Characteristics of surgical prosthetic heart valves and problems around labelling: a document from the European Association for Cardio-Thoracic Surgery (EACTS)-The Society of Thoracic Surgeons (STS)-American Association for Thoracic Surgery (AATS) Valve Labelling Task Force.
Durko, Andras P.; Head, Stuart J.; Pibarot, Philippeet al.
2019 • In European Journal of Cardio-Thoracic Surgery, 55 (6), p. 1025-1036
[en] Intraoperative surgical prosthetic heart valve (SHV) choice is a key determinant of successful surgery and positive postoperative outcomes. Currently, many controversies exist around the sizing and labelling of SHVs rendering the comparison of different valves difficult. To explore solutions, an expert Valve Labelling Task Force was jointly initiated by the European Association for Cardio-Thoracic Surgery (EACTS), The Society of Thoracic Surgeons (STS) and the American Association for Thoracic Surgery (AATS). The EACTS-STS-AATS Valve Labelling Task Force, comprising cardiac surgeons, cardiologists, engineers, regulators and representatives from the International Organization for Standardization (ISO) and major valve manufacturers, held its first in-person meeting in February 2018 in Paris, France. This article was derived from the meeting's discussions. The Task Force identified the following areas for improvement and clarification: reporting of physical dimensions and characteristics of SHVs determining and labelling of SHV size, in vivo and in vitro testing and reporting of SHV haemodynamic performance and thrombogenicity. Furthermore, a thorough understanding of the regulatory background and the role of the applicable ISO standards, together with close cooperation between all stakeholders (including regulatory and standard-setting bodies), is necessary to improve the current situation. Cardiac surgeons should be provided with appropriate information to allow for optimal SHV choice. This first article from the EACTS-STS-AATS Valve Labelling Task Force summarizes the background of SHV sizing and labelling and identifies the most important elements where further standardization is necessary.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Durko, Andras P.
Head, Stuart J.
Pibarot, Philippe
Atluri, Pavan
Bapat, Vinayak
Cameron, Duke E.
Casselman, Filip P. A.
Chen, Edward P.
Dahle, Gry
Ebels, Tjark
Elefteriades, John A.
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Characteristics of surgical prosthetic heart valves and problems around labelling: a document from the European Association for Cardio-Thoracic Surgery (EACTS)-The Society of Thoracic Surgeons (STS)-American Association for Thoracic Surgery (AATS) Valve Labelling Task Force.
Publication date :
2019
Journal title :
European Journal of Cardio-Thoracic Surgery
ISSN :
1010-7940
eISSN :
1873-734X
Volume :
55
Issue :
6
Pages :
1025-1036
Peer reviewed :
Peer reviewed
Commentary :
This article has been co-published with permission in the European Journal of Cardio-Thoracic Surgery, The Annals of Thoracic Surgery and The Journal of Thoracic and Cardiovascular Surgery. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style. Either citation can be used when citing this article. (c) 2019 European Association for Cardio-Thoracic Surgery, The Society of Thoracic Surgeons, and The American Association for Thoracic Surgery. Published by Oxford University Press and Elsevier Inc.
Head SJ, Mokhles MM, Osnabrugge RL, Pibarot P, Mack MJ, Takkenberg JJ et al. The impact of prosthesis-patient mismatch on long-Term survival after aortic valve replacement: A systematic review and meta-Analysis of 34 observational studies comprising 27 186 patients with 133 141 patient-years. Eur Heart J 2012;33:1518-29.
ISO. International Standard, ISO 5840:2015. Cardiovascular Implants-Cardiac Valve Prostheses. International Organization for Standardization (ISO), 2015. www.iso.org (3 April 2018, date last accessed).
Doenst T, Amorim PA, Al-Alam N, Lehmann S, Mukherjee C, Faerber G. Where is the common sense in aortic valve replacement? A review of hemodynamics and sizing of stented tissue valves. J Thorac Cardiovasc Surg 2011;142:1180-7.
ISO. ISO-International Organization for Standardization. 2018. https://www.iso.org/home.html (14 March 2018, date last accessed).
Wu Y, Butchart EG, Borer JS, Yoganathan A, Grunkemeier GL. Clinical evaluation of new heart valve prostheses: update of objective performance criteria. Ann Thorac Surg 2014;98:1865-74.
Head SJ, Mylotte D, Mack MJ, Piazza N, van Mieghem NM, Leon MB et al. Considerations and recommendations for the introduction of objective performance criteria for transcatheter aortic heart valve device approval. Circulation 2016;133:2086-93.
The Council of the European Communities, Council Directive 93/42/EEC, http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CONSLEG:1993L00 42:20071011:en:PDF (3 April 2018, date last accessed)
The European Parliament and the Council of the European Union, Regulation (EU) 2017/745 http://eur-lex.europa.eu/legal-content/ENG/TXT/PDF/?uri=CELEX:32017R0745 =EN (3 April 2018, date last accessed).
International Organization for Standardization (ISO), European Committee for Standardization (CEN). Agreement on Technical Cooperation between ISO and CEN (Vienna Agreement). 2001. https://boss.cen.eu/ref/Vienna-Agreement.pdf (3 April 2018, date last accessed).
U.S. Food and Drug Administration. Premarket Approval (PMA): U.S. Department of Health and Human Services. 2018. https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/ucm2007514.htm#data (3 April 2018, date last accessed).
U.S. Food and Drug Administration. Recognition and Use of Consensus Standards, Guidance for Industry and FDA Staff. U.S. Food and Drug Administration, 2007. https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm077295.pdf (3 April 2018, date last accessed).
Mohammadi H, Mequanint K. Prosthetic aortic heart valves: modeling and design. Med Eng Phys 2011;33:131-47.
Konakci KZ, Bohle B, Blumer R, Hoetzenecker W, Roth G, Moser B et al. Alpha-Gal on bioprostheses: xenograft immune response in cardiac surgery. Eur J Clin Invest 2005;35:17-23.
Flameng W, Rega F, Vercalsteren M, Herijgers P, Meuris B. Antimineralization treatment and patient-prosthesis mismatch are major determinants of the onset and incidence of structural valve degeneration in bioprosthetic heart valves. J Thorac Cardiovasc Surg 2014;147: 1219-24.
Scherman J, Bezuidenhout D, Ofoegbu C, Williams DF, Zilla P. TAVI for low to middle income countries. Eur Heart J 2017;38:1182-4.
Bezuidenhout D, Williams DF, Zilla P. Polymeric heart valves for surgical implantation, catheter-based technologies and heart assist devices. Biomaterials 2015;36:6-25.
Glaser N, Jackson V, Franco-Cereceda A, Sartipy U. Survival after aortic valve replacement with bovine or porcine valve prostheses: A systematic review and meta-Analysis. Thorac Cardiovasc Surg 2018; doi: 10.1055/s-0038-1649513
Hickey GL, Bridgewater B, Grant SW, Deanfield J, Parkinson J, Bryan AJ et al. National registry data and record linkage to inform postmarket surveillance of prosthetic aortic valve models over 15 Years. JAMA Intern Med 2017;177:79-86.
Allen KB, Chhatriwalla AK, Cohen DJ, Saxon JT, Aggarwal S, Hart A et al. Bioprosthetic valve fracture to facilitate transcatheter valve-in-valve implantation. Ann Thorac Surg 2017;104:1501-8.
Bapat V, Mydin I, Chadalavada S, Tehrani H, Attia R, Thomas M. A guide to fluoroscopic identification and design of bioprosthetic valves: A reference for valve-in-valve procedure. Catheter Cardiovasc Interv 2013;81: 853-61.
Bapat VN, Attia R, Thomas M. Effect of valve design on the stent internal diameter of a bioprosthetic valve: A concept of true internal diameter and its implications for the valve-in-valve procedure. JACC Cardiovasc Interv 2014;7:115-27.
Cevasco M, Mick SL, Kwon M, Lee LS, Chen EP, Chen FY. True external diameter better predicts hemodynamic performance of bioprosthetic aortic valves than the manufacturers? stated size. J Heart Valve Dis 2013; 22:377-82.
Ruzicka DJ, Hettich I, Hutter A, Bleiziffer S, Badiu CC, Bauernschmitt R et al. The complete supraannular concept: in vivo hemodynamics of bovine and porcine aortic bioprostheses. Circulation 2009;120:139-45.
Tabata M, Shibayama K, Watanabe H, Sato Y, Fukui T, Takanashi S. Simple interrupted suturing increases valve performance after aortic valve replacement with a small supra-Annular bioprosthesis. J Thorac Cardiovasc Surg 2014;147:321-5.
Cameron D. Little things matter. J Thorac Cardiovasc Surg 2015;149: 918-19.
Christakis GT, Buth KJ, Goldman BS, Fremes SE, Rao V, Cohen G et al. Inaccurate and misleading valve sizing: A proposed standard for valve size nomenclature. Ann Thorac Surg 1998;66:1198-203.
Ruzicka DJ, Eichinger WB, Hettich IM, Bleiziffer S, Bauernschmitt R, Lange R. Hemodynamic performance of the new St. Jude Medical Epic Supra porcine bioprosthesis in comparison to the Medtronic Mosaic on the basis of patient annulus diameter. J Heart Valve Dis 2008;17:426-33; discussion 34.
Walther T, Falk V, Weigl C, Diegeler A, Rauch T, Autschbach R et al. Discrepancy of sizers for conventional and stentless aortic valve implants. J Heart Valve Dis 1997;6:145-8.
Bartels C, Leyh RG, Matthias JF, Joubert-Hubner E, Sievers HH. Discrepancies between sizer and valve dimensions: implications for small aortic root. Ann Thorac Surg 1998;65:1631-3.
Retta SM, Kepner J, Marquez S, Herman BA, S Shu MC, Grossman LW. In-vitro pulsatile flow measurement in prosthetic heart valves: An interlaboratory comparison. J Heart Valve Dis 2017;26:72-80.
Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R et al. Recommendations for the imaging assessment of prosthetic heart valves: A report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2016;17:589-90.
Zoghbi WA, Chambers JB, Dumesnil JG, Foster E, Gottdiener JS, Grayburn PA et al. Recommendations for evaluation of prosthetic valves with echocardiography and Doppler ultrasound: A report from the American Society of Echocardiography?s Guidelines and Standards Committee and the Task Force on Prosthetic Valves, developed in conjunction with the American College of Cardiology Cardiovascular Imaging Committee, Cardiac Imaging Committee of the American Heart Association, the European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography and the Canadian Society of Echocardiography, endorsed by the American College of Cardiology Foundation, American Heart Association, European Association of Echocardiography, a registered branch of the European Society of Cardiology, the Japanese Society of Echocardiography, and Canadian Society of Echocardiography. J Am Soc Echocardiogr 2009;22:975-1014.
Gaspar T, Adawi S, Sachner R, Asmer I, Ganaeem M, Rubinshtein R et al. Three-dimensional imaging of the left ventricular outflow tract: impact on aortic valve area estimation by the continuity equation. J Am Soc Echocardiogr 2012;25:749-57.
Kamperidis V, van Rosendael PJ, Katsanos S, van der Kley F, Regeer M, Al Amri I et al. Low gradient severe aortic stenosis with preserved ejection fraction: reclassification of severity by fusion of Doppler and computed tomographic data. Eur Heart J 2015;36:2087-96.
Mooney J, Sellers SL, Blanke P, Pibarot P, Hahn RT, Dvir D et al. CTdefined prosthesis-patient mismatch downgrades frequency and severity, and demonstrates no association with adverse outcomes after transcatheter aortic valve replacement. JACC Cardiovasc Interv 2017;10: 1578-87.
Clavel MA, Malouf J, Messika-Zeitoun D, Araoz PA, Michelena HI, Enriquez-Sarano M. Aortic valve area calculation in aortic stenosis by CT and Doppler echocardiography. JACC Cardiovasc Imaging 2015;8: 248-57.
Hahn RT, Leipsic J, Douglas PS, Jaber WA, Weissman NJ, Pibarot P et al. Comprehensive echocardiographic assessment of normal transcatheter valve function. JACC Cardiovasc Imaging 2018;
Pibarot P, Garcia D, Dumesnil JG. Energy loss index in aortic stenosis: from fluid mechanics concept to clinical application. Circulation 2013; 127:1101-4.
Evin M, Pibarot P, Guivier-Curien C, Tanne D, Kadem L, Rieu R. Localized transvalvular pressure gradients in mitral bileaflet mechanical heart valves and impact on gradient overestimation by Doppler. J Am Soc Echocardiogr 2013;26:791-800.
Pibarot P, Hahn RT, Weissman NJ, Monaghan MJ. Assessment of paravalvular regurgitation following TAVR: A proposal of unifying grading scheme. JACC Cardiovasc Imaging 2015;8:340-60.
Fattouch K, Lancellotti P, Vannan MA, Speziale G (Eds). Advances in Treatments for Aortic Valve and Root Diseases. 1st edn. Springer International Publishing, 2018. doi: 10.1007/978-3-319-66483-5.
Ribeiro HB, Orwat S, Hayek SS, Larose É , Babaliaros V, Dahou A et al. Cardiovascular magnetic resonance to evaluate aortic regurgitation after transcatheter aortic valve replacement. J Am Coll Cardiol 2016;68: 577-85.
Mohty D, Dumesnil JG, Echahidi N, Mathieu P, Dagenais F, Voisine P et al. Impact of prosthesis-patient mismatch on long-Term survival after aortic valve replacement: influence of age, obesity, and left ventricular dysfunction. J Am Coll Cardiol 2009;53:39-47.
Dayan V, Vignolo G, Soca G, Paganini JJ, Brusich D, Pibarot P. Predictors and outcomes of prosthesis-patient mismatch after aortic valve replacement. JACC Cardiovasc Imaging 2016;9:924-33.
Head SJ, Celik M, Kappetein AP. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J 2017;38:2183-91.
Fallon JM, DeSimone JP, Brennan JM, O?Brien S, Thibault DP, DiScipio AW et al. The incidence and consequence of prosthesis-patient mismatch after surgical aortic valve replacement. Ann Thorac Surg 2018; 106:14-22.
Johnston DR, Soltesz EG, Vakil N, Rajeswaran J, Roselli EE, Sabik JF 3rd et al. Long-Term durability of bioprosthetic aortic valves: implications from 12, 569 implants. Ann Thorac Surg 2015;99:1239-47.
Bleiziffer S, Eichinger WB, Hettich I, Guenzinger R, Ruzicka D, Bauernschmitt R et al. Prediction of valve prosthesis-patient mismatch prior to aortic valve replacement: which is the best method? Heart 2007; 93:615-20.
Falk V, Baumgartner H, Bax JJ, De Bonis M, Hamm C, Holm PJ et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease. Eur J Cardiothorac Surg 2017;52:616-64.
Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC Guideline for the management of patients with valvular heart disease: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol 2017;70:252-89.
Eikelboom JW, Connolly SJ, Brueckmann M, Granger CB, Kappetein AP, Mack MJ et al. Dabigatran versus warfarin in patients with mechanical heart valves. N Engl J Med 2013;369:1206-14.
Puskas JD, Gerdisch M, Nichols D, Fermin L, Rhenman B, Kapoor D et al. Anticoagulation and antiplatelet strategies after On-X mechanical aortic valve replacement. J Am Coll Cardiol 2018;71:2717-26.
Koertke H, Zittermann A, Wagner O, Secer S, Sciangula A, Saggau W et al. Telemedicine-guided, very low-dose international normalized ratio self-control in patients with mechanical heart valve implants. Eur Heart J 2015;36:1297-305.
Torella M, Aquila I, Chiodini P, Amarelli C, Romano G, Della Ratta EE et al. Low-dose anticoagulation after isolated mechanical aortic valve replacement with Liva Nova Bicarbon prosthesis: A post hoc analysis of LOWERING-IT Trial. Sci Rep 2018;8:8405.
Makkar RR, Fontana G, Jilaihawi H, Chakravarty T, Kofoed KF, De Backer O et al. Possible subclinical leaflet thrombosis in bioprosthetic aortic valves. N Engl J Med 2015;373:2015-24.
Chakravarty T, Sondergaard L, Friedman J, De Backer O, Berman D, Kofoed KF et al. Subclinical leaflet thrombosis in surgical and transcatheter bioprosthetic aortic valves: An observational study. Lancet 2017;389: 2383-92.
Kappetein AP, Head SJ, Généreux P, Piazza N, van Mieghem NM, Blackstone EH et al. Updated standardized endpoint definitions for transcatheter aortic valve implantation: The Valve Academic Research Consortium-2 consensus document. Eur J Cardiothorac Surg 2012;42:S45-S60.