The Experts below are selected from a list of 315 Experts worldwide ranked by ideXlab platform
Jacques Moret - One of the best experts on this subject based on the ideXlab platform.
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An In Vitro Study of silk stent morphology
Neuroradiology, 2011Co-Authors: Thaweesak Aurboonyawat, Raphaël Blanc, Michel Piotin, Laurent Spelle, Amir Nakib, Paul Schmidt, Jacques MoretAbstract:Introduction Morphology of the Silk stent (Balt, Montmorency, France) after deployment is not fully understood, especially In tortuous vessels. An In Vitro Study was conducted to Study morphology and flow-divertIng parameters of this stent. Methods Two sets of different-sized and curved polytetrafluoroethylene tubes were studied. To simulate the aneurysm neck, a small hole was created In a tube. A stent was placed In each of the different tubes. Angiographic computerized tomography and macroscopic photography were then obtaIned. The images were analyzed to calculate a Percentage of Area Coverage (PAC). Results Good stent conformability was observed. The PAC was 21% In the straight model with matched stent and vessel diameter. In the straight model with an oversized stent, the PAC was Increased. In the curved models, dynamic wire repositionIng occurred. The repositionIng was affected by the size of the stent and the angle of the vessel curve. Compared to the straight model, this Increased the PAC In two Instances: on the convexity (oversized stent), and on the concavity (matched stent and vessel diameter). The PAC did not significantly change at the sides of the curve. Conclusions By design, the wires of the silk stent move relative to each other. In a curved model, the PAC is different at the convexity, concavity, and lateral walls. The stent diameter affects the PAC. These results are clInically relevant because it is desirable to maximize and mInimize the PAC across the aneurysm neck and branch vessel orifice, respectively.
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An In Vitro Study of silk stent morphology
Neuroradiology, 2010Co-Authors: Thaweesak Aurboonyawat, Raphaël Blanc, Paul J. Schmidt, Michel Piotin, Laurent Spelle, Amir Nakib, Jacques MoretAbstract:Introduction Morphology of the Silk stent (Balt, Montmorency, France) after deployment is not fully understood, especially In tortuous vessels. An In Vitro Study was conducted to Study morphology and flow-divertIng parameters of this stent.
Philippe Pibarot - One of the best experts on this subject based on the ideXlab platform.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
Journal of Thoracic and Cardiovascular Surgery, 2016Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Objectives: The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods: A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results: The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 +/- 0.21 cm 2 vs 1.65 +/- 0.37 cm 2; P 23 mm was associatedwith higher risk of paravalvular regurgitation when oversizIng was 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
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Effect of oversizIng and elliptical shape of aortic annulus on transcatheter valve hemodynamics: An In Vitro Study
International Journal of Cardiology, 2016Co-Authors: Erwan Salaün, Philippe Pibarot, Morgane Evin, Anne-sophie Zenses, Frederic Collart, Gilbert Habib, Régis RieuAbstract:Background: Transcatheter aortic valve implantation (TAVI) is often performed In patients with non-circular aortic annulus and In oversizIng (OS) conditions. The impact of elliptical annulus shape and the consequences of oversizIng/underdeployment on the hemodynamic performance are still debated. Objective: This In-Vitro Study aims to assess and compare the valve hemodynamic performances of the Edwards SAPIEN transcatheter heart valve (THV) In the different current conditions of use: important oversizIng In small circular annuli and In elliptical annuli, moderate oversizIng In circular and In elliptical annuli of various degrees of eccentricity. Methods: A pulsed cardiovascular simulator was used. Edwards SAPIEN 23 and 26 (mm) were implanted In different circular and elliptical annuli of various sizes and eccentricity. Transvalvular mean pressure gradients (TPGm), effective orifice area (EOA) after implantation of Edwards SAPIEN THV were measured by Dopplere-chocardiography and the performance Index (PI - 100 x EOA / Annulus Area) was calculated. Para and transvalvular regurgitation was assessed by color-Doppler and leakage volume was quantified by flowmeter measurement. Results: For a given aortic annulus area, EOAs after implantation of Edwards SAPIEN THV were generally larger and TPGms lower with elliptical annuli compared to circular annuli. The PI was higher (p = 0.047) for elliptical (48 +/- 3%) than for circular annuli (43 +/- 5%). Paravalvular regurgitation occurred only In the case of the SAPIEN 26 implanted In the elliptical annulus with highest eccentricity. Conclusion: The results of this In-Vitro Study suggest that the EOAs of Edwards SAPIEN are better In elliptical than In circular annuli. No transvalvular regurgitation occurred and only one paravalvular regurgitation was observed after implantation of SAPIEN 26 In the highly eccentric annulus. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
The Journal of thoracic and cardiovascular surgery, 2015Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Abstract Objectives The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 ± 0.21 cm 2 vs 1.65 ± 0.37 cm 2 ; P P 20%, and IOD > 23 mm was associated with higher risk of paravalvular regurgitation when oversizIng was Conclusions This In Vitro Study shows that VInV withIn mitral surgical bioprostheses provides satisfactory hemodynamic results In the majority of patients. However, significant mitral stenosis is more likely to occur when the IOD of the surgical bioprosthesis is 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
Thaweesak Aurboonyawat - One of the best experts on this subject based on the ideXlab platform.
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An In Vitro Study of silk stent morphology
Neuroradiology, 2011Co-Authors: Thaweesak Aurboonyawat, Raphaël Blanc, Michel Piotin, Laurent Spelle, Amir Nakib, Paul Schmidt, Jacques MoretAbstract:Introduction Morphology of the Silk stent (Balt, Montmorency, France) after deployment is not fully understood, especially In tortuous vessels. An In Vitro Study was conducted to Study morphology and flow-divertIng parameters of this stent. Methods Two sets of different-sized and curved polytetrafluoroethylene tubes were studied. To simulate the aneurysm neck, a small hole was created In a tube. A stent was placed In each of the different tubes. Angiographic computerized tomography and macroscopic photography were then obtaIned. The images were analyzed to calculate a Percentage of Area Coverage (PAC). Results Good stent conformability was observed. The PAC was 21% In the straight model with matched stent and vessel diameter. In the straight model with an oversized stent, the PAC was Increased. In the curved models, dynamic wire repositionIng occurred. The repositionIng was affected by the size of the stent and the angle of the vessel curve. Compared to the straight model, this Increased the PAC In two Instances: on the convexity (oversized stent), and on the concavity (matched stent and vessel diameter). The PAC did not significantly change at the sides of the curve. Conclusions By design, the wires of the silk stent move relative to each other. In a curved model, the PAC is different at the convexity, concavity, and lateral walls. The stent diameter affects the PAC. These results are clInically relevant because it is desirable to maximize and mInimize the PAC across the aneurysm neck and branch vessel orifice, respectively.
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An In Vitro Study of silk stent morphology
Neuroradiology, 2010Co-Authors: Thaweesak Aurboonyawat, Raphaël Blanc, Paul J. Schmidt, Michel Piotin, Laurent Spelle, Amir Nakib, Jacques MoretAbstract:Introduction Morphology of the Silk stent (Balt, Montmorency, France) after deployment is not fully understood, especially In tortuous vessels. An In Vitro Study was conducted to Study morphology and flow-divertIng parameters of this stent.
Régis Rieu - One of the best experts on this subject based on the ideXlab platform.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
Journal of Thoracic and Cardiovascular Surgery, 2016Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Objectives: The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods: A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results: The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 +/- 0.21 cm 2 vs 1.65 +/- 0.37 cm 2; P 23 mm was associatedwith higher risk of paravalvular regurgitation when oversizIng was 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
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Effect of oversizIng and elliptical shape of aortic annulus on transcatheter valve hemodynamics: An In Vitro Study
International Journal of Cardiology, 2016Co-Authors: Erwan Salaün, Philippe Pibarot, Morgane Evin, Anne-sophie Zenses, Frederic Collart, Gilbert Habib, Régis RieuAbstract:Background: Transcatheter aortic valve implantation (TAVI) is often performed In patients with non-circular aortic annulus and In oversizIng (OS) conditions. The impact of elliptical annulus shape and the consequences of oversizIng/underdeployment on the hemodynamic performance are still debated. Objective: This In-Vitro Study aims to assess and compare the valve hemodynamic performances of the Edwards SAPIEN transcatheter heart valve (THV) In the different current conditions of use: important oversizIng In small circular annuli and In elliptical annuli, moderate oversizIng In circular and In elliptical annuli of various degrees of eccentricity. Methods: A pulsed cardiovascular simulator was used. Edwards SAPIEN 23 and 26 (mm) were implanted In different circular and elliptical annuli of various sizes and eccentricity. Transvalvular mean pressure gradients (TPGm), effective orifice area (EOA) after implantation of Edwards SAPIEN THV were measured by Dopplere-chocardiography and the performance Index (PI - 100 x EOA / Annulus Area) was calculated. Para and transvalvular regurgitation was assessed by color-Doppler and leakage volume was quantified by flowmeter measurement. Results: For a given aortic annulus area, EOAs after implantation of Edwards SAPIEN THV were generally larger and TPGms lower with elliptical annuli compared to circular annuli. The PI was higher (p = 0.047) for elliptical (48 +/- 3%) than for circular annuli (43 +/- 5%). Paravalvular regurgitation occurred only In the case of the SAPIEN 26 implanted In the elliptical annulus with highest eccentricity. Conclusion: The results of this In-Vitro Study suggest that the EOAs of Edwards SAPIEN are better In elliptical than In circular annuli. No transvalvular regurgitation occurred and only one paravalvular regurgitation was observed after implantation of SAPIEN 26 In the highly eccentric annulus. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
The Journal of thoracic and cardiovascular surgery, 2015Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Abstract Objectives The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 ± 0.21 cm 2 vs 1.65 ± 0.37 cm 2 ; P P 20%, and IOD > 23 mm was associated with higher risk of paravalvular regurgitation when oversizIng was Conclusions This In Vitro Study shows that VInV withIn mitral surgical bioprostheses provides satisfactory hemodynamic results In the majority of patients. However, significant mitral stenosis is more likely to occur when the IOD of the surgical bioprosthesis is 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
Morgane Evin - One of the best experts on this subject based on the ideXlab platform.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
Journal of Thoracic and Cardiovascular Surgery, 2016Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Objectives: The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods: A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results: The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 +/- 0.21 cm 2 vs 1.65 +/- 0.37 cm 2; P 23 mm was associatedwith higher risk of paravalvular regurgitation when oversizIng was 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
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Effect of oversizIng and elliptical shape of aortic annulus on transcatheter valve hemodynamics: An In Vitro Study
International Journal of Cardiology, 2016Co-Authors: Erwan Salaün, Philippe Pibarot, Morgane Evin, Anne-sophie Zenses, Frederic Collart, Gilbert Habib, Régis RieuAbstract:Background: Transcatheter aortic valve implantation (TAVI) is often performed In patients with non-circular aortic annulus and In oversizIng (OS) conditions. The impact of elliptical annulus shape and the consequences of oversizIng/underdeployment on the hemodynamic performance are still debated. Objective: This In-Vitro Study aims to assess and compare the valve hemodynamic performances of the Edwards SAPIEN transcatheter heart valve (THV) In the different current conditions of use: important oversizIng In small circular annuli and In elliptical annuli, moderate oversizIng In circular and In elliptical annuli of various degrees of eccentricity. Methods: A pulsed cardiovascular simulator was used. Edwards SAPIEN 23 and 26 (mm) were implanted In different circular and elliptical annuli of various sizes and eccentricity. Transvalvular mean pressure gradients (TPGm), effective orifice area (EOA) after implantation of Edwards SAPIEN THV were measured by Dopplere-chocardiography and the performance Index (PI - 100 x EOA / Annulus Area) was calculated. Para and transvalvular regurgitation was assessed by color-Doppler and leakage volume was quantified by flowmeter measurement. Results: For a given aortic annulus area, EOAs after implantation of Edwards SAPIEN THV were generally larger and TPGms lower with elliptical annuli compared to circular annuli. The PI was higher (p = 0.047) for elliptical (48 +/- 3%) than for circular annuli (43 +/- 5%). Paravalvular regurgitation occurred only In the case of the SAPIEN 26 implanted In the elliptical annulus with highest eccentricity. Conclusion: The results of this In-Vitro Study suggest that the EOAs of Edwards SAPIEN are better In elliptical than In circular annuli. No transvalvular regurgitation occurred and only one paravalvular regurgitation was observed after implantation of SAPIEN 26 In the highly eccentric annulus. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
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Mitral valve-In-valve hemodynamic performance: An In Vitro Study
The Journal of thoracic and cardiovascular surgery, 2015Co-Authors: Morgane Evin, Josep Rodés-cabau, Carine Guivier-curien, Régis Rieu, Philippe PibarotAbstract:Abstract Objectives The valve-In-valve (VInV) procedure may be used In high-risk patients with failed mitral surgical bioprostheses. The objective of this In Vitro Study was to assess the hemodynamic function of different VInV configurations. Methods A double activation duplicator was used to test 11 valve configurations (surgical bioprostheses alone) and 15 VInV configurations (Sapien [Edwards Lifesciences, IrvIne, Calif] implanted withIn the surgical bioprosthesis) under 8 different hemodynamic conditions. The Internal orifice diameter (IOD) of the surgical bioprosthesis was measured with a Smartscope (OGP Multi Sensor MeasurIng Instruments, SIngapore). Results The VInV procedure was associated with significant deterioration In antegrade hemodynamic parameters compared with valve configuration (effective orifice area, 1.51 ± 0.21 cm 2 vs 1.65 ± 0.37 cm 2 ; P P 20%, and IOD > 23 mm was associated with higher risk of paravalvular regurgitation when oversizIng was Conclusions This In Vitro Study shows that VInV withIn mitral surgical bioprostheses provides satisfactory hemodynamic results In the majority of patients. However, significant mitral stenosis is more likely to occur when the IOD of the surgical bioprosthesis is 20%. Significant paravalvular regurgitation is rare and occurs with larger IODs and lower percentage of oversizIng (8%).
