Transcatheter aortic valve deployment influences neo‐sinus thrombosis risk: An in vitro flow study

Objectives We investigated the impact of (transcatheter heart valve) THV expansion at the level of the native annulus and implant depth on valve performance and neo‐sinus flow stasis. Background Flow stasis in the neo‐sinus is one of the identified risk factors of THV thrombosis. Methods A 29 mm CoreValve and 26 mm SAPIEN 3 were deployed under different expansions (CoreValve, SAPIEN 3) and implant depths (CoreValve) within a patient‐derived aortic root in a pulse duplicator. Fluorescent dye was injected during diastole into the neo‐sinus and imaged over 20 cardiac cycles. Washout times were computed as a measure of flow stasis for each deployment. Results The 10% CoreValve under‐expansion improved neo‐sinus washout over full expansion by 8% (p