micro-computed tomography (micro-CT) was conducted to provide post-implantation imaging with approximately 60-micron resolution. Utilizing these imaging modalities in a reanimated human heart allows for the unique opportunity to collect data for TAVR procedures in real human anatomies for the subsequent educational uses by the physicians treating aortic valvular disease and/or the designers of future TAVR technologies and procedures. |
| first_indexed | 2024-03-09T16:17:18Z |
| format | Article |
| id | doaj.art-ef11d03f0c66480aa0a3966f77315dd3 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T16:17:18Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-ef11d03f0c66480aa0a3966f77315dd32023-11-24T15:41:22ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-11-0191241310.3390/jcdd9120413Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant AnalysesMichael A. Bielecki0Amanda N. DeVos1Francesco Bianchini2Paul A. Iaizzo3Departments of Surgery and Biomedical Engineering, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USADepartments of Surgery and Biomedical Engineering, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USACardiology, Fondazione Policlinico Universitario Agostino Gemelli, 00168 Metropolitan City of Rome, ItalyDepartments of Surgery and Biomedical Engineering, Institute for Engineering in Medicine, University of Minnesota, Minneapolis, MN 55455, USATranscatheter aortic valve replacement (TAVR) has become a popular treatment option for severe aortic stenosis for patients with a high risk for mortality with surgical aortic valve replacement (SAVR). Coronary artery occlusion (CAO) following the implantation of the device is a potential and sometimes devastating complication of this procedure, that provokes a sudden deterioration of hemodynamic status followed by cardiogenic shock and electrical instability. With patients that present a high risk for coronary obstruction, coronary protection with a chimney stenting technique is an effective strategy that can ensure coronary perfusion during TAVR in case of acute CAO. Utilizing Visible Heart<sup>®</sup> methodologies, a human heart was reanimated. A chimney stenting technique was implemented simultaneously with the deployment of a Medtronic Evolut<sup>™</sup> Pro+ valve (Medtronic PLC; Minneapolis, MN, USA). The entire procedure was recorded utilizing endoscopic cameras, fluoroscopy, optical coherence tomography, and echocardiography. In addition to these procedural visualizations, post-procedural micro-computed tomography (micro-CT) was conducted to provide post-implantation imaging with approximately 60-micron resolution. Utilizing these imaging modalities in a reanimated human heart allows for the unique opportunity to collect data for TAVR procedures in real human anatomies for the subsequent educational uses by the physicians treating aortic valvular disease and/or the designers of future TAVR technologies and procedures.https://www.mdpi.com/2308-3425/9/12/413Evolut<sup>™</sup> Pro+transcatheter aortic valve replacement (TAVR)chimneypercutaneous coronary intervention (PCI)post-TAVR PCIdeployment |
| spellingShingle | Michael A. Bielecki Amanda N. DeVos Francesco Bianchini Paul A. Iaizzo Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses Journal of Cardiovascular Development and Disease Evolut<sup>™</sup> Pro+ transcatheter aortic valve replacement (TAVR) chimney percutaneous coronary intervention (PCI) post-TAVR PCI deployment |
| title | Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses |
| title_full | Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses |
| title_fullStr | Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses |
| title_full_unstemmed | Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses |
| title_short | Multimodal Imaging of a Chimney-Stenting Procedure Performed Simultaneously with a Transcatheter Aortic Valve Replacement (TAVR) in a Reanimated Human Heart including Post-Implant Analyses |
| title_sort | multimodal imaging of a chimney stenting procedure performed simultaneously with a transcatheter aortic valve replacement tavr in a reanimated human heart including post implant analyses |
| topic | Evolut<sup>™</sup> Pro+ transcatheter aortic valve replacement (TAVR) chimney percutaneous coronary intervention (PCI) post-TAVR PCI deployment |
| url | https://www.mdpi.com/2308-3425/9/12/413 |
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