Transcatheter heart valve crimping and the protecting effects of a polyester cuff

Authors: Guidoin, Robert; Zegdi, Rachid; lin, Jing; Mao, JifuRochette-Drouin, Olivier; how, D.; Guan, X.; Bruneval, Patrick; Wang, Lu; Germain, LucieZhang, Ze
Abstract: Introduction - Prior to deployment, the percutaneous heart valves must be crimped and loaded into sheaths of diameters that can be as low as 6 mm for a 23 mm diameter valve. However, as the valve leaflets are fragile, any damage caused during this crimping process may contribute to reducing its long-term durability in vivo. Material and method Bovine pericardium percutaneous valves were manufactured as follows. The leaflets were sutured on a nitinol frame. A polyester cuff fabric served as a buffer between the pericardium and the stent. Two valves were crimped and one valve was used as control. The valves were examined in gross observation and micro-CT scan and then the leaflets were processed for histology and analyzed in scanning electron microscopy, light microscopy and transmission electron microscopy. Result Crimping of the valves resulted in the increase thickness of the leaflets and there was no evidence of additional delamination. The heavy prints of the stents were irregularly distributed on the outflow surface in the crimped devices and were shallow and did not penetrate throughout the thickness of the leaflets. However, the wavy microscopy of collagen fiber bundles was well preserved. They were found to remain individualized without any agglutination as shown by the regular banding appearance. Conclusion Crimping of self-deployable valves per se caused only minor damages to the leaflets. However, the procedure could be refined in order to minimize areas of high pressure and swelling of the tissue that can be accompanied with flow surface disruption and increase of the hydraulic conductance. The incorporation of a polyester buffer serves to prevent the deleterious effects that may be caused if the pericardium tissue were in direct contact with the nitinol stent.
Document Type: Article de recherche
Issue Date: 22 July 2016
Open Access Date: Restricted access
Document version: VoR
Permalink: http://hdl.handle.net/20.500.11794/16864
This document was published in: Morphologie, Vol. 100 (331), 234–244 (2016)
https://doi.org/10.1016/j.morpho.2016.06.005
Elsevier Masson
Alternative version: 10.1016/j.morpho.2016.06.005
27461102
Collection:Articles publiés dans des revues avec comité de lecture

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