Abstract
Background: Recent studies have shown that subclinical valve thrombosis in heart valve prosthesis (HVP) can be responsible for reduced leaflet motion detectable only by advanced imaging diagnostics. We conceived a novel sensorized HVP able to detect earlier any thrombus formation that may alter the leaflets motion using an electric impedance measurement, IntraValvular Impedance (IVI). Methods: For IVI measurement, dedicated electrodes are embedded in the structure of the HVP to generate a local electric field that is altered by the moving valve leaflets during their cyclic opening/closing. We present preliminary in vitro results using a first prototype of sensorized mechanical heart valve connected to an external impedance measurement system. The prototype was tested on a circulatory mock loop system and the IVI signals were recorded during both normal dynamics and experimentally induced altered working of the leaflets. Results: Recordings showed a very repetitive and stable IVI signal during the normal cyclic opening/closing of the HVP. The induced alterations in leaflet motion were reflected in the IVI signal. Conclusions: The novel sensorized HVP has great potential to give early warning of possible subclinical valve thrombosis altering the valve leaflet motion, and to help in tailoring the anticoagulation therapy.
Highlights
Valvular heart diseases affect more than 100 million persons worldwide and are associated with significant morbidity and mortality [1,2]
In the last 10 years, there has been a proliferation of transcatheter aortic valve replacement (TAVR), alternately known as transcatheter aortic valve implantation (TAVI), which is a procedure in which a diseased aortic valve is replaced via an endovascular or transapical approach, using an expandable valve delivered with a catheter
Results of Tests with Altered Leaflet Dynamics overall variation between the valve in the completely open position and in the partially closed one the incomplete closure of the valvesponge), by interposing thetosponge
Summary
Valvular heart diseases affect more than 100 million persons worldwide and are associated with significant morbidity and mortality [1,2]. BHVs, made either of porcine origin or synthesized from a sheet of bovine pericardium, are less thrombogenic than MHV and exhibit more natural hemodynamic properties, but are less durable. Recent studies have shown that subclinical valve thrombosis in heart valve prosthesis (HVP) can be responsible for reduced leaflet motion detectable only by advanced imaging diagnostics. We conceived a novel sensorized HVP able to detect earlier any thrombus formation that may alter the leaflets motion using an electric impedance measurement, IntraValvular Impedance (IVI). Methods: For IVI measurement, dedicated electrodes are embedded in the structure of the HVP to generate a local electric field that is altered by the moving valve leaflets during their cyclic opening/closing. Results: Recordings showed a very repetitive and stable IVI signal during the normal cyclic opening/closing of the HVP
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