8 results on '"Hensey, Mark"'
Search Results
2. Single-center prospective study examining use of the Wattson temporary pacing guidewire for transcatheter aortic valve replacement.
- Author
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Hensey M, Sathananthan J, Alkhodair A, Landes U, Wood DA, Daniels D, and Webb JG
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis physiopathology, Equipment Design, Female, Humans, Male, Prospective Studies, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Cardiac Catheters, Cardiac Pacing, Artificial, Pacemaker, Artificial, Transcatheter Aortic Valve Replacement adverse effects
- Abstract
Objectives: To assess the safety and efficacy of the Wattson temporary pacing guidewire., Background: Transcatheter aortic valve replacement (TAVR) requires a guidewire for device delivery and generally requires temporary pacing wire for burst and back-up pacing. The Wattson wire provides concomitant support and bipolar pacing without the need to place a temporary venous pacemaker (TVP)., Methods: This was a single-center nonrandomized prospective clinical trial enrolling 20 patients. The primary endpoint was defined as successful rapid pacing and transcatheter heart valve (THV) delivery with no loss of capture. Safety, qualitative and quantitative secondary outcomes were also analyzed., Results: Mean age was 77.4 ± 9.0 years. Mean Society of Thoracic Surgery (STS) score was 3.0 ± 1.5%. All patients received a balloon-expandable valve via a transfemoral approach. All patients met the primary end-point. One patient (5%) had balloon predilatation and six patients (30%) had postdilatation, all using the wire. Mean pacing threshold was 2.2 ± 1.2 mA that was evaluated prior to placing an insulating catheter over the wire. One patient required TVP placement and subsequent permanent pacemaker implantation due to complete heart block post THV deployment. There were no incidences of cardiac perforation or tamponade. One patient required valve reintervention, which was not related to the device., Conclusions: The Wattson wire offered predictable guidewire support with concomitant reliable bipolar pacing at low thresholds to allow safe THV delivery in this patient cohort. It has the potential to make TAVR a safer and more efficient procedure., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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3. Mitral regurgitation in patients undergoing transcatheter aortic valve implantation for degenerated surgical aortic bioprosthesis: Insights from PARTNER 2 Valve-in-Valve Registry.
- Author
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Murdoch DJ, Sathananthan J, Hensey M, Alu MC, Liu Y, Crowley A, Wood D, Cheung A, Ye J, Feldman T, Hahn RT, Jaber WA, Mack MJ, Malaisrie SC, Leon MB, and Webb JG
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Insufficiency diagnostic imaging, Aortic Valve Insufficiency mortality, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Female, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality, Humans, Male, Mitral Valve diagnostic imaging, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency mortality, Recovery of Function, Registries, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve surgery, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Mitral Valve physiopathology, Mitral Valve Insufficiency physiopathology, Prosthesis Failure, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement mortality
- Abstract
Background: Valve-in-valve (VIV) treatment with transcatheter aortic valve replacement (TAVR) is a viable option for patients with failing aortic bioprosthetic valves. Optimal management of those with concomitant mitral regurgitation (MR) remains undetermined. Therefore, we sought to assess the implications of concomitant MR in patients undergoing VIV-TAVR., Methods and Results: The PARTNER 2 VIV registry enrolled patients with degenerated surgical aortic bioprosthesis at high risk for reoperation. Patients with core-laboratory echocardiographic assessment of MR were analyzed; severe MR was excluded. We compared patients with ≤mild MR versus moderate MR and assessed changes in MR severity and clinical outcomes. A total of 339 patients (89 initial registry, 250 continued access) underwent VIV procedures; mean age 79.0 ± 10.2 years, mean Society of Thoracic Surgeon score 8.9 ± 4.5%. At baseline, 228/339 (67.3%) had ≤mild MR and 111/339 (32.7%) had moderate MR. In paired analysis, there was significant improvement in ≥moderate MR from baseline to 30 days (32.6% vs. 14.5%, p < .0001 [n = 304]), and no significant change between 30 days and 1 year (13.4% vs. 12.1%, p = .56 [n = 224]) or 1 year and 2 years (11.0% vs. 10.4%, p = .81 [n = 182]). There was no difference in death or stroke between ≤mild MR and moderate MR at 30 days (4.0% vs. 7.2%, p = .20), 1 year (15.5% vs. 15.3%, p = .98) or 2 years (26.5% vs. 23.5%, p = .67)., Conclusion: Moderate concomitant MR tends to improve with VIV-TAVR, and was not a predictor of long-term adverse outcomes in this cohort. In selected patients undergoing VIV-TAVR, it may be appropriate to conservatively manage concomitant MR., Clinical Trial Registration: ClinicalTrials.gov NCT# 03225001., (© 2020 Wiley Periodicals, Inc.)
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- 2020
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4. Implications of hydrodynamic testing to guide sizing of self-expanding transcatheter heart valves for valve-in-valve procedures.
- Author
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Sathananthan J, Hensey M, Fraser R, Landes U, Blanke P, Hatoum H, Dasi LP, Sedaghat A, Bapat VN, Leipsic J, Søndergaard L, Wood DA, and Webb JG
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- Cardiac Catheterization adverse effects, Heart Valve Diseases physiopathology, Heart Valve Prosthesis Implantation adverse effects, Heart Valves physiopathology, Humans, Hydrodynamics, Materials Testing, Prosthesis Design, Time Factors, Transcatheter Aortic Valve Replacement adverse effects, Bioprosthesis, Cardiac Catheterization instrumentation, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Heart Valves surgery, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Aims: The commonly used valve-in-valve (VIV) app recommends sizing based on dimensions of both the transcatheter heart valve (THV) and bioprosthetic surgical valve. The implications of hydrodynamic testing to guide VIV sizing are poorly understood. This bench study assessed the hydrodynamic performance of different sizes of self-expanding supra-annular THVs in three different surgical aortic bioprostheses at different implantation depths., Methods: A small versus medium ACURATE neo (ACn), and a 26 mm versus 29 mm Evolut R were assessed after VIV implantation in 25 mm Mitroflow, Mosaic, and Magna Ease aortic surgical bioprostheses, at three implantation depths (+2 mm, -2 mm, and -6 mm)., Results: The medium-sized ACn had lower gradients compared to the small ACn when the THV was implanted high (+2 mm, or -2 mm). The 29 mm Evolut R had lower gradients compared to a 26 mm Evolut R for all implantation depths, except for a depth of -2 mm in the 25 mm Mitroflow. The medium ACn and 29 mm Evolut R had larger effective orifice areas compared to the small ACn and 26 mm Evolut R, respectively. Both Evolut R sizes had acceptable regurgitant fractions (<15%), while both ACn sizes were above the acceptable performance criteria (>15%), at all implantation depths., Conclusions: Use of a larger self-expanding THV was associated with superior hydrodynamic performance if the THV was implanted high. Hydrodynamic testing can provide additional information to the VIV app to help guide VIV sizing., (© 2019 Wiley Periodicals, Inc.)
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- 2020
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5. Performance of the TRUE dilatation balloon valvuloplasty catheter beyond rated burst pressure: A bench study.
- Author
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Sathananthan J, Hensey M, Sellers S, Barlow AM, Chhatriwalla AK, Allen KB, Cheung A, Søndergaard L, Blanke P, Ye J, Leipsic J, Wood D, and Webb J
- Subjects
- Equipment Design, Equipment Failure Analysis, Materials Testing, Pressure, Balloon Valvuloplasty instrumentation, Cardiac Catheters
- Abstract
Objectives: We undertook an independent bench test assessing the performance of the TRUE dilatation (TD) balloon valvuloplasty catheter (Bard Vascular Inc., Tempe, AZ) beyond its rated burst pressure (RBP)., Background: The TD balloon has a RBP of six atmospheres (atm), and its performance beyond this RBP is poorly understood. Techniques such as bioprosthetic valve fracture require inflation pressures beyond manufacturer recommendations., Methods: A 20, 22, 24, 26, and 28 mm TD balloon were inflated to increasing pressures in increments of 3 atm until balloon failure. Measurements were performed at the proximal, middle, and distal balloon segments with scientific digital calipers. Z-MED balloons (Braun Interventional Systems Inc., Bethlehem, PA) were used as a comparator., Results: The mean diameter at the middle of the 20, 22, 24, 26, and 28 mm TD balloon at nominal pressure (3 atm) was 20.02 ± 0.09, 21.77 ± 0.07, 23.9 ± 0.06, 25.82 ± 0.08, and 27.62 ± 0.08 mm, respectively. The maximal mean diameter at the middle of the 20, 22, 24, 26, and 28 mm TD balloon was 20.39 ± 0.03 mm (15 atm), 22.35 ± 0.03 mm (15 atm), 24.55 ± 0.02 mm (15 atm), 26.48 ± 0.02 mm (12 atm), and 28.39 ± 0.03 mm (12 atm), respectively. The 20/22/24 and 26/28 mm balloon failed when inflated beyond 15 atm and 12 atm, respectively. Failure was due to either leakage or longitudinal balloon rupture. TD balloons were more likely to maintain dimensions similar to their labeled size and less likely to fail at higher pressures as compared to Z-MED balloons., Conclusion: The TD balloon catheter maintains a similar diameter to its labeled size, when inflated beyond its RBP. When inflated beyond 12 atm, the TD balloon can fail due to either leakage or rupture. This has implications for percutaneous structural heart interventions., (© 2019 Wiley Periodicals, Inc.)
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- 2020
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6. Overexpansion of older generation balloon expandable transcatheter heart valves: An ex-vivo bench study.
- Author
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Sathananthan J, Sellers S, Barlow A, Hensey M, Landes U, Cheung A, Ye J, Alkhodair A, Blanke P, Søndergaard L, Pibarot P, Wood D, Leipsic J, and Webb J
- Subjects
- Materials Testing, Prosthesis Failure, Balloon Valvuloplasty, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Background: The SAPIEN 3 (S3) transcatheter heart valve (THV) can be over-expanded beyond its labeled diameter. Overexpansion can be achieved with use of either a compliant or non-compliant balloon. Objective data regarding the ability to over-expand older generation balloon expandable valves are limited. We sought to assess the effects of over-expanding the SAPIEN and SAPIEN XT (Edwards Lifesciences, Irvine, CA) valve beyond labeled size (diameter) through an ex-vivo bench study., Methods and Results: We assessed SAPIEN and SAPIEN XT THVs, sized 23/26 mm and 23/26/29 mm, respectively. The SAPIEN THVs were explanted samples. Valves were expanded to nominal dimensions, and then incrementally overexpanded with balloons sized 1-, 2-, and 3-mm larger than the recommended diameter. When an appropriate sized non-compliant balloon was not available, a compliant balloon was utilized. Valves underwent visual and radiographic assessment of overexpansion. SAPIEN THVs with labeled size of 23 and 26 mm could be incrementally overexpanded to midvalve (MV) diameters of 26.7 and 27.4 mm, respectively. SAPIENT XT THVs with labeled size of 23, 26, and 29 mm could be incrementally overexpanded to MV diameters of 26.8, 28.3, and 28.8 mm, respectively. The desired degree of overexpansion was only achieved with use of non-compliant balloons and not with compliant balloons. The outflow of the SAPIEN and SAPIEN XT had larger diameters than the MV and inflow of the THV., Conclusion: Overexpansion of older generation SAPIEN and SAPIEN XT THVs is possible. Achieving the desired degree of overexpansion was only achieved with use of non-compliant balloons. This has potential implications for the treatment of failed THVs., (© 2019 Wiley Periodicals, Inc.)
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- 2019
- Full Text
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7. TAVR and SAVR in ESRD: Just because we can doesn't necessarily mean that we should.
- Author
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Hensey M and Webb JG
- Subjects
- Aortic Valve surgery, Humans, Risk Factors, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Valve Prosthesis Implantation, Kidney Failure, Chronic, Transcatheter Aortic Valve Replacement
- Abstract
In patients with end stage renal disease on hemodialysis, TAVR resulted in reduced length of stay, hospitalization cost, complication rate and higher rates of home discharge compared to SAVR. In-hospital mortality and complication rates were high in both groups. Careful patient selection and further research is required to identify patients with end-stage renal disease who might, or might not, benefit from intervention., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2018
- Full Text
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8. The use of a novel ROX central arteriovenous fistula formation device in a patient with severe drug-resistant hypertension and prior aortic graft.
- Author
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Hensey M, Smyth E, Gilroy E, and Galvin J
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- Blood Vessel Prosthesis, Drug Therapy, Combination, Female, Humans, Hypertension diagnosis, Hypertension physiopathology, Iliac Artery diagnostic imaging, Iliac Artery physiopathology, Iliac Vein diagnostic imaging, Iliac Vein physiopathology, Middle Aged, Prosthesis Design, Treatment Outcome, Antihypertensive Agents therapeutic use, Aorta surgery, Arteriovenous Shunt, Surgical instrumentation, Blood Pressure drug effects, Blood Vessel Prosthesis Implantation instrumentation, Drug Resistance, Hypertension surgery, Iliac Artery surgery, Iliac Vein surgery
- Abstract
We report a case of the successful use of a central arteriovenous (cAV) coupler device to treat severe drug-resistant primary hypertension in a 46-year-old female. The device is inserted via a femoral approach to create an ateriovenous fistula between the external iliac artery and vein and has shown promise in the treatment of severe hypertension. The patient's 24-hr ambulatory blood pressure (ABP) pre device insertion on eleven anti-hypertensive medications revealed a mean 24-hr ABP of 165/98 mm Hg. The insertion of the cAV coupler resulted in a sustained anti-hypertensive effect nine months post-procedure, with mean 24-hr ABP of 154/91 mm Hg on only two anti-hypertensives. Her significant anti-hypertensive response may be explained by the presence of an inelastic aortic graft that had been inserted due to prior aortic dissection as it allowed the restoration of elasticity in a previously inelastic arterial system. We believe that the ROX cAV coupler device warrants further investigation. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)
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- 2017
- Full Text
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