Locations:
Search IconSearch

Images of Note: In Aortic Valve Replacement, Two Parts May Be Better than One

Novel bioprosthesis offers leaflet exchangeability for multiple benefits

ValveXchange-690×380

The following intraoperative images show essential steps in the implantation of a promising advance in aortic valve replacement: the advent of a two-part aortic bioprosthetic valve — namely, the ValveXchange Vitality™ aortic bioprosthesis.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

This novel approach involves surgical placement of the valve’s base in the aortic root (first image above) followed by installation of a tri-leaflet set (three bovine pericardium tissue leaflets mounted on a circular frame) on top of the base (second image above). The two component parts of the bioprosthesis are depicted below.

Smaller (inset) image

Several objectives drove this two-part valve design, including:

  • Greater visibility during implantation of the valve base, with no leaflets blocking the view
  • The opportunity for smaller incisions, since the base is half the height of the ultimately assembled valve
  • The ability to exchange the initial leaflet set with a new one during re-do valve replacement procedures

The latter objective of leaflet exchangeability becomes increasingly desirable as patients receive tissue valves at ever-younger ages and live increasingly long and active lives (see related post). In these cases, if a reoperation is eventually needed to replace a worn-out tissue valve, only the leaflet (not the base) needs to be replaced, which can be done less invasively and more quickly than full bioprosthetic replacement.

Cleveland Clinic surgeon and Heart & Vascular Institute Chair Lars G. Svensson, MD, PhD, implanted the first Vitality aortic bioprosthesis in a human in September 2011, and Cleveland Clinic continues to play a lead role in studying the device, which is approved for use in Europe but still investigational in the United States.

Advertisement

Related Articles

chemical structure of erythritol drawn in a teaspoon
Evidence Mounts That Sugar Substitute Erythritol Raises Cardiovascular Risk

Study authors urge reevaluation of the sweetener’s safety designation by food regulators

x-ray of bone fracture in a forearm
TRAVERSE Substudy Links Testosterone Therapy to Increased Fracture Risk in Older Men With Hypogonadism

Surprise findings argue for caution about testosterone use in men at risk for fracture

photo of intubated elderly woman in hospital bed
Proteomic Study Characterizes Markers of Frailty in Cardiovascular Disease and Their Links to Outcomes

Findings support emphasis on markers of frailty related to, but not dependent on, age

GettyImages-1252287413 [Converted]
Black Residents of Historically Redlined Areas Have Increased Heart Failure Risk

Large database study reveals lingering health consequences of decades-old discrimination

21-HVI-2577809_septal-myectomy-LVOTO-repair_650x450
Study Confirms Quality-of-Life Benefits of Myectomy in Obstructive HCM

Prospective SPIRIT-HCM trial demonstrates broad gains over 12-month follow-up

21-HVI-2211308 gender-scales_650x450
8 Ways to Increase Women’s Participation in Cardiovascular Trials

An ACC committee issues recommendations to accelerate sluggish progress

20-HVI-1998312_carotid-endarterectomy_650x450
Carotid Endarterectomy and the High-Risk Patient

Review of our recent experience shows it’s still a safe option

Ad