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Aortic annular calcification

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https://www.readbyqxmd.com/read/28886071/dynamics-of-the-aortic-annulus-in-4d-ct-angiography-for-transcatheter-aortic-valve-implantation-patients
#1
Mustafa A Elattar, Leon W Vink, Martijn S van Mourik, Jan Baan, Ed T vanBavel, R Nils Planken, Henk A Marquering
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a well-established treatment for patients with severe aortic valve stenosis. This procedure requires pre-operative planning by assessment of aortic dimensions on CT Angiography (CTA). It is well-known that the aortic root dimensions vary over the heart cycle. However, sizing is commonly performed at either mid-systole or end-diastole only, which has resulted in an inadequate understanding of its full dynamic behavior. STUDY GOAL: We studied the variation in annulus measurements during the cardiac cycle and determined if this variation is dependent on the amount of calcification at the annulus...
2017: PloS One
https://www.readbyqxmd.com/read/28799113/angles-between-the-aortic-root-and-the-left-ventricle-assessed-by-mdct-are-associated-with-the-risk-of-aortic-regurgitation-after-transcatheter-aortic-valve-replacement
#2
Vincent Roule, Alexandre Placente, Rémi Sabatier, Mathieu Bignon, Vladimir Saplacan, Calin Ivascau, Paul Milliez, Farzin Beygui
OBJECTIVES: To evaluate the impact of the angles quantified by multidetector computed tomography (MDCT) between the ascending aorta's long axis and, the left ventricular inflow long axis (LVLA), or the left ventricule outflow tract long axis, and the occurrence of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR). METHODS: We prospectively included 136 consecutive patients who underwent a transfemoral TAVR with a preoperative MDCT. The groups were defined according to AR <2 or ≥2 assessed by echocardiography at 1 month...
August 10, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28760473/transapical-mitral-valve-implantation-for-native-mitral-valve-stenosis-using-a-balloon-expandable-prosthesis
#3
Philipp Kiefer, Thilo Noack, Joerg Seeburger, Alexandro Hoyer, Axel Linke, Norman Mangner, Lukas Lehmkuhl, Friedrich Wilhelm Mohr, David Holzhey
BACKGROUND: Transcatheter mitral valve implantation (TMVI) is still in its infancy and is mainly limited to valve-in-valve or valve-in-ring implantations. We present the early experience with TMVI for severe calcified native MV stenosis. METHODS: Between January 2014 and June 2015, 6 of 11 patients screened (mean age, 77.4 ± 6.3 years; 66% men) with severe native mitral valve (MV) stenosis (mean gradient [Pmean], 11.1 ± 2.1 mm Hg; mean effective orifice area [EOA], 0...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28646403/routine-ct-angiography-to-detect-severe-coronary-artery-disease-prior-to-transcatheter-aortic-valve-replacement
#4
S Chava, G Gentchos, A Abernethy, B Leavitt, E Terrien, H L Dauerman
Patients undergoing TAVR undergo routine CT angiography (CTA) to assess aorto-iliac pathology and annular dimensions. While coronary CTA may exclude severe CAD in younger patients, its efficacy in defining CAD severity prior to TAVR may be limited. We retrospectively studied 50 consecutive patients undergoing both invasive coronary angiography (ICA) and routine pre-TAVR CTA. Severe CAD was defined as ≥50% stenosis by quantitative coronary angiography and compared to a blinded CTA visual estimation of ≥50% stenosis...
August 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28583687/relation-of-serum-vitamin-d-to-risk-of-mitral-annular-and-aortic-valve-calcium-from-the-multi-ethnic-study-of-atherosclerosis
#5
MULTICENTER STUDY
Martin Tibuakuu, Di Zhao, Ian H de Boer, Eliseo Guallar, Anna E Bortnick, Pamela L Lutsey, Matthew J Budoff, Jorge R Kizer, Bryan R Kestenbaum, Erin D Michos
Serum 25-hydroxyvitamin D [25(OH)D] concentration has been identified as a possible modifiable risk factor for cardiovascular disease (CVD). We hypothesized that serum 25(OH)D concentration would be associated with calcifications of the left-sided heart valves, which are markers of CVD risk. Aortic valve calcium (AVC) and mitral annular calcium (MAC) were quantified from cardiac computed tomography scans performed on 5,530 Multi-Ethnic Study of Atherosclerosis participants at the baseline examination (2000 to 2002) and at a follow-up visit at either Examination 2 (2002 to 2004) or Examination 3 (2004 to 2005)...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28560501/relationship-of-bone-mineral-density-with-valvular-and-annular-calcification-in-community-dwelling-older-people-the-cardiovascular-health-study
#6
Daniele Massera, Shuo Xu, Traci M Bartz, Anna E Bortnick, Joachim H Ix, Michel Chonchol, David S Owens, Eddy Barasch, Julius M Gardin, John S Gottdiener, John R Robbins, David S Siscovick, Jorge R Kizer
Associations between bone mineral density and aortic valvular, aortic annular, and mitral annular calcification were investigated in a cross-sectional analysis of a population-based cohort of 1497 older adults. Although there was no association between continuous bone mineral density and outcomes, a significant association between osteoporosis and aortic valvular calcification in men was found. INTRODUCTION: The process of cardiac calcification bears a resemblance to skeletal bone metabolism and its regulation...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#7
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/28471092/anatomical-risk-models-for-paravalvular-leak-and-landing-zone-complications-for-balloon-expandable-transcatheter-aortic-valve-replacement
#8
Jose F Condado, Frank E Corrigan, Stamatios Lerakis, Ioannis Parastatidis, Arthur E Stillman, Jose N Binongo, James Stewart, Kreton Mavromatis, Chandan Devireddy, Bradley Leshnower, Robert Guyton, Jessica Forcillo, Ateet Patel, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
BACKGROUND: Though several anatomical characteristics have been reported separately as risk factors for paravalvular leak (PVL) and landing zone (LZ) complications after transcatheter aortic valve replacement (TAVR), multivariate risk models are needed. METHODS: Patients that underwent balloon-expandable TAVR with multidetector cardiac computed tomography (MDCT) sizing were studied. MDCT images were analyzed and the association between anatomical factors and ≥mild PVL, ≥moderate PVL, and LZ complications (annular rupture, requirement of new permanent pacemaker, and coronary obstruction) was determined, and subsequently competing predictive models were developed and validated...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28444177/single-centre-experience-with-transapical-transcatheter-mitral-valve-implantation%C3%A2
#9
Gry Dahle, Kjell-Arne Rein, Arnt E Fiane
OBJECTIVES: A transcatheter heart valve technique can be used in failed mitral valve repairs with annuloplasty rings, deterioriated bioprostheses and in mitral annular calcification, all serving as 'docking stations' for balloon-expandable valves. Specially designed transcatheter mitral valve platforms are used in ongoing studies for native mitral valve regurgitation. We present our single centre experience with transcatheter mitral valve implantation-transapical approach procedures in eleven patients...
April 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28407126/mitral-valve-replacement-in-severely-calcified-mitral-valve-annulus-a-10-year-experience
#10
Kareem Salhiyyah, Hassan Kattach, Ahmed Ashoub, Diana Patrick, Szabolcs Miskolczi, Geoffrey Tsang, Sunil K Ohri, Clifford W Barlow, Theodore Velissaris, Steve Livesey
OBJECTIVES: Severe calcification in the mitral valve annulus is a challenging problem during mitral valve surgery. We describe our experience with mitral valve replacement in severely calcified mitral valve without decalcification of the annulus. METHODS: Between April 2001 and July 2011, 61 patients underwent mitral valve replacement with severe mitral annulus calcification without decalcification of the annulus. This retrospective study was performed to assess the surgical and the long-term postoperative outcomes in this group...
September 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28117281/optimal-sizing-for-sapien-3-transcatheter-aortic-valve-replacement-in-patients-with-or-without-left-ventricular-outflow-tract-calcification
#11
Yoshio Maeno, Yigal Abramowitz, Hasan Jilaihawi, Sharjeel Israr, Sunghan Yoon, Rahul P Sharma, Yoshio Kazuno, Hiroyuki Kawamori, Masaki Miyasaka, Tanya Rami, Geeteshwar Mangat, Nobuyuki Takahashi, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Raj R Makkar
AIMS: The impact of left ventricular outflow tract calcification (LVOT-CA) on SAPIEN 3 transcatheter aortic valve replacement (S3-TAVR) is not well understood. The aims of the present study were to determine optimal device sizing for S3-TAVR in patients with or without LVOT-CA and to evaluate the influence of residual paravalvular leak (PVL) on survival after S3-TAVR in these patients. METHODS AND RESULTS: This study analysed 280 patients (LVOT-CA=144, no LVOT-CA=136) undergoing S3-TAVR...
April 7, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#12
EDITORIAL
James M McCabe, Larry S Dean
Increasing annular calcification portends more adverse outcomes and worse hemodynamic results following percutaneous structural heart interventions. Though the Direct Flow prosthesis did not appear to have significantly different post-procedural gradients based on aortic valve calcium burden in a selected group of patients, the average residual gradients were relatively high in all cases and the presence of a paravalvular leak was more common with increasing valvular calcification. It is unclear how the Direct Flow prosthesis fits into the armamentarium of TAVR prostheses...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28108576/dual-source-computed-tomography-based-analysis-of-stent-performance-its-association-with-valvular-calcification-and-residual-aortic-regurgitation-after-implantation-of-a-balloon-expandable-transcatheter-heart-valve
#13
Julius Gerstmeyer, Maximilian Kütting, Buntaro Fujita, Annika Schuhbäck, Martin Arnold, Jochen Börgermann, Stephan Achenbach, Ulrich Steinseifer, Jan Gummert, Stephan Ensminger
Objectives: The aim of this study was to investigate the mutual influence of valvular calcifications and transcatheter aortic valve stent geometry during and after implantation of a balloon-expandable SAPIEN ® /SAPIEN XT ® prostheses. Aortic valve calcification has been linked with adverse complications after transcatheter aortic valve implantation (TAVI). However, little is known about the fate of the calcifications after TAVI as well as its influence on transcatheter heart valve geometry...
April 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28100877/transcatheter-aortic-valve-implantation-with-different-valve-designs-for-severe-device-landing-zone-calcification
#14
COMPARATIVE STUDY
Yoshio Maeno, Yigal Abramowitz, Yoshio Kazuno, Hiroyuki Kawamori, Geeteshwar Mangat, Nobuyuki Takahashi, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Hasan Jilaihawi, Raj R Makkar
Severe device landing zone calcification (DLZ-CA) predicted paravalvular leak (PVL) and post-dilatation (PD) after transcatheter aortic valve implantation (TAVI). The aim of this study was to determine the influence of DLZ-CA on PVL or PD rates after SAPIEN XT (XT) versus CoreValve (CV).We analyzed patients undergoing TAVI who had severe DLZ-CA. Severe DLZ-CA defined the upper left ventricular outflow tract calcification; the cross-sectional region 2 mm inferior to the annular plane. PVL was evaluated at 30days using transthoracic echocardiography...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28039339/concomitant-mitral-annular-calcification-and-severe-aortic-stenosis-prevalence-characteristics-and-outcome-following-transcatheter-aortic-valve-replacement
#15
Yigal Abramowitz, Yoshio Kazuno, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, David Anderson, Zev Allison, Geeteshwar Mangat, Wen Cheng, Ambarish Gopal, Hasan Jilaihawi, Michael J Mack, Raj R Makkar
Aims: Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have certain similar etiology and pathophysiological mechanisms. MAC is frequently encountered in pre-procedural computed tomography (CT) imaging of patients that undergo transcatheter aortic valve replacement (TAVR), but its prognostic implications for these patients have not been thoroughly investigated. This study sought to evaluate the prevalence of MAC among patients with severe AS and to assess the clinical implications of MAC on these patients during and following TAVR...
April 21, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28028747/non-occlusive-mesenteric-ischemia-accompanied-by-aortic-regurgitation-after-transcatheter-aortic-valve-implantation
#16
Kentaro Meguro, Junro Ishizaki, Tomoyoshi Yanagisawa, Toshimi Koitabashi, Tadashi Kitamura, Junya Ako
An 81-year-old male with severe symptomatic aortic stenosis with ventricular tachycardia was referred for treatment. Balloon aortic valvuloplasty was performed under cardiopulmonary resuscitation. Though transcatheter aortic valve implantation (TAVI) was considered high risk for annulus rupture and aortic regurgitation due to annular calcification, TAVI was performed because of extremely high surgical risk. Moderate-to-severe aortic regurgitation (AR) remained and progression of acidosis could not be managed with continuous hemodiafiltration...
December 27, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28010874/predictors-of-paravalvular-regurgitation-after-transcatheter-aortic-valve-implantation-for-aortic-stenosis-using-new-generation-balloon-expandable-sapien-3
#17
Hidehiro Kaneko, Frank Hoelschermann, Grit Tambor, Sung-Han Yoon, Michael Neuss, Christian Butter
Paravalvular regurgitation (PVR) is a common and serious complication after transcatheter aortic valve implantation (TAVI). New-generation balloon-expandable SAPIEN 3 has an outer sealing skirt to minimize PVR. However, the predictors of PVR after SAPIEN 3 transcatheter heart valve (THV) implantation have not been well investigated. We sought to clarify the determinants of PVR after TAVI using SAPIEN 3 with quantitative multidetector computed tomography (MDCT) assessment. This study analyzed 281 patients with severe symptomatic aortic stenosis who underwent TAVI using SAPIEN 3...
February 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28009942/morphological-characteristics-and-calcification-of-the-native-aortic-valve-and-the-relation-to-significant-aortic-regurgitation-after-corevalve-tavi
#18
Bart Bosmans, Valérie Collas, Eva Verhoelst, Bernard Paelinck, Jos Vander Sloten, Johan Bosmans
BACKGROUND: Aortic regurgitation (AR) is a frequent and life-limiting complication after transcatheter aortic valve implantation (TAVI). The study aim was to relate post-TAVI AR, using a self-expandable stent, to detailed baseline anatomical and morphological characteristics of the native aortic valve. METHODS: A total of 82 patients (40 males, 42 females; mean age 80 ± 7 years) who received a Medtronic CoreValve implant was included. Aortic root morphology, aortic annulus and implant size mismatch, implant position, extent of aortic annulus and leaflet calcification, the connected sub-annular calcification volume, and their distribution were quantified based on computed tomography scan analysis...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009941/evaluation-of-aortic-paravalvular-leak-a-special-reference-for-anatomical-localization
#19
Mustafa Ozan Gürsoy, Macit Kalçık, Mehmet Özkan, Mehmet Ali Astarcıoğlu, Süleyman Karakoyun, Sabahattin Gündüz, Tayyar Gökdeniz, Mahmut Yesin, Mehmet Altuğ Tuncer, Cengiz Köksal
BACKGROUND: Paravalvular leakage (PVL) remains an unavoidable complication of heart valve surgery and in its severe forms may lead to heart failure and hemolysis. The study aim was to evaluate the echocardiographic, clinical, surgical and laboratory characteristics of patients with aortic PVL. METHODS: A total of 77 aortic PVL patients underwent transthoracic and transesophageal echocardiography examinations. Clinical, echocardiographical and surgical findings were also recorded...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989039/patho-histological-findings-of-annular-rupture-related-to-left-ventricular-outflow-tract-lvot-calcification-following-transcatheter-aortic-valve-replacement-tavr
#20
Ankur Kalra, Wesley R Pedersen, Shannon M Mackey-Bojack, Emily R Duncanson, Kevin M Harris
Peri-aortic hematoma has been recently described as a potentially life-threatening complication following transcatheter aortic valve replacement (TAVR). Patient- and procedure-related factors exist that predispose to peri-aortic hematoma formation, which can progress to myocardial rupture at the aortic root-myocardial junction. While conservative therapy with blood pressure control is the expectant management following peri-aortic hematoma formation, myocardial rupture can occur at the site of the aortic annulus...
May 2016: Journal of Heart Valve Disease
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