The AVP Device: A Tool for Intraoperative Evaluation of Aortic Valve After Repair

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Aortic valve repair procedures can be technically challenging and there are no tools to evaluate the valve intraoperatively. Echocardiography after repair is considered the standard method, but if there are no satisfactory results, another clamp session is needed. There is an unmet need for an intraoperative evaluation tool similar to the “water test” in mitral valvuloplasty.

The AVP device is an intraoperative aortic valve visualization and pressurization device. It enables valve inspection and evaluation under physiological conditions and it allows measurements of potential aortic valve regurgitation.

The AVP device has been used in 26 patients undergoing valve-sparing root replacement with the reimplantation technique. In 24 patients, postoperative valvular regurgitation was less than grade 1. In three of these patients, additional targeted adjustments were performed. The median leakage measured was 90 ml/min with IQR 55 – 120 ml/min. In two patients with complex anatomy, the valve was replaced after evaluation with the AVP device (300 ml/min).

This novel AVP device enables intraoperative evaluation of valve repair procedures in different physiological conditions. Visualization of the valve before reimplantation of the coronary arteries allows for targeted adjustments on the valve and prevents extra CPB and cardiac arrest time in case of failed repair. It is easy to use and makes valve-sparing procedures more accessible.

References

1. Aortic valve visualization and pressurization device: A novel device for intraoperative evaluation of aortic valve repair procedures. Arabkhani B, Sandker SC, Braun J, Hjortnaes J, Van Brakel TJ, Koolbergen DR, Klautz RJM, Hazekamp MG. Eur J Cardiothorac Surg. 2023 Aug 23.
2. A multicentre, propensity score matched analysis comparing a valve-sparing approach to valve replacement in aortic root aneurysm: Insight from the AVIATOR database. B Arabkhani, R.J.M. Klautz, F de Heer, L. De Kerchove, G. El Khoury, E. Lansac, H.J. Schäfers, I. El-Hamamsy, M. Marien Lenoir, J. Aramendi, B. Meuris, P. Verbrugghe, J. Kluin, D.R. Koolbergen, O. Bouchot, I. Rudez, A. Kolesar,T.J. van Brakel. Eur J Cardiothorac Surg. 2023 Feb 3;63(2):ezac514.

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