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Open Access 01-01-2018 | Cardiac

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

Authors: Floortje van Kesteren, Laurens W. Wollersheim, Jan Baan Jr., Aart. J. Nederveen, Abdullah Kaya, S. Matthijs Boekholdt, Bas A. de Mol, Pim van Ooij, R. Nils Planken

Published in: European Radiology | Issue 1/2018

Abstract

Objectives

To evaluate aortic velocity, wall shear stress (WSS) and viscous energy loss (EL) of stented and stentless bioprostheses using 4D flow MRI 1 year after surgical aortic valve replacement.

Methods

For this cross-sectional study 28 patients with stented (n = 14) or stentless (n = 14) bioprosthesis underwent non-contrast-enhanced 4D-flow MRI at 1.5 T. Analyses included a comparison of velocity, WSS and EL in the ascending aorta during peak systole for both spatially averaged values and a comparison of local differences using per-voxel analysis.

Results

No significant differences were found in peak and mean velocity (stented vs. stentless: 2.45 m/s vs. 2.11 m/s; p = 0.09 and 0.60 m/s vs. 0.62 m/s; p = 0.89), WSS (0.60 Pa vs. 0.59 Pa; p = 0.55) and EL (10.17 mW vs. 7.82 mW; p = 0.10). Per-voxel analysis revealed significantly higher central lumen velocity, and lower outer lumen velocity, WSS and EL for stentless versus stented prostheses.

Conclusion

One year after aortic valve implantation with stented and stentless bioprostheses, velocity, WSS and EL were comparable when assessed for averaged values in the ascending aorta. However, the flow profile described with local analysis for stentless prosthesis is potentially favourable with a significantly higher central velocity profile and lower values for outer lumen velocity, WSS and EL.

Key Points

• Stentless bioprostheses can be implanted instead of stented aortic valve bioprostheses.

• Haemodynamic performance of valve prosthesis can be assessed using 4D flow MRI.

• Averaged ascending aorta PSV, WSS and EL are comparable 1 year post-implantation.

• Centreline velocity is highest, WSS and EL is lowest for stentless prosthesis.

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Title: Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses
Authors: Floortje van Kesteren
Laurens W. Wollersheim
Jan Baan Jr.
Aart. J. Nederveen
Abdullah Kaya
S. Matthijs Boekholdt
Bas A. de Mol
Pim van Ooij
R. Nils Planken
Publication date: 01-01-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 1/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-4953-2

At a glance: The STEP trials

Springer Medicine

Four-dimensional flow MRI of stented versus stentless aortic valve bioprostheses

Abstract

Objectives

Methods

Results

Conclusion

Key Points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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