Influence of Paravalvular Leakage after TAVR on Left Ventricular Work and Coronary Flow: An In-vitro Study
Abstract
Influence of Paravalvular Leakage after TAVR on Left Ventricular Work and Coronary Flow: An In-vitro Study Matthias F. Menne, Serap Özdemir, Thomas Schmitz-Rode, and Ulrich Steinseifer RWTH Aachen University, Aachen, Germany Objective: To assess the influence of paravalvular leakage (PVL) on stroke work and coronary flow (CF) after transcatheter aortic valve replacement in a pulse duplicator. Methods: A Medtronic CoreValve 29mm aortic valve was used for the measurements. The aortic root model featured three sinuses of valsalvae, two coronary arteries and a mechanism to induce progressive PVL at each of the sinuses. Pressure, flow and PV-loops were measured at normotensive conditions (no PVL, 5L/min cardiac output (CO), 100mmHg mean aortic pressure (MAP)) and at various degrees of PVL up to leakage rates considered severe in clinical routine. The PV loops allowed for the calculation of left ventricular work. Results: CO decreased steadily with increasing PVL up to a minimum of 3.4L/min at severe PVL at 40%. MAP decreased with increasing PVL (MAP 60mmHg at 40% PVL, p<0.01). The stroke work required to maintain normotensive conditions with PVL increased significantly with more severe leakage up to a maximum of 2.2J at 40% PVL (baseline 1.27J, p<0.01). Coronary flow decreased with increasing PVL by up to 33% and 43% for the left and right coronary artery, respectively, at 40% PVL. The location of the PVL with regards to the coronary ostia did not show any impact on CF.…
Read the paper
Related studies
- In silico strategies for modeling RNA aptamers and predicting binding sites of their molecular targets
- Folic acid-hydrophilic polymer coated mesoporous silica nanoparticles target doxorubicin delivery
- Anti-phytopathogenic and plant growth promoting potential of endophytic fungi isolated from Dysoxylum gotadhora
- Mercury toxicity causes iron and sulfur deficiencies along with oxidative injuries in alfalfa (Medicago sativa)
- Suppression of lncRNA GAS6-AS2 alleviates sepsis-related acute kidney injury through regulating the miR-136-5p/OXSR1 axis in vitro and in vivo
- Assessing the Protective Effect of Moringa oleifera Extract against Bone Metastasis: An In Vitro Simulated Digestion Approach
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.