Figure 2-5 - uploaded by Kenneth Park
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View of an aortic root opened longitudinally, showing the basal ring (white line) and the VAJ (black dashed line), from De Kerchove et al. (2015). (L-Left coronary cusp; R-Right coronary cusp; N-Non-coronary cusp)
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Background:
Transaxillary access (TAx) has shown promise as an excellent alternative TAVR option, but data on the Edwards SAPIEN 3 in TAx-TAVR is limited. We sought to study the safety and efficacy of TAx-TAVR using this current-generation balloon-expandable valve.
Methods:
A retrospective study of our first 24 TAx and 20 transthoracic (TT) TAVR...
Transcatheter aortic valve replacement (TAVR) is the gold standard treatment for patients with symptomatic aortic stenosis. The utility of existing risk prediction tools for in-hospital mortality post-TAVR is limited due to two major factors: (a) the predictive accuracy of these tools is insufficient when only preoperative variables are incorporate...
Purpose of review:
Cardiac Rehabilitation (CR) was originally designed to return patients to their prior level of functioning after myocardial infarction (MI). Research has since revealed the mortality benefit of CR, and CR has been given a class 1A recommendation by the American Heart Association/American College of Cardiology (AHA/ACC). In this...
Citations
... Parallel progress in the design of affordable percutaneous tools for insertion of these valves is being made (109)(110)(111). ...
Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference “Rheumatic Heart Disease: from Molecules to the Global Community,” experts from 21 countries formulated an approach for addressing the problem of RHD: “The Cairo Accord on Rheumatic Heart Disease.” The Accord attempts to set policy priorities for the eradication of acute rheumatic fever (ARF) and RHD and builds on a recent series of policy initiatives and calls to action. We present an update on the recommendations of the Cairo Accord and discuss recent progress toward the eradication of RHD, including contributions from our own Aswan Rheumatic Heart Disease Registry (ARGI).
... The attachment curve was defined with Bézier curves (Park, 2017). Bézier curves were defined as follows, ...
... The coordinates of the control points were defined on the X-Y plane, therefore, a 2-D spline was generated. While P0 was selected as the origin of the plane, P3 was selected as the point at the valve height, y = 14.3 mm, and at one-sixth of the valve circumference, x = 12.04 mm (Park, 2017). The coordinates of the P1 and P2 were used as non-constant parameters to generate different attachment curves. ...
Valvular diseases, such as aortic stenosis, are considered a common condition in the US. In severe cases, either mechanical or prosthetic heart valves are employed to replace the diseased native valve. The prosthetic heart valve has been a focal point for researchers to gain a better understanding of the mechanics, which will lead to improved longevity. In this study, our objective was to evaluate the effect of fundamental curves on the geometric orifice area and the coaptation area by implementing a two-level Taguchi Orthogonal Array (OA) design (Analysis of Variance (ANOVA) technique) and the interaction plots to investigate the individual contributions. The leaflet geometry was represented with the attachment curve, the free edge, and the belly curve. A total of three varying control coordinates were used to form different leaflet surfaces. With two different biocompatible polymers, 16 finite element models were prepared. Each model was subjected to time-varying transvalvular pressure. The results showed that the control coordinate for the belly curve has the highest impact on the coaptation area of the valve models with higher average 100% modulus. The geometric orifice area was affected by both control points of the attachment curve and the belly curve. A similar effect was also observed for the valve models with lower average 100% modulus.
