Novel Humanized Biosimulator to Predict Coronary Obstruction in High-Risk Valve-in-Valve Procedures

Nils Perrin; Guillaume Bonnet; Réda Ibrahim; Raoul Bonan; Lionel Leroux; Juan F Granada; Jean Claude Tardif; Thomas Modine; Walid Ben Ali

doi:10.1016/j.jaccas.2022.101711

Novel Humanized Biosimulator to Predict Coronary Obstruction in High-Risk Valve-in-Valve Procedures

JACC Case Rep. 2022 Dec 24:7:101711. doi: 10.1016/j.jaccas.2022.101711. eCollection 2023 Feb 1.

Authors

Nils Perrin^{1

2}, Guillaume Bonnet³, Réda Ibrahim¹, Raoul Bonan¹, Lionel Leroux³, Juan F Granada⁴, Jean Claude Tardif¹, Thomas Modine³, Walid Ben Ali¹

Affiliations

¹ Structural Heart Intervention Program, Montreal Heart Institute, Montreal, Quebec, Canada.
² Cardiology Division, Geneva University Hospitals, Switzerland.
³ Service Médico-Chirurgical: Valvulopathies-Chirurgie Cardiaque-Cardiologie Interventionelle Structurelle, Hôpital Cardiologique de Haut Lévèque, CHU Bordeaux, France.
⁴ Cardiovascular Research Foundation, New York, New York, USA.

Abstract

We developed humanized biosimulator to predict the risk of coronary obstruction among high-risk patients undergoing valve-in-valve (ViV) procedures. In this case, based on unchanged instantaneous wave-free ratio values measured during a ViV simulation session, the procedure was performed safely in the patient the day afterward, without coronary artery issues and with good hemodynamic results. (Level of Difficulty: Advanced.).

Keywords: CT, computed tomography; LAD, left anterior descending; RCA, right coronary arteries; ViV, valve-in-valve; case planning; coronary obstruction; iFR, instantaneous wave-free ratio; simulator; valve-in-valve; virtual-to-coronary distance.