| Title |
Pulsed Cavitational Ultrasound Softening A New Noninvasive Therapeutic Approach for Calcified Bioprosthetic Valve Stenosis
|
|---|---|
| Published in |
JACC: Basic to Translational Science, June 2017
|
| DOI | 10.1016/j.jacbts.2017.03.012 |
| Pubmed ID | |
| Authors |
Olivier Villemain, Justine Robin, Alain Bel, Wojciech Kwiecinski, Patrick Bruneval, Bastien Arnal, Mathieu Rémond, Mickael Tanter, Emmanuel Messas, Mathieu Pernot |
| Abstract |
The majority of prosthetic heart valves currently implanted are tissue valves that can be expected to calcify with time and eventually fail. Surgical or percutaneous redux valve replacement is associated with higher rate of complications. We propose a novel non-invasive therapeutic approach based on the use of pulsed cavitational ultrasound (PCU) to improve the valvular function of degenerative calcified bioprosthesis. Our study aims to demonstrate in vitro and in vivo on an ovine model that PCU can significantly improve the bioprosthesis opening by softening remotely the calcified stiff cusps. All the experiments were performed on calcified bioprosthetic valves explanted from human patients. PCU was performed in vitro on calcified bioprosthesis mounted on a hydraulic bench with pulsatile flow (n=8) and in vivo on an ovine model with implanted calcified bioprosthesis (n=7). We used 3D echocardiography, pressure and flow sensors, quantitative stiffness evaluation using shear wave elastography, micro-CT imaging and histology to evaluate in vitro and in vivo the effect of PCU. The transvalvular gradient was found to decrease by a mean of 50% after PCU in both in vitro (from 21.1±3.9 to 9.6±1.7 mmHg, p<0.001) and in vivo setup (from 16.2±3.2 to 8.2±1.3 mmHg, p<0.001), with a decrease of valve stiffness (in vitro: from 105.8±9 to 46.6±4 kPa, p<0.001; in vivo: from 82.6±10 to 41.7±7 kPa, p<0.001) and an increase of valve area (from 1.10±0.1 to 1.58±0.1 cm2, p<0.001). Histology and micro-CT imaging showed modifications of calcification structure without loss of calcification volume or alteration of the leaflet superficial structures. We have demonstrated in vitro and in vivo that PCU can decrease a calcified bioprosthesis stenosis by softening the leaflets remotely. This new non-invasive approach has the potential to improve the outcome of patients with severe bioprosthesis stenosis. |
X Demographics
The data shown below were collected from the profiles of 110 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 31 | 28% |
| United Kingdom | 11 | 10% |
| Spain | 5 | 5% |
| Australia | 3 | 3% |
| Venezuela, Bolivarian Republic of | 3 | 3% |
| Mexico | 3 | 3% |
| Pakistan | 2 | 2% |
| France | 2 | 2% |
| Colombia | 2 | 2% |
| Other | 16 | 15% |
| Unknown | 32 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 60 | 55% |
| Practitioners (doctors, other healthcare professionals) | 23 | 21% |
| Scientists | 23 | 21% |
| Science communicators (journalists, bloggers, editors) | 4 | 4% |
Mendeley readers
The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 46 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 17% |
| Student > Master | 5 | 11% |
| Student > Bachelor | 4 | 9% |
| Lecturer | 3 | 7% |
| Other | 3 | 7% |
| Other | 10 | 22% |
| Unknown | 13 | 28% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 22% |
| Engineering | 9 | 20% |
| Physics and Astronomy | 5 | 11% |
| Agricultural and Biological Sciences | 2 | 4% |
| Computer Science | 2 | 4% |
| Other | 6 | 13% |
| Unknown | 12 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 135. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 December 2023.
All research outputs
#312,120
of 25,732,188 outputs
Outputs from JACC: Basic to Translational Science
#26
of 822 outputs
Outputs of similar age
#6,530
of 332,736 outputs
Outputs of similar age from JACC: Basic to Translational Science
#1
of 8 outputs
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