TY - JOUR
T1 - Real-time magnetic resonance-guided aortic valve replacement using Engager valve
AU - Kindzelski, Bogdan A.
AU - Li, Ming
AU - Mazilu, Dumitru
AU - Hunt, Timothy
AU - Horvath, Keith A.
N1 - Funding Information:
This research was made possible by funding from the Intramural Research Program of the National Heart, Lung, and Blood Institute, NIH, DHHS, and the NIH Medical Research Scholars Program, a public–private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc, The Doris Duke Charitable Foundation, The Alexandria Real Estate Equities, Inc and Mr. and Mrs. Joel S. Marcus, and the Howard Hughes Medical Institute, as well as other private donors. The authors would like to thank Medtronic for generously providing the Engager valves and delivery devices for the rtCMR-guided experiments. The authors had full freedom of investigation.
Publisher Copyright:
© 2014 The Society of Thoracic Surgeons.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - Purpose New-generation stented bioprostheses coupled with better imaging modalities are expanding the clinical utility of transcatheter aortic valve replacement (TAVR). This study aimed at evaluating the feasibility of real-time cardiovascular magnetic resonance (rtCMR) -guided TAVR using the Medtronic Engager aortic valve system in a preclinical model.Description The Engager delivery device was slightly modified to make it CMR-compatible. Ten Yucatan swine underwent rtCMR-guided transapical TAVR. Postplacement phase-contrast and first-pass perfusion CMR sequences were used to evaluate for aortic regurgitation and myocardial perfusion, respectively.Conclusions The Engager valve can be implanted transapically under rtCMR guidance with a modified, CMR-compatible delivery device in a preclinical model. Cardiovascular magnetic resonance allowed for accurate preplacement evaluation, real-time guidance, and postplacement functional assessment.Evaluation Real-time CMR provided excellent visualization of cardiac anatomy during TAVR. Nine of 10 animals had proper valve placement in the aortic annulus as determined by CMR and confirmed by necropsy inspection. Postplacement phase-contrast scans confirmed no intravalvular or paravalvular leaks. Perfusion scans demonstrated sufficient coronary flow. Roentgenographs confirmed proper placement of the prostheses.
AB - Purpose New-generation stented bioprostheses coupled with better imaging modalities are expanding the clinical utility of transcatheter aortic valve replacement (TAVR). This study aimed at evaluating the feasibility of real-time cardiovascular magnetic resonance (rtCMR) -guided TAVR using the Medtronic Engager aortic valve system in a preclinical model.Description The Engager delivery device was slightly modified to make it CMR-compatible. Ten Yucatan swine underwent rtCMR-guided transapical TAVR. Postplacement phase-contrast and first-pass perfusion CMR sequences were used to evaluate for aortic regurgitation and myocardial perfusion, respectively.Conclusions The Engager valve can be implanted transapically under rtCMR guidance with a modified, CMR-compatible delivery device in a preclinical model. Cardiovascular magnetic resonance allowed for accurate preplacement evaluation, real-time guidance, and postplacement functional assessment.Evaluation Real-time CMR provided excellent visualization of cardiac anatomy during TAVR. Nine of 10 animals had proper valve placement in the aortic annulus as determined by CMR and confirmed by necropsy inspection. Postplacement phase-contrast scans confirmed no intravalvular or paravalvular leaks. Perfusion scans demonstrated sufficient coronary flow. Roentgenographs confirmed proper placement of the prostheses.
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U2 - 10.1016/j.athoracsur.2014.09.017
DO - 10.1016/j.athoracsur.2014.09.017
M3 - Article
C2 - 25468087
AN - SCOPUS:84919458292
SN - 0003-4975
VL - 98
SP - 2194
EP - 2199
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 6
ER -