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Standardized Bench Test Evaluation of Biomechanical Characteristics of Stents Used in Right Ventricular Outflow Tract Revalvulation

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Abstract

Purpose

Pre-stenting of the right ventricular outflow tract (RVOT) is commonly performed before percutaneous pulmonary valve implantation (PPVI), to relieve obstruction, prevent valved stent fractures, and provide a landing zone. This study aimed to evaluate the biomechanical characteristics of the stents currently used to perform pre-stenting of the RVOT.

Methods

We assessed five commercially available stents: Cheatham-Platinum Stent (“CP Stent”), AndraStent XL, AndraStent XXL, Optimus XL, and Optimus XXL. Following stent deployment at nominal pressure, radial and longitudinal elastic recoils and radial resistance were measured. The bending stiffness of the stents crimped onto the balloons was also evaluated.

Results

Three samples were tested for each stent. Our study showed no significant difference between the stent platforms in terms of radial elastic recoil, which was relatively low (< 10%). The longitudinal elastic recoil was also low for all the devices (< 5%). Significant differences were observed in radial resistance (P < 0.001). CP Stent and AndraStent XL exhibited the highest radial resistances. The bending stiffnesses of the stents crimped on their balloons were significantly different (P < 0.00001). Optimus XL and XXL were more flexible than the other stents.

Conclusion

This study highlights the significant differences between the stents currently used in RVOT pre-stenting. Stents with good radial resistance are preferred, especially for calcified vessels, and flexibility is crucial for tortuous vessels. We proposed an algorithm for selecting the most suitable stent according to the need for radial force and flexibility, which will help inform clinicians considering RVOT revalvulation.

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Data Availability

The data that support the findings of this study are available upon reasonable request.

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Authors and Affiliations

  1. Nantes Université, CHU Nantes, Service de Cardiologie, l’institut du Thorax, 44000, Nantes, France

    Pierre-Guillaume Piriou, Julien Plessis, Thibaut Manigold, Vincent Letocart, Robin Le Ruz, Paul Padovani & Patrice Guérin

  2. INSERM Unit 1229, Regenerative Medicine and Skeleton, Nantes, France

    Patrice Guérin

Authors
  1. Pierre-Guillaume Piriou
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  2. Julien Plessis
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  3. Thibaut Manigold
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  4. Vincent Letocart
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  5. Robin Le Ruz
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  6. Paul Padovani
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  7. Patrice Guérin
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Correspondence to Pierre-Guillaume Piriou.

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Associate Editor Jamshid Karimov oversaw the review of this article.

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Longitudinal elastic recoil (TIFF 169 kb)

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Piriou, PG., Plessis, J., Manigold, T. et al. Standardized Bench Test Evaluation of Biomechanical Characteristics of Stents Used in Right Ventricular Outflow Tract Revalvulation. Cardiovasc Eng Tech (2024). https://doi.org/10.1007/s13239-024-00726-1

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