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https://www.readbyqxmd.com/read/27899293/valvular-regurgitation-after-implantation-of-prostheses-secured-with-cor-knot-automated-fasteners
#1
Alexander A Brescia, Steven F Bolling, Himanshu J Patel
Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular less common. The Cor-knot automated fastener (LSI SOLUTIONS, Victor, NY, USA) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two cases in which Cor-Knot fastener orientation appeared to result in transvalvular regurgitation necessitating redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results...
November 26, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27889349/acquired-aseptic-intracardiac-shunts-following-transcatheter-aortic-valve%C3%A2-replacement-a%C3%A2-systematic-review
#2
Paol Rojas, Ignacio J Amat-Santos, Carlos Cortés, Javier Castrodeza, Javier Tobar, Rishi Puri, Teresa Sevilla, Silvio Vera, Luis H Varela-Falcón, Jose Luis Zunzunegui, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: The aim of this study was to describe the incidence, mechanisms, features, and management of aseptic intracardiac shunts (AICS). BACKGROUND: AICS following transcatheter aortic valve replacement (TAVR) are an uncommon and barely described complication. METHODS: A systematic review was performed of all published cases of AICS following TAVR, and the incidence, predictors, main features, management, and related outcomes were analyzed...
November 17, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27834758/current-status-of-tissue-engineering-heart-valve
#3
Toshiharu Shinoka, Hideki Miyachi
The development of surgically implantable heart valve prostheses has contributed to improved outcomes in patients with cardiovascular disease. However, there are drawbacks, such as risk of infection and lack of growth potential. Tissue-engineered heart valve (TEHV) holds great promise to address these drawbacks as the ideal TEHV is easily implanted, biocompatible, non-thrombogenic, durable, degradable, and ultimately remodels into native-like tissue. In general, three main components used in creating a tissue-engineered construct are (1) a scaffold material, (2) a cell type for seeding the scaffold, and (3) a subsequent remodeling process driven by cell accumulation and proliferation, and/or biochemical and mechanical signaling...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27798318/comparing-usual-care-with-a-warfarin-initiation-protocol-after-mechanical-heart-valve-replacement
#4
Gregory Roberts, Rasha Razooqi, Stephen Quinn
BACKGROUND: The immediate postoperative warfarin sensitivity for patients receiving heart valve prostheses is increased. Established warfarin initiation protocols may lack clinical applicability, resulting in dosing based on clinical judgment. OBJECTIVE: To compare current practice for warfarin initiation with a known warfarin initiation protocol, with doses proportionally reduced to account for the increased postoperative sensitivity. METHODS: We compared the Mechanical Heart Valve Warfarin Initiation Protocol (Protocol group) with current practice (clinical judgment-Empirical group) for patients receiving mechanical heart valves in an observational before-and-after format...
October 25, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27780149/nanofibrous-bioengineered-heart-valve-application-in-paediatric-medicine
#5
REVIEW
Mehrdad Namdari, Ali Eatemadi
Heart valves are currently under thorough investigation in tissue engineering (TE) research. Mechanical and biological heart valve prostheses which are recently used have several shortcomings. While allogenic and xenogenic biological prostheses are related to graft rejection, degeneration and thrombosis, resulting in a high rate of reoperation. Mechanical prostheses on the other hand are based on metallic, carbon, and polymeric components, and require continuous treatment with anticoagulant, which result in adverse reactions, e...
October 22, 2016: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/27666180/anticoagulation-after-heart-valve-replacement-or-transcatheter-valve-implantation
#6
Anthony P Carnicelli, Patrick T O'Gara, Robert P Giugliano
Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines...
August 13, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27636399/which-type-of-valve-should-we-use-in-tricuspid-position-long-term-comparison-between-mechanical-and-biological-valves
#7
Ana Redondo Palacios, José López Menéndez, Javier Miguelena Hycka, Miren Martín García, Laura Varela Barca, Andrea Ferreiro Marzal, Rafael Muñoz Pérez, Enrique Oliva De Anquín, Ignacio García Andrade, Tomasa Centella Hernández, Daniel Celemín Canorea, Jorge Rodríguez-Roda Stuart
BACKGROUND: Nowadays, Tricuspid valve replacement (TVR) is much less common than aortic or mitral valve replacement, since repair is almost always preferable. Prosthetic tricuspid valves are associated with high mortality and morbidity, mostly due to thrombotic or hemorrhagic events. Nevertheless, there is lack of evidence of which is the optimal type of valve (biological versus mechanical) in tricuspid position. METHODS: We analysed all the patients who underwent TVR in our Institution, from 2005 to 2015...
September 16, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27583703/adherence-of-staphylococcus-aureus-to-dyneema-purity%C3%A2-patches-and-to-clinically-used-cardiovascular-prostheses
#8
Amir Basir, Paul Gründeman, Frans Moll, Joost van Herwaarden, Gerard Pasterkamp, Reindert Nijland
Various materials that are used for vascular and heart valve prostheses carry drawbacks: some require anticoagulant drugs or have moderate durability; others are not suitable for endovascular treatment. These prostheses are associated with bacterial infections. A material potentially suitable for prostheses is Dyneema Purity®, made of ultra-high-molecular-weight polyethylene. Dyneema Purity® fibers are very thin, flexible, resistant to fatigue and abrasion, and have high strength. S. aureus adherence to Dyneema Purity® was tested and compared with currently used cardiovascular prostheses...
2016: PloS One
https://www.readbyqxmd.com/read/27573761/effects-of-leaflet-design-on-transvalvular-gradients-of-bioprosthetic-heart-valves
#9
Yaghoub Dabiri, Janet Ronsky, Imtiaz Ali, Ameen Basha, Alisha Bhanji, Kishan Narine
Bioprosthetic aortic valves (BAVs) are becoming the prostheses of choice in heart valve replacement. The objective of this paper is to assess the effects of leaflet geometry on the mechanics and hemodynamics of BAVs in a fluid structure interaction model. The curvature and angle of leaflets were varied in 10 case studies whereby the following design parameters were altered: a circular arch, a line, and a parabola for the radial curvature, and a circular arch, a spline, and a parabola for the circumferential curvature...
December 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27521817/experimental-investigations-on-the-fluid-mechanics-of-an-electrospun-heart-valve-by-means-of-particle-image-velocimetry
#10
Costantino Del Gaudio, Pier Luca Gasbarroni, Giovanni Paolo Romano
End-stage failing heart valves are currently replaced by mechanical or biological prostheses. Both types positively contribute to restore the physiological function of native valves, but a number of drawbacks limits the expected performances. In order to improve the outcome, tissue engineering can offer an alternative approach to design and fabricate innovative heart valves capable to support the requested function and to promote the formation of a novel, viable and correctly operating physiological structure...
December 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27503339/transapical-aortic-valve-implantation-in-patients-with-pre-existing-mitral-valve-prostheses-a-case-report
#11
Kristina Wachter, Samir Ahad, Christian J Rustenbach, Ulrich F W Franke, Hardy Baumbach
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has proven to be a valid option for patients with severe aortic stenosis who are at high perioperative risk, particularly in patients with previous cardiac surgery. Several patients with previous mitral valve surgery were reported to have been successfully treated with TAVI. CASE PRESENTATION: Two patients, one with mechanical and one with biological mitral valve prosthesis, presented with symptomatic severe aortic stenosis...
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27456412/computational-comparison-of-aortic-root-stresses-in-presence-of-stentless-and-stented-aortic-valve-bio-prostheses
#12
M G C Nestola, E Faggiano, C Vergara, R M Lancellotti, S Ippolito, C Antona, S Filippi, A Quarteroni, R Scrofani
We provide a computational comparison of the performance of stentless and stented aortic prostheses, in terms of aortic root displacements and internal stresses. To this aim, we consider three real patients; for each of them, we draw the two prostheses configurations, which are characterized by different mechanical properties and we also consider the native configuration. For each of these scenarios, we solve the fluid-structure interaction problem arising between blood and aortic root, through Finite Elements...
February 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/27442920/compliance-mismatch-and-compressive-wall-stresses-drive-anomalous-remodelling-of-pulmonary-trunks-reinforced-with-dacron-grafts
#13
Francesco Nappi, Angelo Rosario Carotenuto, Arsenio Cutolo, Pierre Fouret, Christophe Acar, Juan Carlos Chachques, Massimiliano Fraldi
Synthetic grafts are often satisfactory employed in cardiac and vascular surgery, including expanded poly(ethylene terephthalate) or expanded poly(tetrafluoroethylene). However, accumulating evidences suggest the emergence of worrisome issues concerning the long-term fate of prosthetic grafts as large vessel replacement. Disadvantages related to the use of synthetic grafts can be traced in their inability of mimicking the elasto-mechanical characteristics of the native vascular tissue, local suture overstress leading to several prosthesis-related complications and retrograde deleterious effects on valve competence, cardiac function and perfusion...
October 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27401780/safety-and-feasibility-of-treatment-with-rivaroxaban-for-non-canonical-indications-a-case-series-analysis
#14
Domenico Acanfora, Chiara Acanfora, Pietro Scicchitano, Marialaura Longobardi, Giuseppe Furgi, Gerardo Casucci, Bernardo Lanzillo, Ilaria Dentamaro, Annapaola Zito, Raffaele Antonelli Incalzi, Marco Matteo Ciccone
BACKGROUND AND OBJECTIVES: The new oral anticoagulants (NOACs) are used for the prevention of thromboembolic complications in patients with non-valvular atrial fibrillation (AF) and those at risk of deep venous thrombosis. Their rapid onset of action and predictable pharmacokinetic and pharmacodynamic profiles make them the optimal alternative to warfarin in the treatment of these two categories of patients. Unfortunately, however, NOACs cannot be used in patients with valvular AF or valvular cardiac prostheses...
October 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27375186/bicuspid-and-unicuspid-aortic-valve-fate-of-moderate-severe-mixed-aortic-valve-disease
#15
Alexander C Egbe, Heidi M Connolly, Joseph T Poterucha, Carole A Warnes
OBJECTIVES: There is a paucity of data about mixed aortic valve disease (MAVD) in patients with bicuspid/unicuspid aortic valve (BAV). This study sought to describe the outcomes of patients with moderate/severe MAVD. METHODS: We queried our database for patients with BAV and moderate/severe MAVD seen between 1994 and 2013. We excluded patients with baseline New York Heart Association (NYHA) III/IV symptoms, left ventricular ejection fraction <50%, aortic dimension >50 mm, and significant disease of other valves...
July 4, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27326237/choice-of-prosthetic-heart-valve-in-a-developing-country
#16
Shiv Kumar Choudhary, Sachin Talwar, Balram Airan
Mechanical prostheses and stented xenografts (bioprosthesis) are most commonly used substitutes for aortic and mitral valve replacement. The mechanical valves have the advantage of durability but are accompanied with the risk of thromboembolism, problems of long-term anticoagulation, and associated risk of bleeding. In contrast, bioprosthetic valves do not require long-term anticoagulation, but carry the risk of structural valve degeneration and re-operation. A mechanical valve is favoured in young patients (<40 years) if reliable anticoagulation is ensured...
2016: Heart Asia
https://www.readbyqxmd.com/read/27255294/benefits-and-medium-term-outcome-of-the-sorin-pericarbon-freedom-stentless-aortic-prosthesis-in-cases-of-acute-bacterial-endocarditis
#17
Guglielmo Stefanelli, Fabrizio Pirro, Marco Meli, Davide Trevisan, Mariassunta Telesca, Barbara Campisano, Cristina Mussini, Andrea Barbieri
OBJECTIVES: The aim of this study is to evaluate the ease of use and the advantages of Sorin Pericarbon Freedom (SPF) stentless valve in cases of acute bacterial endocarditis and to check the intermediate-term results after the implant of SPF with respect to resistance to infection, valve deterioration and durability. METHODS: Between June 2003 and February 2015, 26 patients with active aortic valve bacterial endocarditis underwent aortic valve replacement with SPF pericardial stentless aortic prosthesis...
October 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27245620/reduction-of-aberrant-aortic-haemodynamics-following-aortic-root-replacement-with-a-mechanical-valved-conduit
#18
Eric J Keller, S Chris Malaisrie, Jane Kruse, Patrick M McCarthy, James C Carr, Michael Markl, Alex J Barker, Jeremy D Collins
OBJECTIVES: Previous work suggests that aortic root and valve prostheses alter blood flow patterns in the ascending aorta, creating aberrant haemodynamics compared with those of healthy volunteers. Various valve designs have been proposed to better restore physiological haemodynamics. In this study, magnetic resonance imaging (MRI) was used to non-invasively assess three-dimensional (3D) ascending aortic haemodynamics after aortic root replacement (ARR) with a mechanical valved conduit postulated to create less turbulent blood flow...
September 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27193081/percutaneous-transcatheter-aortic-valve-implantation-for-degenerated-surgical-bioprostheses-the-first-case-series-in-asia-with-one-year-follow-up
#19
Paul Toon-Lim Chiam, See-Hooi Ewe, Jia-Lin Soon, Kay-Woon Ho, Yong-Koong Sin, Swee-Yaw Tan, Soo-Teik Lim, Tian-Hai Koh, Yeow-Leng Chua
INTRODUCTION: Percutaneous transcatheter aortic valve implantation (TAVI) has become an established therapy for inoperable and high-surgical-risk patients with severe aortic stenosis. Although TAVI in patients with degenerated surgical aortic bioprostheses (i.e. valve-in-valve TAVI) is increasingly reported in Western studies, such data is lacking in Asian patients. We describe the initial experience of valve-in-valve TAVI in Asia. METHODS: Eight patients who underwent valve-in-valve TAVI due to degenerated aortic bioprostheses were enrolled...
July 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27162649/bioprosthetic-versus-mechanical-prostheses-for-valve-replacement-in-end-stage-renal-disease-patients-systematic-review-and-meta-analysis
#20
Kevin Phan, Dong Fang Zhao, Jessie J Zhou, Aran Karagaratnam, Steven Phan, Tristan D Yan
BACKGROUND: Patients with end-stage renal disease (ESRD) indicated for dialysis are increasingly requiring cardiac valve surgery. The choice of bioprosthetic or mechanic valve prosthesis for such patients requires careful risk assessment. A systematic review and meta-analysis was performed to assess current evidence available. METHODS: A comprehensive search from six electronic databases was performed from their inception to February 2015. Results from patients with ESRD undergoing cardiac surgery for bioprosthetic or mechanical valve replacement were identified...
May 2016: Journal of Thoracic Disease
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