Ricerc@Sapienza

Mechanical and biological heart valve prostheses are currently used in patients. Despite recent improvements, the ideal prosthesis still does not exist. Prosthesis-related problems necessitate reoperation or cause death in 50-60% of patients within 10 years post-implantation.The risk for prosthetic valve thrombosis can reach 6% per patient-year. In recent years, transcatheter aortic valve implantation (TAVI) has become a valuable and steadily increasing alternative to surgical valve replacement. Recent works indicate that thrombosis also occurs after the TAVI procedure, even if patients are under dual antiplatelet therapy. In a general manner, despite the immense number of materials used in medicine as blood contacting devices, only few fundamental mechanisms of blood/material interactions are elucidated by now.
We hypothesize that TAVI complications relates to the extent of local flow alterations, as well as to patient's chronic low-grade inflammatory status. These conditions may interfere with the resolution of inflammatory responses, thereby promoting thrombosis, microemboli, or calcium phosphate deposits.
The main objectives of our proposal are:
- To study the association of patients' clinical characteristics with TAVI complications, i.e., thrombosis, stroke rate, prosthesis degeneration.
- To assess the utility of imaging modalities, and systemic biomarkers to predict adverse events, and improve outcome.
Before TAVI procedure, brain MRI will be performed and several systemic biomarkers will be collected to assess the thrombotic and inflammation status. After the procedure and at 6 months follow-up a transcranial Doppler, a 4D flow CMR, a 3D CT scan a 3D transesophageal echocardiography will be performed. Systemic biomarkers will be also collected after the procedure and at follow-up
This is a cooperative study between the Department of Cardiology at Sapienza University of Rome and the Department of Cardiology at University of Liège | ulg