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Needs Presentation. Joe Tartakoff RIT Mechanical Engineering. Paravalvular Leakage in TAVI. Problem: Severity of valve calcification linked to degree of paravalvular aortic regurgitation Needs: Better adhesion for valve stenting to calcified leaflets
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Needs Presentation Joe Tartakoff RIT Mechanical Engineering
Paravalvular Leakage in TAVI • Problem: Severity of valve calcification linked to degree of paravalvular aortic regurgitation • Needs: • Better adhesion for valve stenting tocalcified leaflets • Better devices/techniques to reduce the need for balloon redilation or second valve implantation • 45,000 TAVI procedures done worldwide since start, of which 12-20% develop postprocedural PVL (severe aortic regurgitation is rare)
Endoleaks after TEVAR Procedure • Problem: Endoleaks develop in 29% of all TEVAR procedures, leading to increased risk of postprocedural aneurysm rupture • Needs: • Develop better aortic fixation (Type I endoleaks – 40%) • Develop better monitoring of aneurysm sac (Type II endoleaks – 35%) • Develop better connections between graft components (Type III endoleaks – 20%) • 200,000 AAA per year • 30,000 TAA per year
IVC Filter Removal • Problem: Successful removal of IVC filters are rare (3.7% of retrievable IVC filters are actually removed) • Needs: • Develop technique/device to make removal of IVC filters easier for the surgeon (better proximal-distal control) • Develop a new IVC filter that can be removed easily • About 200,000 IVC filters implanted per year in US (use of IVC filters has increased over the last 3 years)
Ablation in Maze Procedure • Problem: MAZE procedures can be time consuming due to non-transmural ablation and variations in the heart’s nervous structure • Needs: • Improve the delivery and outcome of ablations • Develop techniques to design individualized maze pathways • Atrial fibrillation affects roughly 2.5 million people in US
VAD Power Line • Problem: Transcutaneous power cable responsible for most problems with VADs (infection, cable fraying, limiting device lifetime) • Needs: • Stronger and more flexible cable (higher fatigue life) • Reduce infection at the transcutaneous interface (tissue integration) • Roughly 250,000 implanted each year (only 2,000 transplants) • Existing Technology: • Wireless electromagnetic induction (slow recharge time) • Spiral power cable (Jarvic 2000 – still have infection)
Questions/Comments • Association of aortic valve calcification severity with the degree of aortic regurgitation after transcatheter aortic valve implantation. International Journal of Cardiology. 150 (2011) pg. 142-145. • Endoleaks after endovascular repair of thoracic aneurysms. Journal of Vascular Surgery. September 2006 pg. 447- 452. • Retrievable Inferior Vena Cava Filters are Rarely Removed. The American Surgeon. May 2009. Volume 75, Issue 5 pg. 426. • The Maze Porcedure: A surgical intervention for ablation of atrial fibrillation. Heart & Lung: The Journal of Acute and Critical Care. Volume 37, Issue 6 pg. 432-439.