23 results on '"F. Condemi"'
Search Results
2. Fluid- and Biomechanical Analysis of Ascending Thoracic Aorta Aneurysm with Concomitant Aortic Insufficiency
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O. Trabelsi, Cristina Cavinato, Alex J. Barker, Salvatore Campisi, Stéphane Avril, Magalie Viallon, Michael Markl, F. Condemi, Thomas Troalen, Ambroise Duprey, G. Xuexin, Pierre Croisille, INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lyon, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne), Université Jean Monnet [Saint-Étienne] (UJM), RMN et optique : De la mesure au biomarqueur, Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé (CREATIS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Hospices Civils de Lyon (HCL)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Siemens Healthcare [France], Siemens AG [Munich], Circle Cardiovascular Imaging Inc., Panarctic Plaza, School of Medicine, and Northwestern University
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Adult ,Male ,medicine.medical_specialty ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,0206 medical engineering ,Biomedical Engineering ,Thoracic aorta aneurysm ,Hemodynamics ,Aorta, Thoracic ,Blood Pressure ,02 engineering and technology ,computational fluid dynamics ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Internal medicine ,Healthy volunteers ,Shear stress ,medicine ,Eccentric ,Humans ,Computer Simulation ,4D MRI ,Aged ,Aortic Aneurysm, Thoracic ,business.industry ,Models, Cardiovascular ,[SPI.MECA.BIOM]Engineering Sciences [physics]/Mechanics [physics.med-ph]/Biomechanics [physics.med-ph] ,Anatomy ,Blood flow ,Aortic Valve Stenosis ,Middle Aged ,020601 biomedical engineering ,wall shear stress ,Aortic wall ,mechanical inflation tests and wall strength ,Concomitant ,Cardiology ,Female ,Stress, Mechanical ,business ,Shear Strength ,Blood Flow Velocity ,Magnetic Resonance Angiography - Abstract
International audience; We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemody-namics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair. The healthy volunteers showed no eccentric blood flow, a mean TAWSS of 1.5±0.3 Pa and mean OSI of 0.325±0.025. In 3 aneurismal patients, jet flow impingement on the aortic wall resulted in large TAWSS values and low OSI which were amplified by the AI degree. However, the tissue strength did not appear to be significantly reduced. The fourth patient, which showed the lowest TAWSS due to the absence of jet flow, had the smallest strength in vitro. Interestingly this patient presented a bovine arch abnormality. Jet flow impingement with high WSS values is frequent in ATAAs and our methodology seems to be appropriate for determining whether it may increase the risk of rupture or not.
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- 2017
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3. Club 35 Poster session Friday 13 December: 13/12/2013, 08:30-18:00 * Location: Poster area
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A. Ben Abda, E. Hachulla, A. Polge, M. Richardson, A. Duva Penthia, P. De Groote, D. Montaigne, N. Lamblin, M. Lamer, R. Cinotti, A. Delater, K. Asehnoune, Y. Blanloeil, T. Le Tourneau, B. Rozec, N. Piriou, J. Moon, T. Kim, T. Ahn, W. Chung, M. Chimura, T. Oonishi, Y. Tukishiro, S. Yamada, Y. Taniguchi, Y. Yasaka, T. Kawai, A. Elmissiri, A. Andres Lahuerta, P. Alonso Fernandez, B. Igual Munoz, J. Osca Asensi, O. Cano Perez, R. Jimenez Carreno, M. Sancho-Tello De Carranza, J. Olague De Ros, A. Salvador Sanz, H. Atas, F. Samadov, A. Kepez, M. Sunbul, A. Cincin, H. Direskeneli, K. Tigen, A. Yildiz, M. Karakas, T. Cimen, A. Tuncez, A. Korkmaz, B. Uygur, A. Isleyen, O. Tufekcioglu, F. Melao, M. Paiva, A. Goncalves, T. Pinho, A. Madureira, E. Martins, F. Macedo, M. Maciel, T. Guvenc, H. Erer, S. Kul, D. Oz, B. Koroglu, Y. Kaya, S. Koc, N. Sayar, A. Degirmencioglu, M. Eren, M. Stapor, F. Condemi, V. Bapat, S. Gianstefani, N. Catibog, M. J. Monaghan, A. Carro, A. Pijuan, L. Dos, F. Huguet, C. Abad, N. Gonzalez, B. Miranda, L. Galian, J. Casaldaliga, A. Evangelista, M. M. Gurzun, A. Ionescu, E. Kahraman, T. Sen, S. Guven, G. Keskin, S. Topaloglu, S. Korkmaz, F. Moatemri, A. Mahdhaoui, H. Bouraoui, G. Jeridi, S. Ernez, O. Basaran, G. Gozubuyuk, C. Dundar, O. Tasar, M. Bulut, T. Karaahmet, S. Pala, A. Izgi, C. Kirma, K. Baronaite-Dudoniene, L. Urbaite, V. Smalinskas, R. Veisaite, T. Vasylius, J. Vaskelyte, A. Puodziukynas, G. Teixido-Tura, J. Rodriguez-Palomares, H. Cuellar, V. Pineda, D. Gruosso, L. Gutierrez, S. Moral, M. Gonzalez-Alujas, N. Oprescu, M. Micheu, L. Calmac, D. Pitic, M. Dorobantu, N. Brugger, M. Huerzeler, K. Wustmann, A. Wahl, H. Steck, C. Seiler, H. Ismail, J. Linde, K. Kofoed, U. Dixen, M. Soergaard, J. Hove, J. Willis, D. Oxborough, D. Augustine, D. Knight, G. Coghlan, R. Shah, J. Easaw, R. Verseckaite, G. Pilkauskaite, T. Lapinskas, S. Miliauskas, R. Sakalauskas, R. Jurkevicius, O. Ozeke, O. Turak, F. Ozcan, S. Cay, D. Aras, Z. Golbasi, and S. Aydogdu
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Radiology, Nuclear Medicine and imaging ,General Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2013
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4. Multidetector computed tomography sizing of bioprosthetic valves: guidelines for measurement and implications for valve-in-valve therapies
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F. Condemi, Jessica Webb, Reza Razavi, P. Woodburn, Arjun Nair, Rizwan Attia, Rebecca Preston, Ronak Rajani, Vinayak Bapat, and D. Hodson
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Aortic valve ,medicine.medical_specialty ,medicine.medical_treatment ,Cardiac-Gated Imaging Techniques ,030204 cardiovascular system & hematology ,Prosthesis Design ,Mean difference ,Perimeter ,03 medical and health sciences ,0302 clinical medicine ,Prosthesis Fitting ,Multidetector computed tomography ,Multidetector Computed Tomography ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Bioprosthesis ,Heart Valve Prosthesis Implantation ,medicine.diagnostic_test ,business.industry ,Stent ,General Medicine ,Valve in valve ,medicine.anatomical_structure ,Aortic Valve ,Heart Valve Prosthesis ,cardiovascular system ,Radiology ,business ,Electrocardiography - Abstract
Aim To describe a technique for bioprosthetic multidetector computed tomography (MDCT) sizing and to compare MDCT-derived values against manufacturer-provided sizing. Materials and methods Fourteen bioprosthetic stented valves commonly used in the aortic valve position were evaluated using a Philips 256 MDCT system. All valves were scanned using a dedicated cardiac CT protocol with a four-channel electrocardiography (ECG) simulator. Measurements were made of major and minor axes and the area and perimeter of the internal stent using varying reconstruction kernels and window settings. Measurements derived from MDCT (MDCT ID) were compared against the stent internal diameter (Stent ID) as provided by the valve manufacturer and the True ID (Stent ID + insertion of leaflets). All data were collected and analysed using SPSS for Mac (version 21). Results The mean difference between the MDCT ID and Stent ID was 0.6±1.9 mm ( r =0.649, p =0.012) and between MDCT ID and True ID 2.1±2 mm ( r =0.71, p =0.005). There was no difference in the major ( p =0.90), minor ( p =0.87), area ( p =0.92), or perimeter ( p =0.92) measurements when sharp, standard, and detailed stent kernels were used. Similarly, the measurements remained consistent across differing windowing levels. Conclusion Bioprosthetic stented valves may be reliably sized using MDCT in patients requiring valve-in-valve (VIV) interventions where the valve type and size are unknown. In these cases, clinicians should be aware that MDCT has a tendency to overestimate the True ID size.
- Published
- 2015
5. Non invasive hemodynamic analysis in CRT patients wearing quadripolar left ventricular leads: the importance of pacing electrode selection
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Domenico Sergi, Luca Santini, G. B. Forleo, L Santucci, J Legramante, P. Crobeddu, F. Condemi, G. Panattoni, P. Polisca, and Francesco Romeo
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medicine.medical_specialty ,business.industry ,Internal medicine ,Non invasive ,medicine ,Cardiology ,Hemodynamics ,Cardiology and Cardiovascular Medicine ,business ,Selection (genetic algorithm) - Published
- 2013
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6. Motivations for Enrolment and Dropout of First-Year Undergraduate Nursing Students: A Pilot Multimethod Study.
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Viottini E, Ferrero A, Albanesi B, Acquaro J, Bulfone G, Condemi F, D'Accolti D, Massimi A, Mattiussi E, Sturaro R, Conti A, and Dimonte V
- Abstract
Background/objectives: Higher education institutions must improve the attractiveness and retention of the nursing profession to address the widespread shortage. This pilot multimethod study aimed to preliminarily understand the relationship between motivations for enrolment and dropout among first-year undergraduate nursing students., Methods: A two-step approach was conducted among first-year nursing students from five Italian universities involving: (a) a baseline quantitative online survey collecting their characteristics and motivations for enrolment; (b) a follow-up semi-structured interview qualitative data collection among students who dropped out. Descriptive and inferential statistics were used to describe the motivations for enrolment and differences between universities. Dropout motivations emerged from inductive content analysis, with data categorisation according to Urwin's framework., Results: A total of 759 students completed the online survey. Primary motivations for enrolment included the desire to be useful (88.8%), help suffering people (84.3%), and find employment (74.2%); 22.3% cited unsuccessful admission to another university as motivation for enrolment. Of the 141 students who discontinued, 31 were interviewed (22%). Eleven categories and three themes were identified. More than half of the participants dropped out due to interest in other courses and lack of aptitude, while a smaller number cited personal circumstances. Other motivations for dropout were related to negative learning environments or feelings and difficulties related to course characteristics., Conclusions: This study provides an initial insight into these complex phenomena that will be instrumental in understanding data from an Italian multicenter cohort study. The findings can inform recommendations and strategies to strengthen the future nursing workforce.
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- 2024
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7. [Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study].
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Viottini E, Ferrero A, Acquaro J, Bulfone G, Condemi F, D'Accolti D, Massimi A, Mattiussi E, Sturaro R, Conti A, and Dimonte V
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- Humans, Pilot Projects, Longitudinal Studies, Career Choice, Attitude of Health Personnel, Surveys and Questionnaires, Motivation, Students, Nursing psychology
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. Investing in healthcare professionals. The motivation for enrollment in bachelor nursing courses: results from a pilot study., Introduction: Understanding the reasons for enrolling in a Bachelor of Science in Nursing (BSc Nursing) is crucial for devising strategies to stimulate enrollment and counteract the current decline in applications. A multi-center longitudinal study was initiated to explore motivations for enrollment and dropout rates. The results of the pilot study focusing on enrollment motives are presented., Objective: To identify the reasons for enrolling in BSc Nursing programs at five Italian universities., Methods: First-year BSc Nursing students enrolled in the academic year 2022-2023 completed an online questionnaire exploring socio-demographic and personal information, priority criteria for their choice, information sources, and the following reasons for enrolling (Likert scale 1-5): altruistic motivations, personal interests, preferences, past experiences, job security, advice, fallback options, and the social image of nursing., Results: 759 questionnaires were analyzed (78% of those involved). 64.7% of the students indicated nursing as their first choice, while one-third enrolled as a fallback option, by chance, or because they were uncertain. Altruism was the primary motivation for enrollment (91.8%), but 74.2% of students enrolled to secure a good job or to pursue a career (52.3%), or due to curriculum counseling sessions (13.7%). Some differences were observed between geographical areas., Conclusions: Students primarily enroll in BSc Nursing programs due to altruism, personal experience, and job prospect. These findings may be valuable for guiding and tailoring information campaigns, and for enhancing the appeal of nursing courses.
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- 2024
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8. Wall Shear Stress Differences Between Arterial and Venous Coronary Artery Bypass Grafts One Month After Surgery.
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Tran-Nguyen N, Condemi F, Yan A, Fremes S, Triverio P, and Jimenez-Juan L
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- Male, Humans, Prospective Studies, Veins, Coronary Angiography, Saphenous Vein diagnostic imaging, Treatment Outcome, Coronary Artery Bypass, Mammary Arteries diagnostic imaging, Mammary Arteries surgery
- Abstract
Although coronary artery bypass graft (CABG) surgery is a well-established intervention, graft failure can occur, and the underlying mechanisms remain incompletely understood. The purpose of this prospective study is to utilize computational fluid dynamics (CFD) to investigate how graft hemodynamics one month post surgery may vary among graft types, which have different long-term patency rates. Twenty-four grafts from 10 participants (64.6 ± 8.5 years, 9 men) were scanned with coronary CT angiography and 4D flow MRI one month after CABG surgery. Grafts included 10 left internal mammary arteries (LIMA), 3 radial arteries (RA), and 11 saphenous vein grafts (SVG). Image-guided CFD was used to quantify blood flow rate and wall area exposed to abnormal wall shear stress (WSS). Arterial grafts had a lower abnormal WSS area than venous grafts (17.9% vs. 70.1%; p = 0.001), and a similar trend was observed for LIMA vs. SVG (13.8% vs. 70.1%; p = 0.001). Abnormal WSS area correlated positively to lumen diameter (p < 0.001) and negatively to flow rate (p = 0.001). This CFD study is the first of its kind to prospectively reveal differences in abnormal WSS area 1 month post surgery among CABG types, suggesting that WSS may influence the differential long-term graft failure rates observed among these groups., (© 2022. The Author(s) under exclusive licence to Biomedical Engineering Society.)
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- 2022
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9. Significance of Hemodynamics Biomarkers, Tissue Biomechanics and Numerical Simulations in the Pathogenesis of Ascending Thoracic Aortic Aneurysms.
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Campisi S, Jayendiran R, Condemi F, Viallon M, Croisille P, and Avril S
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- Aorta, Thoracic, Aortic Valve, Biomarkers, Biomechanical Phenomena, Hemodynamics, Humans, Stress, Mechanical, Aortic Aneurysm, Thoracic
- Abstract
Guidelines for the treatment of aortic wall diseases are based on measurements of maximum aortic diameter. However, aortic rupture or dissections do occur for small aortic diameters. Growing scientific evidence underlines the importance of biomechanics and hemodynamics in aortic disease development and progression. Wall shear stress (WWS) is an important hemodynamics marker that depends on aortic wall morphology and on the aortic valve function. WSS could be helpful to interpret aortic wall remodeling and define personalized risk criteria. The complementarity of Computational Fluid Dynamics and 4D Magnetic Resonance Imaging as tools for WSS assessment is a promising reality. The potentiality of these innovative technologies will provide maps or atlases of hemodynamics biomarkers to predict aortic tissue dysfunction. Ongoing efforts should focus on the correlation between these non-invasive imaging biomarkers and clinico-pathologic situations for the implementation of personalized medicine in current clinical practice., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2021
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10. Deciphering ascending thoracic aortic aneurysm hemodynamics in relation to biomechanical properties.
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De Nisco G, Tasso P, Calò K, Mazzi V, Gallo D, Condemi F, Farzaneh S, Avril S, and Morbiducci U
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- Aorta, Hemodynamics, Humans, Stress, Mechanical, Aortic Aneurysm, Thoracic
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The degeneration of the arterial wall at the basis of the ascending thoracic aortic aneurysm (ATAA) is a complex multifactorial process, which may lead to clinical complications and, ultimately, death. Individual genetic, biological or hemodynamic factors are inadequate to explain the heterogeneity of ATAA development/progression mechanisms, thus stimulating the analysis of their complex interplay. Here the disruption of the hemodynamic environment in the ATAA is investigated integrating patient-specific computational hemodynamics, CT-based in vivo estimation of local aortic stiffness and advanced fluid mechanics methods of analysis. The final aims are (1) deciphering the ATAA spatiotemporal hemodynamic complexity and its link to near-wall topological features, and (2) identifying the existing links between arterial wall degeneration and hemodynamic insult. Technically, two methodologies are applied to computational hemodynamics data, the wall shear stress (WSS) topological skeleton analysis, and the Complex Networks theory. The same analysis was extended to the healthy aorta. As main findings of the study, we report that: (1) different spatiotemporal heterogeneity characterizes the ATAA and healthy hemodynamics, that markedly reflect on their WSS topological skeleton features; (2) a link (stronger than canonical WSS-based descriptors) emerges between the variation of contraction/expansion action exerted by WSS on the endothelium along the cardiac cycle, and ATAA wall stiffness. The findings of the study suggest the use of advanced methods for a deeper understanding of the hemodynamics disruption in ATAA, and candidate WSS topological skeleton features as promising indicators of local wall degeneration., Competing Interests: Declaration of Competing Interest The authors state no conflict of interest for the study object of the manuscript. The research was not supported financially by private companies. None of the authors has a financial agreement with peoples or organizations that could inappropriately influence their work., (Copyright © 2020. Published by Elsevier Ltd.)
- Published
- 2020
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11. Computational prediction of hemodynamical and biomechanical alterations induced by aneurysm dilatation in patient-specific ascending thoracic aortas.
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Jayendiran R, Condemi F, Campisi S, Viallon M, Croisille P, and Avril S
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- Aorta, Thoracic physiopathology, Humans, Hydrodynamics, Shear Strength physiology, Stress, Mechanical, Aortic Aneurysm, Thoracic physiopathology, Hemodynamics physiology
- Abstract
The aim of the present work is to propose a robust computational framework combining computational fluid dynamics (CFD) and 4D flow MRI to predict the progressive changes in hemodynamics and wall rupture index (RPI) induced by aortic morphological evolutions in patients harboring ascending thoracic aortic aneurysms (ATAAs). An analytical equation has been proposed to predict the aneurysm progression based on age, sex, and body surface area. Parameters such as helicity, wall shear stress (WSS), time-averaged WSS, oscillatory shear index, relative residence time, and viscosity were evaluated for two patients at different stages of aneurysm growth, and compared with age-sex-matched healthy subjects. The study shows that evolution of hemodynamics and RPI, despite being very slow in ATAAs, is strongly affected by morphological alterations and, in turn could impact biomechanical factors and aortic mechanobiology. An aspect of the current work is that the patient-specific 4D MRI data sets were obtained with a follow-up of 1 year and the measured time-averaged velocity maps and flow eccentricity were compared with the CFD simulation for validation. The computational framework presented here is capable of capturing the blood flow patterns and the hemodynamic descriptors during the various stages of aneurysm growth. Further investigations will be conducted in order to verify these results on a larger cohort of patients and with long follow-up times to finally elucidate the link between deranged hemodynamics, AA geometry, and wall mechanical properties in ATAAs., (© 2020 John Wiley & Sons, Ltd.)
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- 2020
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12. Relationship Between Ascending Thoracic Aortic Aneurysms Hemodynamics and Biomechanical Properties.
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Condemi F, Campisi S, Viallon M, Croisille P, and Avril S
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- Biomechanical Phenomena, Computer Simulation, Hemodynamics, Humans, Magnetic Resonance Imaging, Stress, Mechanical, Aortic Aneurysm, Thoracic diagnostic imaging
- Abstract
Objective: Ascending thoracic aortic aneu-rysm (aTAA) is a major cause of human deaths. Despite important recent progress to better understand its pathogenesis and development, the role played by deranged hemodynamics on aTAA risk of rupture is still partially unknown. Our aim was to develop and apply a novel methodology to assess the correlation between aTAA rupture risk and hemodynamic biomarkers combining for the first time in vivo, in vitro, and in silico analyses., Methods: Computational fluid dynamic analyses were performed and validated on ten patients using patient-specific data derived from CT scan and four-dimensional MRI. Systolic wall shear stress, time-averaged wall shear stress (TAWSS), flow eccentricity (Flow
eccentricity ), and helicity intensity (h2 ) were assessed. A bulge inflation test was carried out in vitro on the ten aTAA samples resected during surgical repair. The biomechanical and rupture properties of these samples were derived: the burst pressure, the physiological tangent elastic modulus (Ephysio ), the Cauchy stress at rupture (σrupt ), the rupture stretch (λrupt ), and the rupture stretch criterion (Υstretch ). Statistical analysis was performed to determine correlation between all variables., Results: Statistically highly significant (p < 0.01) positive correlation between λrupt and the TAWSS (r = 0.867 and p = 0.001) was found., Conclusion: This study shows that relatively low TAWSS significantly correlates with reduced rupture properties in aTAAs., Significance: Understanding the pathogenesis of aTAA remains crucial to reduce morbidity and mortality. Our aim is to establish possible correlations between aTAA rupture risk and hemodynamic biomarkers by combining for the first time in vivo, in vitro, and in silico analyses.- Published
- 2020
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13. AvalonElite Double Lumen Cannula for Total Cavopulmonary Assist in Failing Fontan Sheep Model with Valved Extracardiac Conduit.
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Zhou C, Wang D, Condemi F, Zhao G, Topaz S, Ballard-Croft C, and Zwischenberger JB
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- Animals, Disease Models, Animal, Hemodynamics, Reproducibility of Results, Sheep, Cannula, Fontan Procedure, Heart-Assist Devices
- Abstract
The AvalonElite double lumen cannula (DLC) provides total cavopulmonary assist (CPA) in failing Fontan sheep, but recirculation limits reliability. To improve CPA performance, a two-valve extracardiac conduit (ECC) was used to bracket infusion blood toward pulmonary artery (PA). A total cavopulmonary connection with failing Fontan circulation adult sheep model was created with valved ECC (n = 6). The valved ECC was connected to superior/inferior venae cavae (SVC/IVC) and right PA. The AvalonElite DLC was inserted from right jugular vein with infusion opening between the ECC valves. The DLC drainage lumen withdrew blood from SVC/IVC, and the infusion lumen returned blood to ECC. A failing Fontan sheep model with valved ECC was successfully created. Central venous pressure increased from 9 ± 1 to 17 ± 1 mm Hg, systolic arterial pressure decreased from 103 ± 9 to 51 ± 13 mm Hg, and cardiac output decreased from 3.6 ± 0.3 to 1.4 ± 0.2 L/min. Serum lactate significantly increased, indicating poor tissue perfusion. At 4 L/min pumping flow, the AvalonElite DLC returned hemodynamics/lactate to baseline levels throughout 6 hour CPA. Necropsy revealed intact/well-functioning ECC valves and well-positioned DLC with no visible thrombosis. The AvalonElite DLC provides reliable CPA performance in failing Fontan sheep with valved ECC.
- Published
- 2019
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14. Screening of asymptomatic rheumatic heart disease among refugee/migrant children and youths in Italy.
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Condemi F, Rossi G, Lupiz M, Pagano A, Zamatto F, Marini S, Romeo F, and De Maio G
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- Adolescent, Adult, Child, Feasibility Studies, Female, Humans, Italy epidemiology, Male, Prevalence, Retrospective Studies, Rheumatic Heart Disease epidemiology, Risk Factors, Young Adult, Echocardiography methods, Mass Screening methods, Refugees statistics & numerical data, Rheumatic Heart Disease diagnosis, Transients and Migrants statistics & numerical data
- Abstract
Background: Rheumatic heart disease (RHD) is a chronic condition responsible of congestive heart failure, stroke and arrhythmia. Almost eradicated in high-income countries (HIC), it persists in low- and middle-income countries. The purpose of the study was to assess the feasibility and meaningfulness of ultrasound-based RHD screening among the population of unaccompanied foreign minors in Italy and determine the burden of asymptomatic RHD among this discrete population., Methods: From February 2016 to January 2018, Médecins Sans Frontières conducted a weekly mobile screening by echocardiography in reception centers and family houses for unaccompanied foreign minors in Rome, followed by fix echocardiographic retesting for those resulting positive at screening. 'Definite' and 'borderline' cases were defined according to the World Hearth Federation criteria., Results: Six hundred fifty-three individuals (13-26 years old) were screened; 95.6% were below 18 years old (624/653). Six 'definite RHD' were identified at screening, yielding a detection rate of 9.2‰ (95% CI 4.1-20.3‰), while 285 (436.4‰) were defined as 'borderline' (95% CI 398.8-474.9‰). Out of 172 "non-negative borderline" cases available for being retested (113 "non-negative borderline" lost in follow-up), additional 11 were categorized as 'definite RHD', for a total of 17 'definite RHD', yielding a final prevalence of 26.0‰ (95% CI 16.2-41.5‰) (17/653), and 122 (122/653) were confirmed as 'borderline' (final prevalence of 186.8‰, 95% CI 158.7-218.7). In multivariate logistic regression analysis the presence of systolic murmur was a strong predictor for both 'borderline' (OR 4.3 [2.8-6.5]) and 'definite RHD' (OR 5.2 [1.7-15.2]), while no specific country/geographic area of origin was statistically associated with an increased risk of latent, asymptomatic RHD., Conclusions: Screening for RHD among the unaccompanied migrant minors in Italy proved to be feasible. The burden of 'definite RHD' was similar to that identified in resource-poor settings, while the prevalence of 'borderline' cases was higher than reported in other studies. In view of these findings, the health system of high-income countries, hosting migrants and asylum seekers, are urged to adopt screening for RHD in particular among the silent and marginalized population of refugee and migrant children.
- Published
- 2019
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15. Evaluation of Peak Wall Stress in an Ascending Thoracic Aortic Aneurysm Using FSI Simulations: Effects of Aortic Stiffness and Peripheral Resistance.
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Campobasso R, Condemi F, Viallon M, Croisille P, Campisi S, and Avril S
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- Aorta, Thoracic physiopathology, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic physiopathology, Aortic Rupture diagnostic imaging, Aortic Rupture etiology, Aortic Rupture physiopathology, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Predictive Value of Tests, Prognosis, Regional Blood Flow, Reproducibility of Results, Risk Assessment, Risk Factors, Stress, Mechanical, Aorta, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic diagnostic imaging, Magnetic Resonance Angiography methods, Models, Cardiovascular, Patient-Specific Modeling, Vascular Resistance, Vascular Stiffness
- Abstract
Purpose: It has been reported clinically that rupture or dissections in thoracic aortic aneurysms (TAA) often occur due to hypertension which may be modelled with sudden increase of peripheral resistance, inducing acute changes of blood volumes in the aorta. There is clinical evidence that more compliant aneurysms are less prone to rupture as they can sustain such changes of volume. The aim of the current paper is to verify this paradigm by evaluating computationally the role played by the variation of peripheral resistance and the impact of aortic stiffness onto peak wall stress in ascending TAA., Methods: Fluid-structure interaction (FSI) analyses were performed using patient-specific geometries and boundary conditions derived from 4D MRI datasets acquired on a patient. Blood was assumed incompressible and was treated as a non-Newtonian fluid using the Carreau model while the wall mechanical properties were obtained from the bulge inflation tests carried out in vitro after surgical repair. The Navier-Stokes equations were solved in ANSYS Fluent. The Arbitrary Lagrangian-Eulerian formulation was used to account for the wall deformations. At the interface between the solid domain and the fluid domain, the fluid pressure was transferred to the wall and the displacement of the wall was transferred to the fluid. The two systems were connected by the System Coupling component which controls the solver execution of fluid and solid simulations in ANSYS. Fluid and solid domains were solved sequentially starting from the fluid simulations., Results: Distributions of blood flow, wall shear stress and wall stress were evaluated in the ascending thoracic aorta using the FSI analyses. We always observed a significant flow eccentricity in the simulations, in very good agreement with velocity profiles measured using 4D MRI. The results also showed significant increase of peak wall stress due to the increase of peripheral resistance and aortic stiffness. In the worst case scenario, the largest peripheral resistance (10
10 kg s m-4 ) and stiffness (10 MPa) resulted in a maximal principal stress equal to 702 kPa, whereas it was only 77 kPa in normal conditions., Conclusions: This is the first time that the risk of rupture of an aTAA is quantified in case of the combined effects of hypertension and aortic stiffness increase. Our findings suggest that a stiffer TAA may have the most altered distribution of wall stress and an acute change of peripheral vascular resistance could significantly increase the risk of rupture for a stiffer aneurysm.- Published
- 2018
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16. Ascending thoracic aorta aneurysm repair induces positive hemodynamic outcomes in a patient with unchanged bicuspid aortic valve.
- Author
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Condemi F, Campisi S, Viallon M, Croisille P, Fuzelier JF, and Avril S
- Subjects
- Aortic Valve physiology, Bicuspid Aortic Valve Disease, Heart Valve Diseases, Hemodynamics physiology, Humans, Magnetic Resonance Imaging, Middle Aged, Pulse Wave Analysis, Stress, Mechanical, Vascular Surgical Procedures, Aorta, Thoracic physiology, Aortic Aneurysm, Thoracic physiopathology, Aortic Aneurysm, Thoracic surgery, Aortic Valve abnormalities
- Abstract
We report a patient-specific case of bicuspid aortic valve with fusion of right and left coronary leaflets (R-L type I BAV), moderate aortic valve deficiency and ascending thoracic aortic aneurysms (ATAA) who was treated by only ascending aorta replacement preserving the BAV. The flow eccentricity, the helicity intensity (h
2 ), the circumferential time averaged wall shear stress (TAWSScircumferential ), the cumulative viscous energy loss at the systolic peak (EL ' ) and the pulse wave velocity (PWV) were calculated by combining 4D flow MRI and CFD analysis before (Stage I) and after (Stage II) the surgical procedure. CFD analyses assumed rigid walls, a non-Newtonian behavior for the blood and MRI measured patient-specific blood flow profiles as inlet boundary conditions. Stage II results showed suppression of recirculation in the ascending aorta, loss of jet flow impingement onto the aortic wall, maximum TAWSScircumferential decrease (from 6.69 Pa in Stage I to 6 Pa in Stage II), reduction of flow helicity (from 10.97 in Stage I to 8.47 in Stage II) and EL ' (from 15.8 mW in Stage I to 11.2 mW in Stage II). However, Floweccentricity and PWV were found higher in Stage II due to the diameter reduction (Floweccentricity = 0.60 in Stage I and Floweccentricity = 0.91 in Stage II; PWV = 3.80 m/s in Stage I and PWV = 9.37 m/s in Stage II). Our work has permitted to compute for the first time the hemodynamic alterations obtained after restoration of normal ascending aorta and sinotubular junction geometry even preserving an R-L type I BAV with still acceptable function., (Copyright © 2018 Elsevier Ltd. All rights reserved.)- Published
- 2018
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17. Fluid- and Biomechanical Analysis of Ascending Thoracic Aorta Aneurysm with Concomitant Aortic Insufficiency.
- Author
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Condemi F, Campisi S, Viallon M, Troalen T, Xuexin G, Barker AJ, Markl M, Croisille P, Trabelsi O, Cavinato C, Duprey A, and Avril S
- Subjects
- Adult, Aged, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis etiology, Computer Simulation, Female, Humans, Magnetic Resonance Angiography methods, Male, Middle Aged, Shear Strength, Stress, Mechanical, Aorta, Thoracic physiopathology, Aortic Aneurysm, Thoracic physiopathology, Aortic Valve Stenosis physiopathology, Blood Flow Velocity, Blood Pressure, Models, Cardiovascular
- Abstract
We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair. The healthy volunteers showed no eccentric blood flow, a mean TAWSS of 1.5 ± 0.3 Pa and mean OSI of 0.325 ± 0.025. In 3 aneurismal patients, jet flow impingement on the aortic wall resulted in large TAWSS values and low OSI which were amplified by the AI degree. However, the tissue strength did not appear to be significantly reduced. The fourth patient, which showed the lowest TAWSS due to the absence of jet flow, had the smallest strength in vitro. Interestingly this patient presented a bovine arch abnormality. Jet flow impingement with high WSS values is frequent in ATAAs and our methodology seems to be appropriate for determining whether it may increase the risk of rupture or not.
- Published
- 2017
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18. Validation of Transesophageal Echocardiographic In Vitro Measurements for Bioprosthetic Aortic Valves: Implications for Percutaneous Valve-in-Valve Therapy.
- Author
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Condemi F, Bapat VN, Gianstefani S, Catibog N, Papachristidis A, Douiri A, Romeo F, and Monaghan MJ
- Subjects
- Echocardiography, Transesophageal instrumentation, Equipment Failure Analysis, Heart Valve Prosthesis Implantation instrumentation, Humans, Phantoms, Imaging, Prosthesis Design, Prosthesis Fitting methods, Reproducibility of Results, Sensitivity and Specificity, Surgery, Computer-Assisted methods, Treatment Outcome, Aortic Valve diagnostic imaging, Aortic Valve surgery, Bioprosthesis, Echocardiography, Transesophageal methods, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods
- Abstract
Background: Percutaneous valve-in-valve therapy has become an important treatment option for failing bioprosthetic heart valves. Accurate assessment of valve internal diameter (ID) is essential for effective and safe treatment. These data may not be available in an individual patient, or the manufacturer-supplied dimensions may be incorrect because they do not allow for the space occupied by valve leaflet material., Methods: In total, 2,332 two-dimensional and three-dimensional transesophageal echocardiographic in vitro measurements were performed using both Philips iE33 and GE Vivid E9 systems with a range of system settings on 53 bioprosthetic valves in all available sizes. Two-dimensional echocardiographic ID measurements were made in two orthogonal planes at the level of the sewing ring, and similar three-dimensional measurements were generated from multiplane reconstructions. They were compared with both manufacturer-supplied valve ID (MID) and the true ID (TID) measured with Hegar dilators., Results: Both the iE33 and the Vivid 9 provided comparable valve ID measurements. TID was statistically significantly smaller than MID (P < .001). All echocardiographic measurements were closer to TID than to MID. Two-dimensional measurements were closest to TID because of higher spatial resolution., Conclusions: Transesophageal echocardiographic valve ID measurements compare well with TID, which is overestimated by MID. These findings have potentially important implications for valve-in-valve procedures because an inaccurate measurement of TID might lead to the wrong choice of implanted valve., (Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.)
- Published
- 2016
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19. Multidetector computed tomography sizing of bioprosthetic valves: guidelines for measurement and implications for valve-in-valve therapies.
- Author
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Rajani R, Attia R, Condemi F, Webb J, Woodburn P, Hodson D, Nair A, Preston R, Razavi R, and Bapat VN
- Subjects
- Cardiac-Gated Imaging Techniques, Heart Valve Prosthesis Implantation methods, Humans, Aortic Valve surgery, Bioprosthesis, Heart Valve Prosthesis, Multidetector Computed Tomography methods, Prosthesis Design, Prosthesis Fitting
- Abstract
Aim: To describe a technique for bioprosthetic multidetector computed tomography (MDCT) sizing and to compare MDCT-derived values against manufacturer-provided sizing., Materials and Methods: Fourteen bioprosthetic stented valves commonly used in the aortic valve position were evaluated using a Philips 256 MDCT system. All valves were scanned using a dedicated cardiac CT protocol with a four-channel electrocardiography (ECG) simulator. Measurements were made of major and minor axes and the area and perimeter of the internal stent using varying reconstruction kernels and window settings. Measurements derived from MDCT (MDCT ID) were compared against the stent internal diameter (Stent ID) as provided by the valve manufacturer and the True ID (Stent ID + insertion of leaflets). All data were collected and analysed using SPSS for Mac (version 21)., Results: The mean difference between the MDCT ID and Stent ID was 0.6±1.9 mm (r=0.649, p=0.012) and between MDCT ID and True ID 2.1±2 mm (r=0.71, p=0.005). There was no difference in the major (p=0.90), minor (p=0.87), area (p=0.92), or perimeter (p=0.92) measurements when sharp, standard, and detailed stent kernels were used. Similarly, the measurements remained consistent across differing windowing levels., Conclusion: Bioprosthetic stented valves may be reliably sized using MDCT in patients requiring valve-in-valve (VIV) interventions where the valve type and size are unknown. In these cases, clinicians should be aware that MDCT has a tendency to overestimate the True ID size., (Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2016
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20. Percutaneous Double Lumen Cannula for Right Ventricle Assist Device System: A Computational Fluid Dynamics Study.
- Author
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Condemi F, Wang D, Fragomeni G, Yang F, Zhao G, Jones C, Ballard-Croft C, and Zwischenberger JB
- Abstract
Objectives: Our goal is to develop a double lumen cannula (DLC) for a percutaneous right ventricular assist device (pRVAD) in order to eliminate two open chest surgeries for RVAD installation and removal. The objective of this study was to evaluate the performance, flow pattern, blood hemolysis, and thrombosis potential of the pRVAD DLC., Methods: Computational fluid dynamics (CFD), using the finite volume method, was performed on the pRVAD DLC. For Reynolds numbers <4000, the laminar model was used to describe the blood flow behavior, while shear-stress transport k-ω model was used for Reynolds numbers >4000. Bench testing with a 27 Fr prototype was performed to validate the CFD calculations., Results: There was <1.3% difference between the CFD and experimental pressure drop results. The Lagrangian approach revealed a low index of hemolysis (0.012% in drainage lumen and 0.0073% in infusion lumen) at 5 l/min flow rate. Blood stagnancy and recirculation regions were found in the CFD analysis, indicating a potential risk for thrombosis., Conclusions: The pRVAD DLC can handle up to 5 l/min flow with limited potential hemolysis. Further modification of the pRVAD DLC is needed to address blood stagnancy and recirculation.
- Published
- 2016
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21. Non-invasive hemodynamic analysis in cardiac resynchronization therapy patients wearing quadripolar left ventricular leads: the importance of pacing electrode selection.
- Author
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Santini L, Legramante J, Condemi F, Santucci L, Panattoni M, Crobeddu P, Sergi D, Forleo G, and Romeo F
- Subjects
- Aged, Female, Follow-Up Studies, Heart Failure physiopathology, Heart Ventricles, Hemodynamics, Humans, Male, Middle Aged, Netherlands, Treatment Outcome, Cardiac Resynchronization Therapy methods, Electrodes, Implanted, Heart Failure therapy
- Abstract
Aim: Quadripolar left ventricular (LV) leads offer multiple choices for LV pacing increasing programming flexibility. Aim of this study is to assess the influence of LV pacing vector selection on hemodynamic parameters for patients who underwent cardiac resynchronization therapy (CRT) using quadripolar LV lead chronically evaluated with a non-invasive approach by Nexfin(®) system provided analysis (BMEYE B.V., Amsterdam, The Netherlands)., Methods and Results: In 16 CRT patients implanted with a quadripolar LV lead (mean follow-up 8,8 ±13,4 months after implantation), we measured Cardiac Output (CO), Mean Blood Pressure (MBP), Total Peripheral Resistance (TPR), LV dP/dt max and Stroke volume (SV) from each one of the ten available bipolar pacing configurations. All the recorded parameters showed marked differences among the ten pacing configurations, but dP/dt max, SV and TPR were those showing the wider range, depending of the selected pacing vector. The average delta for the whole group of subjects between the maximum and minimum hemodynamic values for each pacing configuration were 15.9% for SV, 21.1% for dP/dt max and 20.3% for TPR. Inter-individual analysis of data failed to identify a link between a specific pacing vector and the hemodynamic response., Conclusion: Our study demonstrates that different bipolar pacing configurations, even if arising from a single CS branch, substantially modify the hemodynamic effect of LV pacing in CRT patients. Moreover, the non-invasive hemodynamic analysis suggests the better pacing configuration should be established individually and could represent an important issue in optimizing CRT during follow-up.
- Published
- 2014
22. Apicoaortic conduit and cerebral perfusion in mixed aortic valve disease: a computational analysis.
- Author
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Fragomeni G, Rossi M, Condemi F, Mazzitelli R, Serraino GF, and Renzulli A
- Subjects
- Aortic Valve Insufficiency complications, Aortic Valve Insufficiency diagnosis, Aortic Valve Insufficiency physiopathology, Aortic Valve Stenosis complications, Aortic Valve Stenosis diagnosis, Aortic Valve Stenosis physiopathology, Cardiac Surgical Procedures, Computer Simulation, Humans, Regional Blood Flow, Severity of Illness Index, Time Factors, Treatment Outcome, Aortic Valve Insufficiency surgery, Aortic Valve Stenosis surgery, Brachiocephalic Trunk physiopathology, Carotid Arteries physiopathology, Cerebrovascular Circulation, Models, Cardiovascular, Subclavian Artery physiopathology
- Abstract
Objectives: The revival of the apicoaortic conduit has attracted new interest in this alternative treatment for severe aortic stenosis unsuitable for conventional valve replacement. However, doubts still exist about the perfusion of the epiaortic vessels after apicoaortic conduit implantation, especially when severe aortic stenosis is associated with aortic valve insufficiency. The aim of the study was to evaluate the perfusion of the epiaortic vessels (innominate artery, left carotid artery and left subclavian artery) in cases of mixed aortic valve disease before and after apicoaortic conduit implantation., Methods: Starting from the data of a real patient with severe aortic stenosis and mild aortic insufficiency who underwent apicoaortic conduit implantation, we created a computational model where severe aortic valve stenosis was associated with different grades of aortic insufficiency (mild, medium and moderate)., Results: A total of six combinations were analysed. In all simulations, the more severe the concomitant aortic insufficiency, the more the flow through the epiaortic vessels was diminished. After apicoaortic conduit implantation, there was an absolute augmentation of the median output in each epiaortic vessel compared with the same combination of mixed aortic valve disease before implantation. Interestingly, retrograde flow from the conduit in the descending aorta was minimal and did not contribute to the improved output of the epiaortic vessels., Conclusions: The computational analysis suggested a protective effect, rather than steal phenomenon, of the apicoaortic conduit towards the cerebral perfusion, even in cases of mixed aortic valve disease.
- Published
- 2013
- Full Text
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23. Fluoroscopic guide to an ideal implant position for Sapien XT and CoreValve during a valve-in-valve procedure.
- Author
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Bapat VN, Attia RQ, Condemi F, Visagan R, Guthrie M, Sunni S, and Thomas M
- Subjects
- Aortic Valve diagnostic imaging, Aortic Valve Stenosis diagnostic imaging, Aortic Valve Stenosis surgery, Fluoroscopy, Heart Valve Prosthesis Implantation methods, Humans, Prosthesis Design, Aortic Valve surgery, Aortic Valve Stenosis therapy, Bioprosthesis, Cardiac Catheterization instrumentation, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Radiography, Interventional methods
- Abstract
Objectives: This study sought to provide a guide to the fluoroscopic appearances of various valve-in-valve (VIV) combinations by deploying a transcatheter heart valve (THV) within a degenerated surgical heart valve (SHV) in an ideal position., Background: VIV procedures are being increasingly performed with substantial experience acquired in treating degenerated SHV in the aortic position with Sapien/Sapien XT (Edwards Lifesciences Ltd., Irvine, California) and CoreValve/Evolute (Medtronic Inc., Minneapolis, Minnesota) valves. Although less invasive than conventional surgery, securing the THV in an optimal position within the SHV determines the success of this novel treatment., Methods: For VIV implantation, we selected appropriate Sapien XT and CoreValve/Evolute sizes depending on the internal diameter of the SHV. Implantation was performed in vitro. In case of the Sapien XT valve, it was deployed 4 to 5 mm below the sewing ring of the SHV, whereas the CoreValve/Evolute was deployed 5 mm below the level of the sewing ring. Photographs and fluoroscopic images of the various VIV combinations were obtained in side profile to study the ideal position and end-on profile to study the circularity of the THV., Results: Fluoroscopic images obtained in side profile highlighted the differences in various VIV combinations, as all SHV are unique in their fluoroscopic appearances. Also, all THV implants in various VIV combinations achieved a nearly circular shape., Conclusions: To achieve an optimal result when considering VIV, it is important to be familiar with the structure and fluoroscopic appearances of the failed SHV, the THV used, and their combination., (Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
- View/download PDF
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