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https://www.readbyqxmd.com/read/29687702/new-generation-devices-for-transcatheter-aortic-valve-implantation
#1
Laura Gatto, Giuseppe Biondi-Zoccai, Enrico Romagnoli, Giacomo Frati, Francesco Prati, Arturo Giordano
Transcatheter aortic valve implantation (TAVI) has overcome the pioneering phase and thanks to accrued clinical evidence has become a mainstay alternative to surgical aortic valve replacement (SAVR) in patients at high risk for post-operative complications. Despite these successes, TAVI remains a junior technology facing momentous developments in techniques and devices. Indeed, several new-generation devices for TAVI have become available in the last few years, including Acurate, Allegra, Evolut, Lotus, JenaValve, Portico, and SAPIEN3...
April 20, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29618696/subclinical-leaflet-thrombosis-in-transcatheter-aortic-valve-replacement-detected-by-multidetector-computed-tomography-a-review-of-current-evidence
#2
Hashrul N Rashid, Adam J Brown, Liam M McCormick, Ameera S Amiruddin, Kim K Be, James D Cameron, Arthur Nasis, Robert P Gooley
Subclinical leaflet thrombosis (SLT) following transcatheter aortic valve replacement (TAVR) has been increasingly recognized. SLT has the hallmark features of hypo-attenuated leaflet thickening (HALT) on multidetector computed tomography (MDCT), which may result in hypoattenuation affecting motion (HAM). The actual prevalence of this condition is uncertain, with limited observational registries. SLT has caught the attention of the cardiovascular community because of concerns regarding its clinical sequelae, specifically the potential increased incidence of cerebrovascular events...
April 4, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29588739/predilatation-prior-to-transcatheter-aortic-valve-implantation-is-it-still-a-prerequisite
#3
Matteo Pagnesi, Luca Baldetti, Paolo Del Sole, Antonio Mangieri, Marco B Ancona, Damiano Regazzoli, Nicola Buzzatti, Francesco Giannini, Antonio Colombo, Azeem Latib
Predilatation has been historically considered a mandatory step before transcatheter aortic valve implantation (TAVI) since it facilitates valve crossing and prosthesis delivery, ensures optimal valve expansion and improves hemodynamic stability during valve deployment. However, as a result of procedural evolution over time, direct TAVI (without pre-implantation balloon aortic valvuloplasty) has emerged as an interesting option to simplify the procedure and to avoid potential valvuloplasty-related complications...
September 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29322433/biological-aortic-valve-replacement-advantages-and-optimal-indications-of-stentless-compared-to-stented-valve-substitutes-a-review
#4
REVIEW
Reza Tavakoli, Pichoy Danial, Ahmed Hamid Oudjana, Peiman Jamshidi, Max Gassmann, Pascal Leprince, Guillaume Lebreton
Controversy still surrounds the optimal biological valve substitute for aortic valve replacement. In light of the current literature, we review advantages and optimal indications of stentless compared to stented aortic bio-prostheses. Recent meta-analyses, prospective randomized controlled trials and retrospective studies comparing the most frequently used stentless and stented aortic bio-prostheses were analyzed. In the present review, the types and implantation techniques of the bio-prosthesis that are seldom taken into account by most studies and reviews were integrated in the interpretation of the relevant reports...
January 10, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29134537/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-4-valvular-heart-surgery
#5
Kiyoharu Nakano, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
Data from the Japan cardiovascular surgery database from 2013 to 2014 were analyzed to demonstrate the mortality rate and choice of surgical procedures, especially concerning the selection of valve prosthesis for each valve position and patient age group, and the effects of preoperative complications on mortality and prosthetic valve selection. The proportion of each surgical procedure was compared for each patient age in the aortic, mitral, and tricuspid positions. The proportion of mechanical valve prostheses was 23...
January 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29062747/comparison-of-hemodynamic-and-clinical-outcomes-of-transcatheter-and-sutureless-aortic-bioprostheses-how-to-make-the-right-choice-in-intermediate-risk-patients
#6
Augusto D'Onofrio, Assunta Fabozzo, Gino Gerosa
Current surgical treatment options for aortic valve stenosis (AS), as alternatives to that of conventional operation with a midline sternotomy, include sutureless valve replacement (SUAVR) and transcatheter valve implantation (TAVI). Patients with high surgical risk, or those who are judged to be inoperable, are typically good candidates for the TAVI procedure. The best treatment option in patients with an intermediate risk profile, however, the so called "grey zone", is still currently under debate...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29041893/-transcatheter-implantation-of-mitral-valve-prostheses-current-status-of-the-problem
#7
M A Karaskov, Y I Zhuravleva, V A Bogachev-Prokophiev, P D Demidov
Mitral valve disease is highly prevalent and quickly leads to development of severe heart failure. Mitral valve disease of degenerative or ischemic etiology affects 7.5 and 9.3% of population older than 65 and 75 years, respectively. "Open" (with cardiopulmonary bypass) surgical repair or valve replacement are not possible in almost half of affected patients because of their complications and concomitant diseases responsible for extremely high risk of these interventions. In the last decade, minimally invasive endovascular technology - transcatheter aortic valve implantation (TAVI) - has been widely introduced for correction of aortic valve disease in similar category of patients...
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/29032762/a-review-of-evolutionary-and-cyclical-changes-in-the-surgical-approach-to-aortic-valve-disease
#8
Marco Piciche, Guglielmo Actis Dato, Roberto Lorusso, Francesco Musumeci
INTRODUCTION: Aortic valve surgery is no exception to the general rule that history is a cycle in many fields. This manuscript aims to assist readers in transitioning from past to present and on into the future within the field of aortic valve surgery. METHODS: The existing literature has been examined, including old and modern articles published on pubmed, old articles non visible on pubmed, old and recent books on the history of medicine, looking for similarities and repetitions in techniques and surgical approaches to the aortic valve in the past and the current times...
January 31, 2018: Reviews on Recent Clinical Trials
https://www.readbyqxmd.com/read/28962508/replica-sizing-strategy-for-aortic-valve-replacement-improves-haemodynamic-outcome-of-the-epic-supra-valve
#9
David Gonzalez-Lopez, Gloria Faerber, Mahmoud Diab, Paulo Amorim, Natig Zeynalov, Torsten Doenst
OBJECTIVES: Current sizing strategies suggest valve selection based on annulus diameter despite supra-annular placement of biological prostheses potentially allowing placement of a larger size. We assessed the frequency of selecting a larger prosthesis if prosthesis size was selected using a replica (upsizing) and evaluated its impact on haemodynamics. METHODS: We analysed all discharge echocardiograms between June 2012 and June 2014, where a replica sizer was used for isolated aortic valve replacement (Epic Supra: 266 patients, Trifecta: 49 patients)...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28950312/normal-values-for-doppler-echocardiographic-assessment-of-prosthetic-valve-function-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#10
Max-Paul Winter, Martin Zbiral, Antonia Kietaibl, Patrick Sulzgruber, Johannes Kastner, Raphael Rosenhek, Thomas Binder, Irene M Lang, Georg Goliasch
Transcatheter aortic valve replacement has emerged as valuable treatment modality for patients with severe aortic stenosis and an unacceptable risk/benefit ratio for open heart surgery, but particularities specific to TAVR and a rapidly growing number of available TAVR prosthesis make post-procedural assessment of valve function challenging. Aim of the present analysis was to collect and pool all available data currently in the literature regarding normal doppler values for transcatheter prosthetic heart valves and to provide a comprehensive overview...
September 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28921052/in-vitro-evaluation-of-flow-patterns-and-turbulent-kinetic-energy-in-trans-catheter-aortic-valve-prostheses
#11
Daniel Giese, Kilian Weiss, Bettina Baeßler, Navid Madershahian, Yeong-Hoon Choi, David Maintz, Alexander C Bunck
OBJECTIVES: The objective of the current work was to evaluate flow and turbulent kinetic energy in different transcatheter aortic valve implants using highly undersampled time-resolved multi-point 3-directional phase-contrast measurements (4D Flow MRI) in an in vitro setup. MATERIALS AND METHODS: A pulsatile flow setup was used with a compliant tubing mimicking a stiff left ventricular outflow tract and ascending aorta. Five different implants were measured using a highly undersampled multi-point 4D Flow MRI sequence...
February 2018: Magma
https://www.readbyqxmd.com/read/28682324/matching-patients-with-the-ever-expanding-range-of-tavi-devices
#12
REVIEW
Brandon M Jones, Amar Krishnaswamy, E Murat Tuzcu, Stephanie Mick, Wael A Jaber, Lars G Svensson, Samir R Kapadia
Transcatheter aortic valve implantation (TAVI) has become a widely accepted strategy for the treatment of aortic stenosis in patients at intermediate, high, or prohibitive surgical risk. After >1 decade of innovation and clinical trial experience, the available technology for TAVI has grown enormously, and now includes a myriad of vascular access approaches and innovative valve designs. As a result, the range of patients who can benefit from these advances continues to grow rapidly. Furthermore, given the improved safety profile and clinical success of current-generation devices in randomized trials, the use of TAVI among even low-risk populations is justified in current trials...
October 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28674619/on-x-versus-st-jude-medical-regent-mechanical-aortic-valve-prostheses-early-haemodynamics
#13
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/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#14
REVIEW
Arash Salemi, Berhane M Worku
Transcatheter aortic valve replacement (TAVR) has become a widely accepted therapeutic option for patients with severe, symptomatic aortic stenosis at intermediate, high, or extreme risk for conventional surgery as determined through a heart team approach. Two valve prostheses are currently available and the Food and Drug Administration (FDA) approved in the United States for TAVR: the self-expandable Medtronic CoreValve (Medtronic, Inc., Minneapolis, MN, USA) and the balloon-expandable Edwards Sapien Valve (Edwards Lifesciences, Irvine CA, USA)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28454910/evaluation-of-an-aortic-valve-prosthesis-fluid-structure-interaction-or-structural-simulation
#15
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
#16
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...
July 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28317788/current-status-of-transcatheter-mitral-valve-therapy-in-europe-results-from-an-eapci-survey-part-ii
#17
Anna Sonia Petronio, Piera Capranzano, Emanuele Barbato, Nicolò Piazza, Andreas Baumbach, Michael Haude, Stephan Windecker
AIMS: The European Association of Percutaneous Coronary Interventions (EAPCI) assessed the current status of transcatheter valve therapy in Europe through a web-based survey. Our aim here was to report the results of that survey regarding trends in percutaneous mitral valve repair (PMVR) therapy. METHODS AND RESULTS: Among 301 European centres participating in the overall EAPCI survey, 246 (81.7%) responded to the PMVR section questions. A total of 176 (71.5%) have been undertaking a PMVR programme...
March 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/27943176/rationale-and-design-of-the-edwards-sapien-3-periprosthetic-leakage-evaluation-versus-medtronic-corevalve-in-transfemoral-aortic-valve-implantation-elect-trial-a%C3%A2-randomised-comparison-of-balloon-expandable-versus-self-expanding-transcatheter-aortic-valve-prostheses
#18
M Abawi, P Agostoni, N H M Kooistra, M Samim, F Nijhoff, M Voskuil, H Nathoe, P A Doevendans, S A Chamuleau, K Urgel, J Hendrikse, T Leiner, A C Abrahams, B van der Worp, P R Stella
BACKGROUND AND OBJECTIVES: Periprosthetic aortic regurgitation (PPR) after transcatheter aortic valve implantation (TAVI) remains an important issue associated with impaired long-term outcomes. The current randomised study aims to evaluate potential differences between the balloon-expandable Edwards SAPIEN-3 and the self-expanding Medtronic CoreValve system with the main focus on post-TAVI PPR by means of novel imaging endpoints, and an additional focus on other clinical endpoints. ENDPOINTS: The primary endpoint of this study is quantitative assessment of the severity of post-procedural PPR using cardiac magnetic resonance imaging...
May 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27939031/early-hemodynamics-and-clinical-outcomes-of-isolated-aortic-valve-replacement-with-stentless-or-transcatheter-valve-in-intermediate-risk-patients
#19
Alberto Repossini, Lorenzo Di Bacco, Bruno Passaretti, Herko Grubitzsch, Christina Schäfer, Benjamin Claus, Laura Giroletti, Thierry Folliguet, Gianluigi Bisleri, Theodor Fischlein, Giuseppe Santarpino, Roberto Di Bartolomeo, François Laborde, Claudio Muneretto
OBJECTIVE: Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. The aim of the current multi-institutional study was to compare hemodynamics of transcatheter (TAVR) and the Freedom SOLO Stentless (FS) valve in an intermediate risk population undergoing surgical aortic valve replacement. METHODS: From 2010 to 2014, 420 consecutive patients underwent isolated surgical aortic valve replacement with FS and 375 patients underwent TAVR...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27798318/comparing-usual-care-with-a-warfarin-initiation-protocol-after-mechanical-heart-valve-replacement
#20
COMPARATIVE STUDY
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...
March 2017: Annals of Pharmacotherapy
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