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https://www.readbyqxmd.com/read/28706871/tricuspid-valve-regurgitation-after-heart-transplantation
#1
Murray H Kwon, Richard J Shemin
Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28695557/impact-of-new-technologies-and-experience-on-procedural-aspects-of-surgical-aortic-valve-replacement-a-process-analysis
#2
Bettina Langhammer, Maria Nucera, Lars Englberger, Eva Roost, David Reineke, Florian Schönhoff, Henriette Most, Bernhard Winkler, Fabian Gisler, Thierry Carrel, Christoph Huber
BACKGROUND: Surgical aortic valve replacement (SAVR) is the treatment of choice in severe symptomatic aortic valve disease. New techniques and prostheses have been recently developed to facilitate the procedure and reduce aortic cross-clamp time (AOx). The aim of this study was to analyse the different procedural steps in order to identify the most time-consuming part during aortic clamping time and to compare impact of experience on procedural aspects. METHODS: AOx during SAVR was divided into five consecutive steps...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28683947/quantitative-prediction-of-paravalvular%C3%A2-leak-in-transcatheter-aortic%C3%A2-valve-replacement-based-on%C3%A2-tissue-mimicking-3d-printing
#3
Zhen Qian, Kan Wang, Shizhen Liu, Xiao Zhou, Vivek Rajagopal, Christopher Meduri, James R Kauten, Yung-Hang Chang, Changsheng Wu, Chuck Zhang, Ben Wang, Mani A Vannan
OBJECTIVES: This study aimed to develop a procedure simulation platform for in vitro transcatheter aortic valve replacement (TAVR) using patient-specific 3-dimensional (3D) printed tissue-mimicking phantoms. We investigated the feasibility of using these 3D printed phantoms to quantitatively predict the occurrence, severity, and location of any degree of post-TAVR paravalvular leaks (PVL). BACKGROUND: We have previously shown that metamaterial 3D printing technique can be used to create patient-specific phantoms that mimic the mechanical properties of biological tissue...
July 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28674619/on-x-versus-st-jude-medical-regent-mechanical-aortic-valve-prostheses-early-haemodynamics
#4
Robert Xu, Mohammad Rahnavardi, Bradley Pitman, Masoumeh Shirazi, Robert Stuklis, James Edwards, Michael Worthington
OBJECTIVE: We aimed to compare the early haemodynamic data of the On-X and St Jude Medical (SJM) Regent bileaflet mechanical prostheses in the aortic position. METHODS: A retrospective study was performed using data collected prospectively for a national database. Thirty-three patients who had aortic On-X valve (On-X group) and 33 matched patients who had aortic SJM Regent valve (SJM group) were included. The intraoperative and early postoperative data were collected...
2017: Open Heart
https://www.readbyqxmd.com/read/28667440/-surgical-treatment-of-aortic-valve-stenosis
#5
O J Liakopoulos, J Merkle, T Wahlers, Y-H Choi
Surgical aortic valve replacement still represents the gold standard in patients with severe symptomatic aortic valve stenosis. In addition to conventional aortic valve replacement by mechanical or biological prostheses via a median sternotomy, novel approaches including minimally invasive strategies and new devices, such as so-called rapid deployment prostheses, are becoming increasingly more established. Autologous replacement strategies including the Ross and the Ozaki procedures have evolved into reliable options at selected centers of excellence...
June 30, 2017: Herz
https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#6
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28544834/in-vitro-pulsatile-flow-measurement-in-prosthetic-heart-valves-an-inter-laboratory-comparison
#7
Stephen M Retta, Jeff Kepner, Salvador Marquez, Bruce A Herman, Mark C S Shu, Laurence W Grossman
BACKGROUND AND AIM OF STUDY: One of the first steps in qualifying a new prosthetic valve for eventual clinical use is preclinical flow performance testing in vitro. Such testing is typically performed in an in-vitro test system that simulates the pumping mechanics of the left ventricle of the heart, generally referred to as a pulse duplicator or duplicator. Historically, test results in these systems have varied from duplicator to duplicator. This collaborative effort between heart valve manufacturers and the Food and Drug Administration (FDA) was designed to evaluate the variability of the pulse duplicator test technology for pulsatile flow performance measurement in an interlaboratory round robin...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28498907/complicated-infective-aortic-endocarditis-comparison-of-different-surgical-strategies%C3%A2
#8
Miriam Silaschi, Niki Nicou, Ranjit Deshpande, Sanjay Chaubey, Max Baghai, Rafal Dworakowski, Olaf Wendler
OBJECTIVES: The choice of substitute during aortic valve replacement for infective endocarditis (IE) is still widely debated. We retrospectively reviewed all patients operated for aortic IE and compared groups according to the complexity of IE and substitutes implanted. METHODS: From 2000 to 2015, 187 patients were treated using stentless bioprostheses (SBP) as root replacement ( n  = 30), mechanical prostheses (MP, n  = 45) or stented bioprostheses (SP, n  = 112) (mean follow-up 4...
May 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28468510/safety-and-efficacy-of-bridging-with-low-molecular-weight-heparin-during-temporary-interruptions-of-warfarin-a-register-based-cohort-study
#9
Vilhelm Sjögren, Bartosz Grzymala-Lubanski, Henrik Renlund, Peter J Svensson, Anders Själander
Low-molecular-weight heparin (LMWH) is often recommended as a bridging therapy during temporary interruptions in warfarin treatment, despite lack of evidence. The aim of this study was to see whether we could find benefit from LMWH bridging. We studied all planned interruptions of warfarin within the Swedish anticoagulation register Auricula during 2006 to 2011. Low-molecular-weight heparin bridging was compared to nonbridging (control) after propensity score matching. Complications were identified in national clinical registers for 30 days following warfarin cessation, and defined as all-cause mortality, bleeding (intracranial, gastrointestinal, or other), or thrombosis (ischemic stroke or systemic embolism, venous thromboembolism, or myocardial infarction) that was fatal or required hospital care...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/28454910/evaluation-of-an-aortic-valve-prosthesis-fluid-structure-interaction-or-structural-simulation
#10
Giulia Luraghi, Wei Wu, Francesco De Gaetano, Josè Felix Rodriguez Matas, Geoff D Moggridge, Marta Serrani, Joanna Stasiak, Maria Laura Costantino, Francesco Migliavacca
Bio-inspired polymeric heart valves (PHVs) are excellent candidates to mimic the structural and the fluid dynamic features of the native valve. PHVs can be implanted as prosthetic alternative to currently clinically used mechanical and biological valves or as potential candidate for a minimally invasive treatment, like the transcatheter aortic valve implantation. Nevertheless, PHVs are not currently used for clinical applications due to their lack of reliability. In order to investigate the main features of this new class of prostheses, pulsatile tests in an in-house pulse duplicator were carried out and reproduced in silico with both structural Finite-Element (FE) and Fluid-Structure interaction (FSI) analyses...
June 14, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28444168/mechanical-versus-bioprosthetic-aortic-valve-replacement
#11
Stuart J Head, Mevlüt Çelik, A Pieter Kappetein
Mechanical valves used for aortic valve replacement (AVR) continue to be associated with bleeding risks because of anticoagulation therapy, while bioprosthetic valves are at risk of structural valve deterioration requiring reoperation. This risk/benefit ratio of mechanical and bioprosthetic valves has led American and European guidelines on valvular heart disease to be consistent in recommending the use of mechanical prostheses in patients younger than 60 years of age. Despite these recommendations, the use of bioprosthetic valves has significantly increased over the last decades in all age groups...
April 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28366467/aortic-root-replacement-for-children-with-loeys-dietz-syndrome
#12
Nishant D Patel, Diane Alejo, Todd Crawford, Narutoshi Hibino, Harry C Dietz, Duke E Cameron, Luca A Vricella
BACKGROUND: Loeys-Dietz syndrome (LDS) is an aggressive aortopathy with a proclivity for aortic aneurysm rupture and dissection at smaller diameters than other connective tissue disorders. We reviewed our surgical experience of children with LDS to validate our guidelines for prophylactic aortic root replacement (ARR). METHODS: We reviewed all children (younger than 18 years) with a diagnosis of LDS who underwent ARR at our institution. The primary endpoint was mortality, and secondary endpoints included complications and the need for further interventions...
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359556/valve-replacement-surgery-in-severe-chronic-kidney-disease
#13
Min Ho Ju, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee, Joon Bum Kim
BACKGROUND: The impact of prosthetic choices in patients with severe chronic kidney disease (CKD) on long-term outcomes has not been well established. METHODS: The study involved 152 adult patients (61.6±14.1yrs.; 64 females) undergoing heart valve surgery who had stage 4 (n=87) or 5 CKD (end-stage; n=65) based on Kidney Disease Outcomes Quality Initiative Guidelines. To reduce the impact of selection bias between mechanical (n=92) and bio-prostheses groups (n=60), propensity score analyses were conducted...
March 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28296135/assessment-of-trans-aortic-pressure-gradient-using-a-coronary-pressure-wire-in-patients-with-mechanical-aortic-and-mitral-valve-prostheses
#14
Nisharahmed Kherada, Juan Carlos Brenes, Annapoorna S Kini, George D Dangas
Accurate evaluation of trans-aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non-invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans-valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290167/simple-interrupted-suturing-for-redo-mitral-valve-replacement
#15
Hiroshi Furukawa, Taishi Tamura, Takeshi Honda, Hiroki Takiuchi, Masahiko Kuinose, Kazuo Tanemoto
BACKGROUND: An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR). METHODS: Among 336 mitral valve surgery patients at the authors' institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290164/risk-factors-for-permanent-pacemaker-after-implantation-of-surgical-or-percutaneous-self-expanding-aortic-prostheses
#16
Emmanuel Villa, Alberto Clerici, Antonio Messina, Luca Testa, Francesco Bedogni, Andrea Moneta, Francesco Donatelli, Giovanni Troise
BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) following the introduction of Nitinol autoexpandable devices has spread rapidly during recent years. In addition, cardiac surgery has been revolutionized due to the use of Nitinol-based sutureless prostheses for aortic valve replacement (AVR). During the same period, however, permanent pacemaker (PPM) implantation has emerged as a frequent complication. The study aim was to identify the risk factors of PPM following the implantation of a Nitinol self-expanding prosthesis (for AVR or TAVI)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28236633/repair-or-replacement-for-isolated-tricuspid-valve-pathology-insights-from-a-surgical-analysis-on-long-term-survival
#17
Mina Farag, Rawa Arif, Anton Sabashnikov, Mohamed Zeriouh, Aron-Frederik Popov, Arjang Ruhparwar, Bastian Schmack, Pascal M Dohmen, Gábor Szabó, Matthias Karck, Alexander Weymann
BACKGROUND Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. MATERIAL AND METHODS Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies...
February 25, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28178887/magnesium-presence-prevents-removal-of-antigenic-nuclear-associated-proteins-from-bovine-pericardium-for-heart-valve-engineering
#18
Ailsa J Dalgliesh, Zhi Zhao Liu, Leigh G Griffiths
Current heart valve prostheses are associated with significant complications, including aggressive immune response, limited valve life expectancy, and inability to grow in juvenile patients. Animal derived "tissue" valves undergo glutaraldehyde fixation to mask tissue antigenicity; however, chronic immunological responses and associated calcification still commonly occur. A heart valve formed from an unfixed bovine pericardium (BP) extracellular matrix (ECM) scaffold, in which antigenic burden has been eliminated or significantly reduced, has potential to overcome deficiencies of current bioprostheses...
March 10, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28117617/patterns-and-determinants-of-functional-and-absolute-iron-deficiency-in-patients-undergoing-cardiac-rehabilitation-following-heart-surgery
#19
Roberto Tramarin, Valeria Pistuddi, Luigi Maresca, Marco Pavesi, Serenella Castelvecchio, Lorenzo Menicanti, Carlo de Vincentiis, Marco Ranucci
Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20% and serum ferritin ≥100 µg/l...
May 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28105540/echocardiographic-assessment-of-long-term-hemodynamic-characteristics-of-mechanical-mitral-valve-prostheses-with-different-mitral-valvular-diseases
#20
Xiliang Zhu, Qian Li, Hong Tang, Xijun Xiao
Mitral stenosis (MS) and mitral insufficiency (MI) have different pre-operative hemodynamic characteristics. However, it is unclear if there are differences in long-term echocardiographic characteristics of MS and MI patients after mechanical mitral valve replacement. This study is to compare long-term echocardiographic results of mechanical mitral valve prostheses between MS and MI patients. From January 2003 to January 2009, a total of 199 consecutive patients were recruited in this study. Patients were classified as group MS (n = 123) and MI (n = 76) according to the manifestation of mitral valvular disease...
March 2017: Australasian Physical & Engineering Sciences in Medicine
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