The Use of a Pulsatile Perfusion Apparatus for the Assessment of Aortic Valve Function within Formalin Fixed Human Hearts: Pre- And Post-Tavr Implantation with Subsequent Micro-CT Analyses

Abstract

Transcatheter aortic valve replacement (TAVR) is often the clinical choice for patients with severe aortic stenosis or as an alternative to surgical aortic valve replacement for high-risk patients. In these patients, the incidence of complications, including aortic annular rupture, coronary occlusion, and newonset atrial fibrillation is just under five percent. The Visible Heart® Laboratories have a library of over 500 perfusion-fixed human hearts preserved in formalin. These specimens can be utilized to better understand aortic valvular function associated with various diseased states with proper pulsatile profusion. This preclinical benchtop model could also be used for the testing of TAVR devices: e.g., to better understand proper placement techniques. Here we describe the continued development of a pulsatile perfusion apparatus constructed to assess the aortic valve function of these human heart specimens: i.e., pre- and post- TAVR deployment. Multi-modal imaging can be utilized, including videoscopes, fluoroscopy, and echocardiography. Resultant placements, the device-tissue interface within the valvular annulus can be subsequently assessed using micro-CT imaging. This pre-clinical approach also allows for this unique human heart. Specimens to be utilized numerous times, providing real anatomical scenarios for the testing of these devices.