24 results on '"Hensey, Mark"'
Search Results
2. Multimodality Imaging to Assess Leaflet Height in Mitral Bioprosthetic Valves: Implications for Mitral Valve-in-Valve Procedure.
- Author
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Akodad M, Sathananthan J, Tzimas G, Salcudean H, Hensey M, Gulsin GS, Meier D, Anthony Chuang MY, Chatfield AG, Landes U, Blanke P, Sondergaard L, Payne GW, Lutter G, Puehler T, Wood DA, Webb JG, Leipsic JA, and Sellers SL
- Subjects
- Humans, Mitral Valve diagnostic imaging, Mitral Valve surgery, Predictive Value of Tests, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation methods, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery
- Abstract
Competing Interests: Funding Support and Author Disclosures Funding was received from St Paul's Foundation and the Providence Health Care Research Institute (PHCRI) Early Career Research Initiative. Dr Akodad has received research funding from Medtronic, Biotronik, MUSE Explore, and Federation Française de Cardiologie. Dr Sathananthan has received speaker fees from Edwards Lifesciences and NVT Medical; and has reported consulting for Edwards Lifesciences, Boston Scientific, and Medtronic. Dr Tzimas has reported support from the Fondation Vaudoise de Cardiologie. Dr Gulsin has reported support from a British Heart Foundation Travel Fellowship (FS/TF/21/33008). Dr Blanke has reported consulting for Edwards Lifesciences, Boston Scientific, and Neovasc; and has provided computed tomography core laboratory services for Edwards Lifesciences, Medtronic, Neovasc, Boston Scientific, and Abbott, for which no direct compensation was received. Dr Sondergaard has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and SMT. Dr Wood has reported consulting for and has received research funding from Edwards Lifesciences and Abbott. Dr Webb has reported consulting for Edwards Lifesciences. Dr Leipsic has reported support from a Canadian Research Chair in Advanced Cardiopulmonary Imaging; has reported consulting for MVRX, HeartFlow, and Circle Cardiovascular Imaging; and has provided computed tomography core laboratory services for Edwards Lifesciences, Medtronic, Neovasc, Boston Scientific, and Abbott, for which no direct compensation is received. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Published
- 2022
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3. The Wattson temporary pacing guidewire for transcatheter heart valve implantation.
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Carey J, Buckley A, O'Connor S, and Hensey M
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- Aortic Valve surgery, Cardiac Pacing, Artificial, Humans, Treatment Outcome, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Pacemaker, Artificial, Transcatheter Aortic Valve Replacement methods
- Abstract
Transcatheter aortic valve implantation and implantation of other transcatheter heart valves, generally requires insertion of a temporary venous pacemaker. Implantation of a temporary venous pacemaker adds complexity, time and risk to the procedure. Guidewire modification to allow pacing is increasingly popular, however it requires technical expertise and provides unipolar pacing resulting in high thresholds and potential capture loss. The Wattson temporary pacing guidewire is a novel device which offers guidewire support for valve delivery and concomitant bipolar pacing. It may offer a safe and effective solution to guidewire pacing for transcatheter aortic valve implantation and other transcatheter heart valve implantations. Herein, we review the literature surrounding left ventricular guidewire pacing along with the features and clinical data of the Wattson wire.
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- 2022
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4. Tricuspid Valve-in-Valve and Bioprosthetic Surgical Tricuspid and Pulmonic Valve Degeneration: Lessons From Imaging and Histopathology.
- Author
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Sellers SL, Hensey M, Cartlidge TRG, Turner CT, Lau K, Lai A, Salcudean H, Sathananthan J, McManus BM, Granville DJ, Payne GW, Pibarot P, Webb JG, Newby DE, Blanke P, Seidman MA, Dweck MR, and Leipsic JA
- Subjects
- Humans, Predictive Value of Tests, Tricuspid Valve surgery, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Tricuspid Valve Insufficiency surgery
- Published
- 2020
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5. Transcatheter Mitral Valve Replacement With the Transseptal EVOQUE System.
- Author
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Webb J, Hensey M, Fam N, Rodés-Cabau J, Daniels D, Smith R, Szeto W, Boone R, Ye J, Moss R, Peterson M, Ong G, Paradis JM, Dagenais F, Wintzer-Wehekind J, Shafi B, Nair D, Szerlip M, Grayburn P, Silvestry F, Koulogiannis K, Hermiller J, Guyton R, and Herrmann H
- Subjects
- Aged, 80 and over, Humans, Treatment Outcome, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Mitral Valve surgery, Mitral Valve Insufficiency surgery
- Abstract
Objectives: The aim of this study was to examine the initial experience with a novel transseptal transcatheter mitral valve replacement (TMVR) system., Background: Transseptal TMVR may offer a less invasive option than surgery for mitral regurgitation (MR) with greater efficacy and fewer anatomic limitations than transcatheter repair., Methods: Patients were treated with the EVOQUE TMVR system from September 2018 to October 2019. Key inclusion criteria were moderate or greater MR, New York Heart Association functional class ≥II, and high or prohibitive surgical risk. The primary outcome was technical success, defined by Mitral Valve Academic Research Consortium criteria., Results: Fourteen patients were treated, all with at least moderate to severe MR. The median age was 84 years, and the median Society of Thoracic Surgeons score was 4.6%. MR was degenerative in 4 (28.6%), functional in 3 (21.4%), and mixed in 7 (50%). Technical success was achieved in 13 patients (92.9%), and 1 patient was converted to surgery. At 30 days there was 1 noncardiovascular mortality (7.1%), 2 strokes (14.3%), no myocardial infarctions, and no rehospitalizations. Two patients (14.3%) underwent paravalvular leak closure. One patient (7.1%) underwent alcohol septal ablation for left ventricular outflow tract obstruction. Including the 2 patients with paravalvular leak closure, MR was mild or less in all implanted patients at 30 days, with no MR in 10 (83.3%). Mean mitral gradient was 5.8 mm Hg (median). New York Heart Association functional class improved to ≤II in 9 patients (81.8%)., Conclusions: This first-in-human experience has demonstrated the feasibility of the transseptal EVOQUE TMVR system. Further clinical studies are required to establish safety and clinical outcomes., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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6. Mitral regurgitation in patients undergoing transcatheter aortic valve implantation for degenerated surgical aortic bioprosthesis: Insights from PARTNER 2 Valve-in-Valve Registry.
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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.)
- Published
- 2020
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7. 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
- Subjects
- 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.)
- Published
- 2020
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8. Reference dimensions of stented surgical aortic bioprostheses for valve size determination.
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Anastasius M, Godoy M, Weir-McCall JR, Bapat V, Sathananthan J, Hensey M, Sellers SL, Cheung A, Ye J, Wood DA, Leipsic J, Webb J, and Blanke P
- Subjects
- Aortic Valve surgery, Prosthesis Design, Stents, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects
- Published
- 2020
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9. Repeat Transcatheter Aortic Valve Replacement for Transcatheter Prosthesis Dysfunction.
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Landes U, Webb JG, De Backer O, Sondergaard L, Abdel-Wahab M, Crusius L, Kim WK, Hamm C, Buzzatti N, Montorfano M, Ludwig S, Schofer N, Voigtlaender L, Guerrero M, El Sabbagh A, Rodés-Cabau J, Guimaraes L, Kornowski R, Codner P, Okuno T, Pilgrim T, Fiorina C, Colombo A, Mangieri A, Eltchaninoff H, Nombela-Franco L, Van Wiechen MPH, Van Mieghem NM, Tchétché D, Schoels WH, Kullmer M, Tamburino C, Sinning JM, Al-Kassou B, Perlman GY, Danenberg H, Ielasi A, Fraccaro C, Tarantini G, De Marco F, Witberg G, Redwood SR, Lisko JC, Babaliaros VC, Laine M, Nerla R, Castriota F, Finkelstein A, Loewenstein I, Eitan A, Jaffe R, Ruile P, Neumann FJ, Piazza N, Alosaimi H, Sievert H, Sievert K, Russo M, Andreas M, Bunc M, Latib A, Govdfrey R, Hildick-Smith D, Sathananthan J, Hensey M, Alkhodair A, Blanke P, Leipsic J, Wood DA, Nazif TM, Kodali S, Leon MB, and Barbanti M
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- Aged, Aortic Valve surgery, Equipment Failure Analysis, Female, Global Health, Humans, Male, Outcome Assessment, Health Care, Registries statistics & numerical data, Survival Analysis, Symptom Assessment statistics & numerical data, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency epidemiology, Aortic Valve Insufficiency etiology, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis adverse effects, Postoperative Complications diagnosis, Postoperative Complications epidemiology, Postoperative Complications surgery, Reoperation instrumentation, Reoperation methods, Reoperation statistics & numerical data, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement instrumentation, Transcatheter Aortic Valve Replacement methods
- Abstract
Background: Transcatheter aortic valve replacement (TAVR) use is increasing in patients with longer life expectancy, yet robust data on the durability of transcatheter heart valves (THVs) are limited. Redo-TAVR may play a key strategy in treating patients in whom THVs fail., Objectives: The authors sought to examine outcomes following redo-TAVR., Methods: The Redo-TAVR registry collected data on consecutive patients who underwent redo-TAVR at 37 centers. Patients were classified as probable TAVR failure or probable THV failure if they presented within or beyond 1 year of their index TAVR, respectively., Results: Among 63,876 TAVR procedures, 212 consecutive redo-TAVR procedures were identified (0.33%): 74 within and 138 beyond 1 year of the initial procedure. For these 2 groups, TAVR-to-redo-TAVR time was 68 (38 to 154) days and 5 (3 to 6) years. The indication for redo-TAVR was THV stenosis in 12 (16.2%) and 51 (37.0%) (p = 0.002) and regurgitation or combined stenosis-regurgitation in 62 (83.8%) and 86 (62.3%) (p = 0.028), respectively. Device success using VARC-2 criteria was achieved in 180 patients (85.1%); most failures were attributable to high residual gradients (14.1%) or regurgitation (8.9%). At 30-day and 1-year follow-up, residual gradients were 12.6 ± 7.5 mm Hg and 12.9 ± 9.0 mm Hg; valve area 1.63 ± 0.61 cm
2 and 1.51 ± 0.57 cm2 ; and regurgitation ≤mild in 91% and 91%, respectively. Peri-procedural complication rates were low (3 stroke [1.4%], 7 valve malposition [3.3%], 2 coronary obstruction [0.9%], 20 new permanent pacemaker [9.6%], no mortality), and symptomatic improvement was substantial. Survival at 30 days was 94.6% and 98.5% (p = 0.101) and 83.6% and 88.3% (p = 0.335) at 1 year for patients presenting with early and late valve dysfunction, respectively., Conclusions: Redo-TAVR is a relatively safe and effective option for selected patients with valve dysfunction after TAVR. These results are important for applicability of TAVR in patients with long life expectancy in whom THV durability may be a concern., (Copyright © 2020. Published by Elsevier Inc.)- Published
- 2020
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10. Bioprosthetic Valve Leaflet Displacement During Valve-in-Valve Intervention: An Ex Vivo Bench Study.
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Hensey M, Sellers S, Sathananthan J, Lai A, Landes U, Alkhodair A, McManus B, Cheung A, Wood D, Blanke P, Leipsic J, Ye J, and Webb J
- Subjects
- Coronary Stenosis etiology, Equipment Failure Analysis, Heart Valve Prosthesis Implantation adverse effects, Humans, Materials Testing, Prosthesis Design, Risk Assessment, Risk Factors, Transcatheter Aortic Valve Replacement adverse effects, Bioprosthesis, Coronary Stenosis prevention & control, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Prosthesis Failure, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Objectives: The aim of this study was to examine the effect of different transcatheter heart valves (THVs) on valve leaflet displacement when deployed within bioprosthetic surgical valves and, thereby, risk for coronary obstruction., Background: Coronary obstruction is a potentially devastating complication during valve-in-valve (ViV) transcatheter aortic valve replacement. Strategies such as provisional stenting and intentional bioprosthetic valve leaflet laceration have been developed to mitigate this risk. Alternatively, the use of a THV that retracts the bioprosthetic leaflet away from the coronary ostium may prevent coronary obstruction., Methods: A 25-mm J-Valve, a 26-mm Evolut Pro, and a 23-mm JenaValve were implanted into both a 25-mm Trifecta surgical valve and a 25-mm Mitroflow surgical valve. A 23-mm and a 26-mm SAPIEN 3 were deployed into the Trifecta and Mitroflow, respectively. Displacement of the surgical valve leaflets (retraction vs. expansion) was measured with implantation of each THV by measuring displacement angle and maximal displacement distance., Results: Within both the Trifecta and Mitroflow valves, implantation of the J-Valve and JenaValve resulted in retraction of the surgical valve leaflets, and placement of the Evolut Pro and SAPIEN 3 resulted in tubular expansion of the surgical valve leaflets. There were significant differences in displacement angles and distances between both the J-Valve and JenaValve and the SAPIEN 3 and Evolut Pro (p < 0.0001)., Conclusions: ViV implantation with new-generation THVs that directly interact with bioprosthetic valve leaflets results in surgical valve leaflet retraction. This might mitigate the risk for coronary obstruction in selected cases of ViV transcatheter aortic valve replacement and also facilitate coronary reaccess after ViV TAVR., (Copyright © 2020 American College of Cardiology Foundation. All rights reserved.)
- Published
- 2020
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11. Impact of implant depth on hydrodynamic function of the ALLEGRA bioprosthesis in valve-in-valve interventions.
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Sathananthan J, Fraser R, Kütting M, Hensey M, Landes U, Alkhodair A, Sedaghat A, Blanke P, Toggweiler S, Leipsic J, Søndergaard L, Wood D, and Webb JG
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- Aortic Valve, Hemodynamics, Hydrodynamics, Prosthesis Design, Prosthesis Failure, Terfenadine analogs & derivatives, Bioprosthesis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Transcatheter Aortic Valve Replacement
- Abstract
Aims: We aimed to assess the impact of implant depth on hydrodynamic function following valve-in-valve (VIV) intervention using the ALLEGRA transcatheter heart valve (THV) in three different surgical valve designs., Methods and Results: Multiple implantation depths (+2 mm, -2 mm and -6 mm) were tested using a 23 mm ALLEGRA THV for VIV intervention in 19 mm, 21 mm, 23 mm, and 25 mm Epic, Mitroflow and Magna Ease bioprosthetic valves. Multimodality imaging and hydrodynamic evaluation was performed at each implantation depth. The 23 mm ALLEGRA valve had gradients <20 mmHg in the Mitroflow and Epic valves sized ≥21 mm, and in all sizes of the Magna Ease valve. Gradients did not increase significantly at lower implantation depths. The 19 mm Epic (+2 mm: 20.1±0.6 mmHg, -2 mm: 18.8±0.5 mmHg, -6 mm: 22.8±0.3 mmHg) and 19 mm Mitroflow (+2 mm: 24.1±0.2 mmHg, -2 mm: 31.5±0.3 mmHg, -6 mm: 25.6±0.2 mmHg) valves had elevated mean gradients. In larger sized surgical valves (≥23 mm) the regurgitant fraction was higher at low implantation depths. Pinwheeling was significantly worse in the smaller sized (≤21 mm) surgical valves and also at low (<-2 mm) implantation depth., Conclusions: The 23 mm ALLEGRA valve had favourable (<20 mmHg) gradients in all surgical valves sized ≥21 mm, even when the THV was implanted low. In 19 mm sized Mitroflow and Epic valves, gradients were elevated (>20 mmHg). While there was no major difference in mean transvalvular gradients, leaflet pinwheeling was worse at lower implantation depths.
- Published
- 2020
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12. Long-Term Durability of Transcatheter Heart Valves: Insights From Bench Testing to 25 Years.
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Sathananthan J, Hensey M, Landes U, Alkhodair A, Saiduddin A, Sellers S, Cheung A, Lauck S, Blanke P, Leipsic J, Ye J, Wood DA, and Webb JG
- Subjects
- Equipment Failure Analysis, Hydrodynamics, Materials Testing, Prosthesis Design, Stress, Mechanical, Time Factors, Transcatheter Aortic Valve Replacement adverse effects, Bioprosthesis, Heart Valve Prosthesis, Hemodynamics, Prosthesis Failure, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Objectives: This study assessed the long-term durability of nominally deployed transcatheter heart valves (THV) to 1 billion cycles (equivalent to 25 years) and non-nominal (overexpansion, underexpansion, and elliptical) THV deployments to 200 million cycles (equivalent to 5 years) with accelerated wear testing., Background: The long-term durability of THVs is currently unknown. As transcatheter aortic valve replacement expands to lower-risk patients, durability will be of increasing importance., Methods: SAPIEN 3 THVs, sized 20, 23, 26, and 29 mm were assessed. Nominally deployed THVs underwent hydrodynamic performance and mechanical durability as assessed with accelerated wear testing to 1 billion cycles. Magna Ease surgical valves were used as comparators. Durability of non-nominal THV deployments was tested to 200 million cycles. Valves were tested to International Standards Organization 5840:2013 standard., Results: THV durability was excellent for both the nominal and non-nominal THV deployments to 1 billion and 200 million cycles, respectively. At 1 billion cycles the regurgitant fraction for the 20-, 23-, 26-, and 29-mm SAPIEN 3 was 0.92 ± 0.47%, 1.29 ± 0.04%, 1.73 ± 0.46%, and 2.47 ± 0.15%, respectively. There was also excellent durability in the comparator Magna Ease valves. The regurgitant fraction of non-nominal overexpanded (20 mm, 4.36 ± 0.53; 23 mm, 7.68 ± 1.39; 26 mm, 6.80 ± 1.17; 29 mm, 9.00 ± 0.37), underexpanded (20 mm, 3.06 ± 0.28; 23 mm, 4.46 ± 0.45; 26 mm, 7.72 ± 0.48; 29 mm, 8.65 ± 2.01), and elliptical (20 mm, 3.30 ± 0.38; 23 mm, 6.13 ± 0.94; 26 mm, 6.77 ± 1.22; 29 mm, 8.72 ± 0.24) THVs were excellent at 200 million cycles., Conclusions: Nominal SAPIEN 3 THVs demonstrated excellent durability, to an equivalent of 25-years wear. THV durability was similar to the comparator surgical valves tested. Non-nominal (overexpansion, underexpansion, and elliptical) THV deployments also had excellent durability to an equivalent of 5 years wear., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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13. Mid-Term Outcomes of Transcatheter Aortic Valve Replacement in Extremely Large Annuli With Edwards SAPIEN 3 Valve.
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Sengupta A, Zaid S, Kamioka N, Terre J, Miyasaka M, Hirji SA, Hensey M, Geloo N, Petrossian G, Robinson N, Sarin E, Ryan L, Yoon SH, Tan CW, Khalique OK, Kodali SK, Kaneko T, Shah PB, Wong SC, Salemi A, Sharma K, Kozina JA, Szerlip MA, Don CW, Gafoor S, Zhang M, Newhart Z, Kapadia SR, Mick SL, Krishnaswamy A, Kini A, Ahmad H, Lansman SL, Mack MJ, Webb JG, Babaliaros V, Thourani VH, Makkar RR, Leon MB, George I, and Tang GHL
- Subjects
- Aged, Aged, 80 and over, Aortic Valve diagnostic imaging, Aortic Valve physiopathology, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis mortality, Aortic Valve Stenosis physiopathology, Female, Hemodynamics, Humans, Male, North America, Postoperative Complications mortality, Postoperative Complications therapy, Recovery of Function, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Transcatheter Aortic Valve Replacement adverse effects, Transcatheter Aortic Valve Replacement mortality, Treatment Outcome, Aortic Valve surgery, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Prosthesis Design, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Objectives: The aim of this study was to report the 1-year results of transcatheter aortic valve replacement (TAVR) with the Edwards SAPIEN 3 (S3) valve in extremely large annuli., Background: Favorable 30-day outcomes of S3 TAVR in annuli >683 mm
2 have previously been reported. Pacemaker implantation rates were acceptable, and a larger left ventricular outflow tract and more eccentric annular anatomy were associated with increasing paravalvular leak., Methods: From December 2013 to December 2018, 105 patients across 15 centers with mean area 721.3 ± 36.1 mm2 (range 683.5 to 852.0 mm2 ) underwent TAVR using an S3 device. Clinical, anatomic, and procedural characteristics were analyzed. One-year survival and echocardiographic follow-up were reached in 94.3% and 82.1% of patients, respectively. Valve Academic Research Consortium-2 30-day and 1-year outcomes were reported., Results: The mean age was 76.9 ± 10.4 years, and Society of Thoracic Surgeons predicted risk score averaged 5.2 ± 3.4%. One-year overall mortality and stroke rates were 18.2% and 2.4%, respectively. Quality-of-life index improved from baseline to 30 days and at 1 year (p < 0.001 for both). Mild paravalvular aortic regurgitation occurred in 21.7% of patients, while moderate or greater paravalvular aortic regurgitation occurred in 4.3%. Mild and moderate or severe transvalvular aortic regurgitation occurred in 11.6% and 0%, respectively. Valve gradients remained stable at 1 year., Conclusions: S3 TAVR in annular areas >683 mm2 is feasible, with favorable mid-term outcomes., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)- Published
- 2020
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14. Overexpansion of older generation balloon expandable transcatheter heart valves: An ex-vivo bench study.
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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.)
- Published
- 2019
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15. Impact of Chronic Kidney Disease on Decision Making and Management in Transcatheter Aortic Valve Interventions.
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Hensey M, Murdoch DJ, Sathananthan J, Wood DA, and Webb JG
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- Aortic Valve Stenosis complications, Humans, Risk Factors, Aortic Valve surgery, Aortic Valve Stenosis surgery, Decision Making, Heart Valve Prosthesis, Practice Guidelines as Topic, Renal Insufficiency, Chronic complications, Transcatheter Aortic Valve Replacement methods
- Abstract
The coexistence of chronic kidney disease (CKD) and severe aortic stenosis (AS) is common, and the prevalence of both is rising. The 2 conditions are inherently linked in that significant CKD may accelerate the development of AS and severe AS may result in deteriorating kidney function. The volume of and indications for transcatheter aortic valve implantation (TAVI) procedures are ever-increasing, and there are many challenges that need to be considered in patients with concomitant severe AS and CKD being assessed for TAVI. Throughout the process of working these patients up for definitive management of their valvular heart disease, the presence of CKD impacts on diagnostic investigations, treatment decisions, and therapeutic interventions. Herein we review the current literature regarding TAVI in patients with CKD focusing on the decision-making process and specific risks involved in TAVI and CKD. We also provide specific practical strategies to best manage this challenging patient cohort., (Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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16. Long-Term Outcomes of the FORMA Transcatheter Tricuspid Valve Repair System for the Treatment of Severe Tricuspid Regurgitation: Insights From the First-in-Human Experience.
- Author
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Asmarats L, Perlman G, Praz F, Hensey M, Chrissoheris MP, Philippon F, Ofek H, Ye J, Puri R, Pibarot P, Attinger A, Moss R, Bédard E, Moschovitis A, Reineke D, Lauck S, Blanke P, Leipsic J, Spargias K, Windecker S, Webb JG, and Rodés-Cabau J
- Subjects
- Aged, Aged, 80 and over, Canada, Cardiac Catheterization adverse effects, Cardiac Catheterization mortality, Compassionate Use Trials, Europe, Female, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation mortality, Humans, Male, Postoperative Complications mortality, Postoperative Complications therapy, Prosthesis Design, Recovery of Function, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Tricuspid Valve diagnostic imaging, Tricuspid Valve physiopathology, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency mortality, Tricuspid Valve Insufficiency physiopathology, Cardiac Catheterization instrumentation, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Hemodynamics, Tricuspid Valve surgery, Tricuspid Valve Insufficiency surgery
- Abstract
Objectives: To evaluate the long-term (≥2 years) outcomes following transcatheter tricuspid valve repair (TTVr) with the FORMA Transcatheter Tricuspid Valve Repair System (Edwards Lifesciences, Irvine, California)., Background: Scarce data exist on long-term outcomes following TTVr., Methods: This multicenter experience included patients with severe tricuspid regurgitation (TR) who underwent TTVr with the FORMA system at 4 centers under a compassionate clinical use program. Data were collected at baseline, 30 days, and 1 year, and yearly thereafter., Results: Nineteen patients (76 ± 9 years of age, 74% women, mean EuroSCORE II [European System for Cardiac Operative Risk Evaluation] 9.2 ± 5.6%) with functional TR were included. Procedural success was achieved in 17 (89%) patients and there were no cases of 30-day mortality. At a median follow-up of 32 (interquartile range: 24 to 36) months, 4 (24%) patients had died (3 from terminal heart failure, 1 from sepsis) and 3 (18%) patients required rehospitalization for heart failure. There was 1 device-related thrombosis and 1 pulmonary embolism, both in the setting of subtherapeutic oral anticoagulation. Less than severe TR was observed at echocardiography in 67% of patients at the 2- to 3-year follow-up. Among 15 successfully implanted patients with at least 24-month follow-up, significant improvements in New York Heart Association functional class (p < 0.001), 6-min walk test (+54 m; p = 0.016) and Kansas City Cardiomyopathy Questionnaire score (+16 points; p = 0.016) were observed, compared with baseline., Conclusions: TTVr using the FORMA system showed favorable long-term safety profile in high-surgical-risk patients, with sustained functional improvement and acceptable TR reduction up to 3 years., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
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- 2019
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17. Impact of implant depth on hydrodynamic function with the ACURATE neo transcatheter heart valve following valve-in-valve transcatheter aortic valve replacement in Mitroflow bioprosthetic valves: an ex vivo bench study.
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Sathananthan J, Sellers SL, Fraser R, Dvir D, Hensey M, Murdoch DJ, Blanke P, Pibarot P, Toggweiler S, Wood D, Leipsic J, and Webb JG
- Subjects
- Aortic Valve, Hydrodynamics, Bioprosthesis, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
- Abstract
Aims: We aimed to assess the impact of implant depth on hydrodynamic function following valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) using the ACURATE neo transcatheter heart valve (THV) through an ex vivo bench study., Methods and Results: Multiple implantation depths were tested at incremental depths of 2 mm using a small size ACURATE neo valve for VIV TAVR in 19 mm, 21 mm, 23 mm, and 25 mm Mitroflow bioprosthetic valves. Multimodality imaging and hydrodynamic evaluation was performed at each implantation depth. A low implantation was associated with higher transvalvular gradients. The highest transvalvular gradient was observed at -10 mm depth for 19 mm (40.0±0.5 mmHg), -8 mm for 21 mm (15.3±0.2 mmHg), -6 mm for 23 mm (14.7±0.3 mmHg) and -8 mm for 25 mm (8.4±0.2 mmHg) surgical valves. The lowest transvalvular gradient was observed at 0 mm depth for the 19 mm (14.9±0.2 mmHg)/21 mm (7.2±0.1 mmHg), and +2 mm depth for the 23 mm (5.7±0.1 mmHg)/25 mm (5.8±0.1 mmHg) surgical valves. At low implantation depth, there was worse leaflet pin-wheeling and also evidence of interaction of THV leaflets with those of the surgical valve that impaired leaflet coaptation, resulting in a high regurgitant fraction (42.5% in the 21 mm and 83.3% in the 23 mm surgical valve at -10 mm depths)., Conclusions: A high implant is desirable to facilitate favourable hydrodynamic function when performing VIV TAVR using the ACURATE neo THV for Mitroflow aortic bioprostheses sized ±25 mm. In a 19 mm Mitroflow valve, positioning the upper crown of the ACURATE neo THV above the posts of the surgical valve is desirable to facilitate favourable transvalvular gradients. Low implantation results in higher transvalvular gradients and worse pin-wheeling, and THV leaflet dysfunction can be severe due to interaction with the surgical valve.
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- 2019
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18. Transcatheter Aortic-Valve Replacement - 10 Years Later.
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Murdoch DJ, Webb JG, Ye J, Sathananthan J, Hensey M, Wood DA, Cheung A, Leipsic J, Blanke P, and Lauck S
- Subjects
- Aged, Aortic Diseases complications, Aortic Valve diagnostic imaging, Aortic Valve surgery, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnostic imaging, Female, Heart Failure etiology, Humans, Tomography, X-Ray Computed, Treatment Outcome, Vascular Calcification complications, Aortic Valve Stenosis surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
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- 2019
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19. Percutaneous Transcatheter Mitral Valve Replacement: First-in-Human Experience With a New Transseptal System.
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Webb JG, Murdoch DJ, Boone RH, Moss R, Attinger-Toller A, Blanke P, Cheung A, Hensey M, Leipsic J, Ong K, Sathananthan J, Wood DA, Ye J, and Tartara P
- Subjects
- Aged, Canada, Echocardiography, Transesophageal methods, Equipment Design, Feasibility Studies, Female, Heart Septum surgery, Humans, Male, Recurrence, Risk Adjustment methods, Severity of Illness Index, Ventricular Function, Left, Cardiac Catheterization methods, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation adverse effects, Heart Valve Prosthesis Implantation instrumentation, Heart Valve Prosthesis Implantation methods, Mitral Valve diagnostic imaging, Mitral Valve surgery, Mitral Valve Insufficiency diagnosis, Mitral Valve Insufficiency physiopathology, Mitral Valve Insufficiency surgery
- Abstract
Background: Severe mitral regurgitation (MR) conveys significant morbidity and mortality, and surgical repair or replacement may not be a desirable option., Objectives: The purpose of this study was to evaluate the feasibility of a percutaneous transseptal transcatheter mitral valve replacement (TMVR) system., Methods: This first-in-human study was conducted between August 2017 and August 2018. The system comprises a nitinol dock, which encircles the chordae tendineae, and a balloon-expandable transcatheter heart valve. The dock and transcatheter heart valve form an ensemble, with the native mitral valve leaflets secured in between, thereby abolishing MR. Key inclusion criteria were severe symptomatic MR and high surgical risk; exclusion criteria included left ventricular ejection fraction <30% or screening suggesting unfavorable anatomy. The primary endpoint was technical success as defined by Mitral Valve Academic Research Consortium (MVARC) criteria at completion of the index procedure. The secondary endpoint was freedom from mortality, stroke, and device dysfunction (MR grade >1, mitral gradient >6 mm Hg, left ventricular outflow tract gradient >20 mm Hg) at 30 days., Results: Ten patients with severe MR of various etiologies (4 degenerative, 4 functional, and 2 mixed) were treated. The device was successfully implanted and the primary endpoint was achieved in 9 of 10 patients (90%). By transesophageal echocardiography, total MR was reduced to ≤ trivial in all implanted patients, and mean transmitral gradient was 2.3 ± 1.4 mm Hg. A pericardial effusion occurred in 1 patient: pericardiocentesis was performed, and the device was not implanted. Median length of hospital stay was 1.5 days. At 30 days, there was no stroke, myocardial infarction, rehospitalization, left ventricular outflow tract obstruction, device migration, embolization, or conversion to mitral surgery. One patient had recurrent regurgitation due to a paravalvular leak, treated with a closure device. All other treated patients had ≤1+ MR. No patients died., Conclusions: Percutaneous transvenous transseptal TMVR is feasible and safe in patients with severe MR who are at high risk for mitral valve surgery. Further evaluation is warranted., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2019
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20. First-in-human experience of a new-generation transfemoral transcatheter aortic valve for the treatment of severe aortic regurgitation: the J-Valve transfemoral system.
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Hensey M, Murdoch DJ, Sathananthan J, Alenezi A, Sathananthan G, Moss R, Blanke P, Leipsic J, Wood DA, Cheung A, Ye J, and Webb JG
- Subjects
- Aortic Valve, Humans, Treatment Outcome, Aortic Valve Insufficiency surgery, Heart Valve Prosthesis, Transcatheter Aortic Valve Replacement
- Published
- 2019
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21. Valve-in-Valve Transcatheter Aortic Valve Replacement and Bioprosthetic Valve Fracture Comparing Different Transcatheter Heart Valve Designs: An Ex Vivo Bench Study.
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Sathananthan J, Sellers S, Barlow AM, Stanová V, Fraser R, Toggweiler S, Allen KB, Chhatriwalla A, Murdoch DJ, Hensey M, Lau K, Alkhodair A, Dvir D, Asgar AW, Cheung A, Blanke P, Ye J, Rieu R, Pibarot P, Wood D, Leipsic J, and Webb JG
- Subjects
- Balloon Valvuloplasty, Materials Testing, Prosthesis Failure, Bioprosthesis, Heart Valve Prosthesis, Prosthesis Design, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Objectives: The authors assessed the effect of valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) followed by bioprosthetic valve fracture (BVF), testing different transcatheter heart valve (THV) designs in an ex vivo bench study., Background: Bioprosthetic valve fracture can be performed to improve residual transvalvular gradients following VIV TAVR., Methods: The authors evaluated VIV TAVR and BVF with the SAPIEN 3 (S3) (Edwards Lifesciences, Irvine, California) and ACURATE neo (Boston Scientific Corporation, Natick, Massachusetts) THVs. A 20-mm and 23-mm S3 were deployed in a 19-mm and 21-mm Mitroflow (Sorin Group USA, Arvada, Colorado), respectively. A small ACURATE neo was deployed in both sizes of Mitroflow tested. VIV TAVR samples underwent multimodality imaging, and hydrodynamic evaluation before and after BVF., Results: A high implantation was required to enable full expansion of the upper crown of the ACURATE neo and allow optimal leaflet function. Marked underexpansion of the lower crown of the THV within the surgical valve was also observed. Before BVF, VIV TAVR in the 19-mm Mitroflow had high transvalvular gradients using either THV design (22.0 mm Hg S3, and 19.1 mm Hg ACURATE neo). After BVF, gradients improved and were similar for both THVs (14.2 mm Hg S3, and 13.8 mm Hg ACURATE neo). The effective orifice area increased with BVF from 1.2 to 1.6 cm
2 with the S3 and from 1.4 to 1.6 cm2 with the ACURATE neo. Before BVF, VIV TAVR with the ACURATE neo in the 21-mm Mitroflow had lower gradients compared with S3 (11.3 mm Hg vs. 16 mm Hg). However, after BVF valve gradients were similar for both THVs (8.4 mm Hg ACURATE neo vs. 7.8 mm Hg S3). The effective orifice area increased from 1.5 to 2.1 cm2 with the S3 and from 1.8 to 2.2 cm2 with the ACURATE neo., Conclusions: BVF performed after VIV TAVR results in improved residual gradients. Following BVF, residual gradients were similar irrespective of THV design. Use of a small ACURATE neo for VIV TAVR in small (≤21 mm) surgical valves may be associated with challenges in achieving optimum THV position and expansion. BVF could be considered in selected clinical cases., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)- Published
- 2019
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22. Transcatheter Tricuspid Valve-in-Valve Replacement With Subsequent Bioprosthetic Valve Fracture to Optimize Hemodynamic Function.
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Hensey M, Alenezi AR, Murdoch DJ, Sathananthan J, Weir-McCall JR, Wood D, Blanke P, and Webb J
- Subjects
- Adult, Female, Heart Valve Prosthesis Implantation adverse effects, Humans, Prosthesis Design, Prosthesis Failure, Recovery of Function, Treatment Outcome, Tricuspid Valve diagnostic imaging, Tricuspid Valve physiopathology, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency physiopathology, Tricuspid Valve Stenosis diagnostic imaging, Tricuspid Valve Stenosis etiology, Tricuspid Valve Stenosis physiopathology, Balloon Valvuloplasty, Bioprosthesis, Cardiac Catheterization instrumentation, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Hemodynamics, Tricuspid Valve surgery, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Stenosis surgery
- Published
- 2018
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23. Overexpansion of the SAPIEN 3 Transcatheter Heart Valve: An Ex Vivo Bench Study.
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Sathananthan J, Sellers S, Barlow A, Fraser R, Stanová V, Cheung A, Ye J, Alenezi A, Murdoch DJ, Hensey M, Dvir D, Blanke P, Rieu R, Wood D, Pibarot P, Leipsic J, and Webb J
- Subjects
- Balloon Valvuloplasty, Materials Testing, Prosthesis Design, Heart Valve Prosthesis, Prosthesis Failure, Transcatheter Aortic Valve Replacement instrumentation
- Abstract
Objectives: This study assessed the effect of overexpansion beyond labeled size (diameter) of transcatheter heart valves through an ex vivo bench study., Background: Transcatheter heart valves function optimally when expanded to specific dimensions. However, clinicians may sometimes wish to overexpand balloon-expandable valves to address specific clinical challenges. The implications of overexpansion have assumed considerable importance, and objective information to guide practice is limited., Methods: We evaluated SAPIEN 3 transcatheter heart valves (Edwards Lifesciences, Irvine, California). Valves (diameters of 23, 26, and 29 mm) were expanded to nominal dimensions, and then incrementally overexpanded with balloons sized 1-, 2-, and 3-mm larger than the recommended diameter. Valves underwent visual, microcomputed tomography, and hydrodynamic evaluation at various degrees of overexpansion., Results: SAPIEN 3 valves with labeled diameters of 23, 26, and 29 mm could be incrementally overexpanded to midvalve diameters of 26.4, 28.4, and 31.2 mm, respectively. With overexpansion, there was visible restriction of the valve leaflets, which was particularly evident with the smaller valves. After maximal overexpansion of a 26-mm valve a leaflet tear was observed. High-speed video demonstrated impaired leaflet motion of both the 23- and 26-mm valves and hydrodynamic testing documented a regurgitant fraction for the 23- and 26-mm valves above accepted international standards. The maximally overexpanded 29-mm SAPIEN 3 still had relatively normal leaflet motion and excellent hydrodynamic function. Durability was not specifically evaluated., Conclusions: Overexpansion of balloon-expandable valves is possible. However, excessive overexpansion may be associated with impaired hydrodynamic function, acute leaflet failure, and reduced durability. Smaller valves may be at greater risk with overexpansion than larger valves. Overexpansion is best avoided unless clinical circumstances are compelling., (Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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24. Transcatheter Tricuspid Valve-in-Valve Replacement With Subsequent Bioprosthetic Valve Fracture to Optimize Hemodynamic Function
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Hensey, Mark, Alenezi, Abdullah R, Murdoch, Dale J, Sathananthan, Janarthanan, Weir-McCall, Jonathan R, Wood, David, Blanke, Philipp, and Webb, John
- Subjects
Adult ,Balloon Valvuloplasty ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,Cardiac Catheterization ,transcatheter valve ,Hemodynamics ,Recovery of Function ,tricuspid valve ,Prosthesis Design ,Tricuspid Valve Insufficiency ,Prosthesis Failure ,Treatment Outcome ,Heart Valve Prosthesis ,Humans ,Female ,Tricuspid Valve Stenosis - Published
- 2018
- Full Text
- View/download PDF
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