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Journal of Heart Valve Disease

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https://www.readbyqxmd.com/read/29302952/letter-to-the-editor-thrombocytopenia-after-sutureless-aortic-valve-implantation-does-it-really-matter
#1
G Santarpino, F Vogt
Despite the limited clinical relevance of thrombocytopenia after bioprosthetic aortic valve replacement (AVR), the postoperative depletion of platelet count continues to attract the attention of many authors. The development of thrombocytopenia has been evaluated either in patients receiving a sutureless bioprosthesis (1,2) or in those undergoing transcatheter aortic valve implantation, where cardiopulmonary bypass bears little or no relation to this phenomenon (3). Recently, Sánchez et al. (1) have published their findings on this topic, but their limited experience with the devices used makes their study of doubtful interest...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302951/percutaneous-therapy-of-a-stenotic-parachute-mitral-valve-previously-treated-by-surgery
#2
Roberta De Rosa, Dietmar Schranz, Mariuca Vasa-Nicotera, Birgit Assmus, Petar Risteski, Anton Moritz, Andreas M Zeiher, Stephan Fichtlscherer
Parachute mitral valve (PMV) is a congenital heart anomaly which consists of a unifocal attachment of the mitral valve chordae into a single or dominant papillary muscle. This morphological anomaly determines the impairment of mitral leaflet motion, resulting in different grades of mitral stenosis. Due to its frequent association with other congenital cardiac defects requiring surgical correction, the therapy of a relevant stenotic PMV is usually represented by surgical commissurotomy. Herein is reported the case of a PMV treated by surgery in infancy, which showed a severe restenosis after 34 years and was successfully treated by percutaneous valvuloplasty with the additional creation of a restrictive atrial communication...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302950/use-of-impella-5-0-prior-to-transcatheter-aortic-valve-replacement-in-a-patient-with-severe-aortic-stenosis-and-cardiogenic-shock
#3
Dustin W Johnson, John P ErwinIII
The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc., Danvers, MA, USA), has also increased. These devices provide superior hemodynamic effects compared to intra-aortic balloon pumping...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302949/simultaneous-transcatheter-intervention-for-coarctation-of-the-aorta-and-bicuspid-aortic-valve
#4
Yukiko Mizutani, Norio Tada, Takahiko Masuda, Masaki Hata
Coarctation of the aorta (CoA) is a relatively common congenital heart anomaly, and bicuspid aortic valve (BAV) is a common congenital heart disease that coexists with CoA. In larger children and adults with CoA, transcatheter intervention has gained acceptance, but for surgical high-risk patients with aortic stenosis, the use of transcatheter aortic valve implantation (TAVI) has been established. Recently, although favorable data have been reported for TAVI when treating BAV, simultaneous transcatheter intervention for CoA and BAV will prove to be a challenge because of the unique anatomy involved requires multiple procedural steps and also has problems of site access...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302948/the-hancock%C3%A2-valved-conduit-for-right-ventricular-outflow-tract-reconstruction-in-sheep-for-assessing-new-devices
#5
John P Carney, Lindsey M Zhang, Jeffrey J Larson, Matthew T Lahti, Nicholas A Robinson, Agustin P Dalmasso, Richard W Bianco
BACKGROUND: Xenograft conduits have been used successfully to repair congenital heart defects, but are prone to failure over time. Hence, in order to improve patient outcomes, better xenografts are being developed. When evaluating a conduit's performance and safety it must first be compared against a clinically available control in a large animal model. The study aim was to evaluate a clinically available xenograft conduit used in right ventricular outflow tract (RVOT) reconstruction in a sheep model...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302947/fenfluramine-phentermine-is-associated-with-an-increase-in-cellular-proliferation-ex-vivo-and-in-vitro
#6
Nalini M Rajamannan
BACKGROUND: Fenfluraminephentermine (FenPhen) has been implicated in accelerated valvular heart disease, characterized by valvular regurgitation and thickening, and resembling the histopathologic lesions found in carcinoid. The study aim was to determine whether cellular proliferation is present in FenPhen-exposed valves, by utilizing an in-vitro model to test whether FenPhen has a direct mitogenic effect on cardiac valvular cells, as compared to serotonin. METHODS: Ex-vivo valves were tested for proliferation in surgically removed FenPhen-exposed valves (n = 10) and compared to proliferation levels in normal human cardiac valves removed at autopsy (n = 10)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302946/the-role-of-protein-z-and-protein-z-dependent-protease-inhibitor-polymorphisms-in-the-development-of-prosthetic-heart-valve-thrombosis
#7
Süleyman Karakoyun, Mustafa Ozan Gürsoy, Macit Kalçık, Mahmut Yesin, Sabahattin Gündüz, Mehmet Ali Astarcıoğlu, Zübeyde Bayram, Beytullah Çakal, Emrah Bayam, Mehmet Özkan
BACKGROUND: Protein Z (PZ) is a vitamin K-dependent factor that is synthesized mainly by the liver. It acts as an activator of serpin, the protein Z-dependent inhibitor (ZPI), which inhibits factor Xa. The potential role of alterations in protein Z and/or ZPI levels in the pathogenesis of thrombotic and/or hemorrhagic diseases has been previously investigated, but results have been conflicting. The study aim was to evaluate the role of PZ/ZPI polymorphisms in the development of prosthetic valve thrombosis (PVT)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302945/a-new-method-to-evaluate-atrial-hemodynamic-and-quantify-mitral-regurgitation-using-cardiovascular-magnetic-resonance-the-pulmonary-venous-flow-approach
#8
Giovanni Benfari, Giulia Vinco, Karl Sayegh, Matthias Friedrich, Andrea Rossi
Pulmonary venous flow (PVF) provides incremental information on left ventricular (LV) diastolic function, and can support the diagnosis of severe mitral regurgitation (MR). The suggestion has been made to combine the left atrial filling volume (LA Fill) and PVF for estimating the mitral regurgitant volume, but echocardiographic PVF evaluation is known to have many limitations. The present case report includes an example of how to assess PVF using cardiovascular magnetic resonance, and a new method is proposed for quantification of the mitral regurgitant volume...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302944/restrictive-mitral-annuloplasty-with-or-without-papillary-muscle-approximation-for-functional-mitral-regurgitation
#9
Yusuke Misumi, Takafumi Masai, Koichi Toda, Teruya Nakamura, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Shunsuke Saito, Keitaro Domae, Satoshi Kainuma, Takayoshi Ueno, Toru Kuratani, Takashi Daimon, Yoshiki Sawa
BACKGROUND: The impact of adding papillary muscle approximation (PMA) to restrictive mitral annuloplasty (RMA) on postoperative left ventricular (LV) function is unknown. Changes in LV function parameters and clinical outcome were evaluated following RMA with and without PMA in patients with clinically relevant functional mitral regurgitation (FMR). METHODS: A total of 176 patients with advanced cardiomyopathy underwent RMA either with (n = 59) or without (n = 117) PMA...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302943/left-heart-ejection-fraction-as-a-load-independent-parameter-for-patients-with-mitral-regurgitation
#10
Hai-Yan Chen, Jun Li, Chun-Sheng Wang, Cui-Zhen Pan, Xian-Hong Shu
BACKGROUND: The functions of the left ventricle and left atrium are closely associated with the outcomes of surgically treated patients with severe mitral regurgitation (MR). However, both parameters were overestimated in the presence of MR. The present study integrated the left atrium and left ventricle as the left heart (LH) to eliminate the influence of MR within the integrated structure. The study aim was to explore whether the emptying fraction of the LH is a load-independent parameter for patients with MR...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302942/pathophysiological-factors-associated-with-left-ventricular-perforation-in-transcatheter-aortic-valve-implantation-by-transfemoral-approach
#11
Tamer Owais, Mohammad El Garhy, Jürgen Fuchs, Kushtrim Disha, Sameh Elkaffas, Martin Breuer, Bernward Lauer, Thomas Kuntze
BACKGROUND: Left ventricular (LV) perforation is one of the rare and most serious complications of transcatheter aortic valve implantation (TAVI). The study aim was to determine the pathophysiological factors associated with this serious complication. METHODS: A retrospective study was conducted of pathophysiological factors shown in echocardiograms and computed tomography angiograms performed preoperatively in patients who developed LV perforation during transfemoral TAVI (study group) with regards to anatomic and functional variables...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302941/long-term-outcomes-in-patients-undergoing-consecutive-bioprosthetic-aortic-valve-replacement
#12
Matthew D Haydock, Carissa F Wilkes, Tharumenthiran Ramanathan, David A Haydock
BACKGROUND: Worldwide, there is increased use of bioprosthetic valves in the aortic position. Part of this increase has been patient-driven for quality of life reasons. More recently, bioprosthetic valves have been chosen by progressively younger patients, with a strategy of performing a valve-in-valve TAVI if the prosthesis should wear out. Thus, a review was undertaken of the present authors' experience with patients whose first two aortic valve replacements (AVRs) were with bioprosthetic valves...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302940/determinants-and-outcome-of-decision-making-among-patients-with-severe-aortic-stenosis
#13
Amjad I Hussain, Andreas Auensen, Cathrine Brunborg, Svend Aakhus, Arnt Fiane, Kjell I Pettersen, Lars Gullestad
BACKGROUND: Aortic valve replacement (AVR) improves survival and quality of life in patients with severe aortic stenosis (AS), but despite clear indications for surgical treatment a significant proportion of patients do not undergo AVR. The study aim was to identify clinical variables associated with the decision to perform AVR, and to assess the prognostic effect of surgery versus medical treatment in patients with severe AS adjusted for significant confounders and effect modifiers. METHODS: A prospective observational study of consenting patients aged >18 years who were under consideration for AVR at the authors' tertiary teaching hospital was conducted...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302939/transcatheter-aortic-valve-implantation-in-high-risk-inoperable-patients-repositionable-versus-non-repositionable-self-expanding-valve
#14
Verena Veulemans, Dagmar B Sötemann, Laura Kleinebrecht, Stefanie Keymel, Christian Jung, Tobias Zeus, Malte Kelm, Ralf Westenfeld
BACKGROUND: Although next-generation cardiac prostheses have shown favorable results in transcatheter aortic valve implantation (TAVI), these have mostly been documented in intermediate-risk patients. Whether this could be translated to high-risk patients is not known. Hence, the safety and clinical performance of the new, repositionable CoreValve Evolut R-System (ERS) was evaluated by comparison with a non-repositionable CoreValve-System (CVS), in 96 high-risk/inoperable (HRI) patients...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302938/long-term-results-of-aortic-root-surgery-in-marfan-syndrome-patients-a-single-center-experience
#15
Francesco Nicolo, Francesco Romeo, Antonio Lio, Emanuele Bovio, Antonio Scafuri, Carlo Bassano, Patrizio Polisca, Antonio Pellegrino, Paolo Nardi, Luigi Chiariello, Giovanni Ruvolo
BACKGROUND: The study aim was to compare long-term results of Marfan syndrome (MFS) patients affected by aortic root disease undergoing aortic root replacement with the Bentall or David operation. METHODS: Since 1994, a total of 59 patients has been followed at the authors' Marfan Center, having undergone either a Bentall operation (Bentall group, n = 30) or a David operation (David group, n = 29). RESULTS: No operative mortality was recorded...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302937/stress-analysis-of-transcatheter-aortic-valve-leaflets-under-dynamic-loading-effect-of-reduced-tissue-thickness
#16
Mostafa Abbasi, Ali N Azadani
BACKGROUND: In order to accommodate transcatheter valves to miniaturized catheters, the leaflet thickness must be reduced to a value which is typically less than that of surgical bioprostheses. The study aim was to use finite-element simulations to determine the impact of the thickness reduction on stress and strain distribution. METHODS: A 23 mm transcatheter aortic valve (TAV) was modelled based on the Edwards SAPIEN XT (Edwards Lifesciences, Irvine, CA, USA)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302936/impact-of-tricuspid-valve-regurgitation-on-early-outcomes-after-transcatheter-aortic-valve-replacement
#17
Mihir Barvalia, Rajiv Tayal, Marc Cohen, Martin Miguel Amor, Lilia Tcharnaia, Chunguang Chen, Mark Russo, Bruce Haik
BACKGROUND: Tricuspid valve regurgitation (TR) is often not taken into consideration in the prognostication of patients undergoing transcatheter aortic valve replacement (TAVR). Accordingly, its impact on such patients remains relatively poorly defined. The study aim was to explore the effect of TR and parameters of right ventricular (RV) function on outcomes in patients undergoing TAVR. METHODS: Baseline demographic and echocardiographic data were collected for 460 consecutive patients undergoing TAVR at the authors' institution between 2012 and 2015...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302935/outcomes-of-surgery-for-severe-aortic-regurgitation-with-systolic-left-ventricular-dysfunction
#18
Piergiorgio Bruno, Federico Cammertoni, Raphael Rosenhek, Andrea Mazza, Marialisa Nesta, Francesco Burzotta, Domenico D'Amario, Massimo Massetti
BACKGROUND: Management of patients with aortic regurgitation (AR) and severe impairment of left ventricular (LV) function characterized by an ejection fraction (EF) ≤35% is challenging. Conflicting results regarding perioperative and long-term survival of these patients have been reported. The study aim was to compare in-hospital outcomes and long-term survival of patients with AR and severe LV dysfunction versus moderate dysfunction (35% <EF <50%) versus preserved LV function (EF ≥50%)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29092127/iatrogenic-lutembacher-syndrome-after-percutaneous-mitral-commissurotomy
#19
Theodoros D Karamitsos, Chrysovalantou Nikolaidou, Athanasios Koutsakis, Kyriakos Anastasiadis, Charalambos Karvounis, Stavros Hadjimiltiades
Atrial septal defects (ASDs) are common immediately after percutaneous mitral commissurotomy (PMC). They are usually small, hemodynamically insignificant, and tend to decrease or disappear within 6 to 12 months. Herein, a case is described of persistent ASD in a patient with mitral valve stenosis who had undergone successful PMC three years previously. The patient had signs and symptoms of right heart failure and severe tricuspid regurgitation (TR) with borderline right ventricular systolic function on echocardiography, in addition to the ASD...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29092126/prosthetic-aortic-valve-endocarditis-without-evidence-of-vegetation
#20
Tasleem Katchi, Howard A Cooper, Srikanth S Yandrapalli, Sahil Khera, John Fallon, David Spielvogel, Wilbert S Aronow, Julio A Panza
Despite significant technological advances, the diagnosis of infective endocarditis (IE) remains a major challenge, and the condition continues to be associated with significant morbidity and mortality. Valvular vegetations have long been the diagnostic and pathologic hallmarks of IE. However, IE can be diagnosed even in the absence of vegetations using the modified Duke criteria. Vegetation-negative endocarditis is rare, and to the present authors' knowledge no cases of septic emboli in the absence of valvular vegetations have been reported...
May 2017: Journal of Heart Valve Disease
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