Valvular & structural heart disease
Deformation of transcatheter heart valves with mitral valve-in-valve
Authors' conclusion
THV deformation, i.e., underexpansion and an hourglass shape, commonly occurs after MViV implantation and is negatively affected by excessive oversizing.
Study context
- Population
- Patients undergoing mitral valve-in-valve with SAPIEN prostheses
- Participants
- 33 patients
- Outcome
- Extent and predictors of THV deformation (deformation index, eccentricity, neosinus volume, asymmetric leaflet expansion, vertical deformation) and HALT on cardiac CT
- Follow-up
- 30 days post-procedure
Methodological detailsComputed tomography (CT) performed prospectively at 30 days
- CT performed prospectively at 30 days
Main finding
As reported in the abstract
THV deformation · 30 days
- Expansion area at narrowest level (median, IQR 68.1-84.1)
- 74.0%
- Transcatheter heart valves (THV) deformation index (median, IQR 1.13-1.29)
- 1.21
- Eccentricity range
- 0.24 to 0.28
- Oversizing associated with greater underexpansion
- β=−0.634; p<0.001
- Oversizing associated with higher deformation index
- β=0.594; p<0.001
Observational data: associations, not effects.
Further findings
Hypoattenuating leaflet thickening (HALT) on 30-day CT
- HALT incidence (9 of 33)
- 27.3%
- On anticoagulation
- 32 of 33
- Prothrombin time and international normalised ratio (PT-INR) <2.5 at CT
- 23 of 32
- With PT-INR <2.5, HALT predominantly with THV deformation index ≥1.18
Original publication
Deformation of transcatheter heart valves with mitral valve-in-valve. EuroIntervention. Published 18 December 2023. doi:10.
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