التفاصيل البيبلوغرافية
| العنوان: |
Hemodynamic performance of transcatheter aortic valve prostheses and strategie of implantation for valve-in-valve procedures : in vitro and in vivo studies ; Performance hémodynamique de prothèses valvulaires aortiques percutanées et stratégies d'implantation lors de procédures 'valve-in-valve' : études in vitro et in vivo |
| المؤلفون: |
Zenses, Anne-Sophie |
| المساهمون: |
Aix-Marseille, Université Laval (Québec, Canada), Rieu, Régis, Pibarot, Philippe |
| المصدر: |
Theses.fr |
| سنة النشر: |
2018 |
| مصطلحات موضوعية: |
Implantation valvulaire aortique percutanée (TAVI), Performance hémodynamique, Bioprothèses dégénérées, Valve-In-Valve, Simulation in vitro, Sténose résiduelle, Surdimensionnement, Transcatheter aortic valve implantation (TAVI), Hemodynamic performance, Degenerated bioprostheses, In vitro simultation, Residual stenosis, Oversizing, demo, socio |
| الوصف: |
Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgery for patients with severe aortic stenosis and high surgical risk. This technique is extending to a wider population (e.g. with more complex anatomy or lower surgical risk), as well as to patients with degenerated surgical bioprostheses (BPs). However, two major concerns remain limiting. Regarding “classical TAVI”, periprosthetic leaks have been associated with increased mortality. Oversizing is used to secure the device within the aortic annulus which is often non circular. The effects of oversizing and annulus shape on the hemodynamic performance are unknown. Regarding ViV implantations, elevated post-procedural gradients are common and have been associated with increased mortality. The principal factors associated with this residual stenosis as well as with increased risk of mortality, have been BPs label size ≤ 21 mm and mode of failure by stenosis. These factors are not specific enough and there is currently no recommendation for the treatment of small BPs. Besides, the actual hemodynamic benefit associated with ViV has not been evaluated (vs. pre ViV status).The general objective of this work is to understand the interactions between the transcatheter prosthesis and the aortic annulus or the BP to be treated, which impact the hemodynamic performance, especially in complex conditions of implantation, in order to extend the indications of TAVI. In the context of ViV, the objective is to specify the factors associated with the hemodynamic performance and utility of the treatment. The final aim is to provide strategies of implantation in order to optimize the success of the procedure. ; L’implantation valvulaire aortique percutanée (TAVI) a émergé comme une alternative à la chirurgie pour les patients avec sténose sévère et haut risque chirurgical. Cette technique s’étend à une population plus large (e.g. anatomie plus complexe, risque chirurgical plus bas), ainsi qu'au traitement Valve-in-Valve (ViV) des bioprothèses (BPs) ... |
| نوع الوثيقة: |
thesis |
| اللغة: |
French |
| العلاقة: |
10670/1.cj7crf; http://www.theses.fr/2018AIXM0417/documentTest |
| الإتاحة: |
http://www.theses.fr/2018AIXM0417/documentTest |
| حقوق: |
other |
| رقم الانضمام: |
edsbas.DCCED84C |
| قاعدة البيانات: |
BASE |
