Valvular & structural heart diseaseResearch article
Fibrotic Tissue Ingrowth of Transcatheter Heart Valve Frames
- Explant pathology study
Authors' conclusion
Fibrotic THV frame ingrowth is a common phenomenon that may complicate THV explantation and impede neosinus washout and coronary access after TAVR.
Study context
- Population
- Explanted transcatheter heart valves after transcatheter aortic valve replacement (TAVR)explanted transcatheter heart valve (THVs)
- Participants
- 34 vs 10
- Comparison
- SAPIEN vs Evolut/CoreValve explanted THVs
- SAPIENn = 34
- EV/CVn = 10
- Outcome
- THV frame obstruction due to fibrotic tissue ingrowth and its potential impact on coronary access and neosinus flow
Main finding
As reported in the abstract
Frame fibrotic ingrowth
- Frame with fibrotic ingrowth, all explanted THVs
- 79.5%
- Implant duration correlated with obstruction severity
- P = 0.003
- Cells in likely cannulation areas not passable by 6-F catheter
- 13.0%
- Redo-TAVR models unable to be fenestrated by 6-F catheter
- up to 76%
- Median granulation tissue thickness
- 0.5 mm
Further findings
Distribution and clinical correlates
- Ingrowth more common in upper and lower regions of EV/CVs and upper cells adjacent to commissures in SAPIEN
- Greater ingrowth associated with damage to native structure at explantation
- Frame adhesions not detectable by standard clinical imaging
Original publication
Fibrotic Tissue Ingrowth of Transcatheter Heart Valve Frames. JACC Cardiovasc Interv. Published 23 February 2026. doi:10.1016/j.jcin.2025.11.003
Summarised from the published abstract; every number is checked against it