Timing of Bioprosthetic valve fracture in transcatheter valve-in-valve intervention: impact on valve durability and leaflet integrity

To assess the impact of bioprosthetic valve fracture (BVF) timing on long-term transcatheter heart valve (THV) durability. Valve testing was performed in the ViVitro Labs testing facilities (ViVitro Labs Inc, Victoria, Canada). Hydrodynamic testing was performed using a commercially available pulse duplicator (ViVitro Labs Inc, Victoria, Canada), meeting the equipment requirements defined in ISO 5840-3 for pulsatile flow testing (16) (Figure 1A). In this bench study, the ACn and the S3 showed acceptable hydrodynamic performances after AWT to 200M cycles, equivalent to 5 years, irrespective of BVF timing compared to no fracture.