Among 20 transcatheter aortic valve explants, 55% had leaflet calcification, with calcified valves tending to have thicker leaflets and calcium distribution varying by valve type.
Observational (n=20)
Yes
What are the frequency and patterns of leaflet calcification and thickening in explanted transcatheter aortic valves?
Explanted transcatheter aortic valves demonstrate that calcification patterns and leaflet thickening vary by valve type, providing important anatomical considerations for redo-TAVR procedures.
BACKGROUND: Degeneration is an inevitable outcome for bioprosthetic heart valves. In the setting of transcatheter aortic valve (TAV) replacement (TAVR), calcifications and leaflet thickening have implications for feasibility and outcomes of repeat interventions, including leaflet modification techniques. In this study, we aimed to investigate the frequency and pattern of leaflet calcification and thickening in explanted TAVs to inform repeat interventions. METHODS: TAV explants were obtained from the Explanted THV registry and clinical institutions. Micro-computed tomography imaging and histology were used to evaluated TAV calcium volume, distribution, and leaflet thickening. RESULTS: Twenty TAV explants were analyzed: 11 self-expanding CoreValve/Evolut (Medtronic, Dublin, Ireland) TAVs, 8 balloon-expandable Sapien 3 (Edwards Lifesciences, Irvine, CA) TAVs, and 1 mechanically-expandable Lotus (Boston Scientific, Marlborough, MA) TAV. Median patient age at explant was 73.0 (interquartile range IQR, 63.0-81.0) years, with a median time to explant of 3 years and 3 months (IQR, 1 year and 10 months to 4 years and 10 months). Eleven TAVs (55%) had leaflet calcification (median, 77.9; IQR, 24.7-336.1) mm CONCLUSIONS: Calcified TAVs tend to have thicker leaflets and calcium distribution appears to vary according to TAV type. These findings might have important clinical implications when considering redo-TAV replacement and leaflet modification techniques.
A Sun, study conducted a observational in Transcatheter aortic valve degeneration (n=20). Micro-computed tomography imaging and histology was evaluated on Frequency and pattern of leaflet calcification and thickening. Among 20 transcatheter aortic valve explants, 55% had leaflet calcification, with calcified valves tending to have thicker leaflets and calcium distribution varying by valve type.