title: Intraprocedural balloon dilation of the direct flow medical transcatheter aortic valve: First United States experience.
abstract: Optimization of hemodynamics during transcatheter aortic valve replacement (TAVR) using the commercially available balloon expandable and self-expanding valves is often accomplished through post-dilation of the valves' metallic frame. The direct flow medical (DFM) valve is a uniquely designed second-generation TAVR prosthetic without a rigid metallic frame. It is not widely known whether balloon dilation of this valve is beneficial when valve hemodynamics after initial deployment suboptimal due to valve underexpansion. We present the first two US patients who underwent TAVR using the DFM valve who had underexpansion in the setting of bulky leaflet calcification that resulted in elevated valve gradients and were treated successfully using intraprocedural balloon dilation. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Associate Program Director, Interventional Cardiology Fellowship, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Amar
authors.initials: A
authors.lastname: Krishnaswamy
authors.affiliation: Department of Cardiac Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mick
authors.affiliation: Chairman, Division of Interventional Cardiology, Director, Sones Cardiac Catheterization Laboratory, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.
authors.forename: Samir R
authors.initials: SR
authors.lastname: Kapadia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization / Q000295:instrumentation*; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States
keywords: aortic valve disease; interventional devices/innovation; percutaneous intervention; percutaneous valve therapy; transcatheter valve implantation