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Aortic annular calcification

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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
#1
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 analyzed 280 patients (LVOT-CA=144, no LVOT-CA=136) undergoing S3-TAVR...
January 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#2
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
#3
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...
January 20, 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
#4
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
#5
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...
December 30, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28028747/non-occlusive-mesenteric-ischemia-accompanied-by-aortic-regurgitation-after-transcatheter-aortic-valve-implantation
#6
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
#7
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...
November 16, 2016: 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/27772601/implantation-of-transcatheter-aortic-prosthesis-in-3-patients-with-mitral-annular-calcification
#11
Heike Baumgarten, John J Squiers, William T Brinkman, J Michael DiMaio, Ambarish Gopal, Michael J Mack, Robert L Smith
Mitral annular calcification (MAC) is a chronic degenerative process at the fibrous base of the mitral valve. It is a feared diagnosis in the context of mitral valve operations because of the risk of severe adverse events such as atrioventricular disruption, injury to the circumflex artery during debridement, and difficult placement of annular sutures. We report a series of 3 consecutive female patients with severe circular MAC who underwent successful mitral valve replacement through a lateral minithoracotomy with use of an inverted transcatheter aortic valve...
November 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27744044/pushing-the-limits-in-transcatheter-aortic-valve-replacement-high-volume-center-s-effect-overconfidence-or%C3%A2-something%C3%A2-else
#12
Francesco Nappi, Cristiano Spadaccio, Jean Louis Sablayrolles
The recent literature on transcatheter aortic valve replacement (TAVR) is shedding new light on the perspective to extend this procedure to other lower risk-category of patients, leading in fact to a potential erosion of the current guidelines. Notwithstanding the warnings provided in the literature regarding the risk of severely impairing complications, unclear survival advantage and cost-inefficiency, many observational studies, especially performed in high-volume centers, support a general drive toward the recruitment of intermediate-low risk patients in the expectation of clinical advantages versus standard surgical replacement...
October 6, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27739165/transcatheter-aortic-valve-implantation-with-the-direct-flow-medical-prosthesis-impact-of-native-aortic-valve-calcification-degree-on-outcomes
#13
Giuseppe D'Ancona, Hüseyin U Agma, Hüseyin Ince, Gihan El-Achkar, Martin Dißmann, Jasmin Ortak, Stephan Kische
OBJECTIVES: We present our single center experience with the direct flow medical (DFM) prosthesis addressing the impact of native aortic valve (AV) calcification degree on outcomes. BACKGROUND: The DFM® has been introduced for transcatheter aortic valve implantation (TAVI). The valve has a nonmetallic and inflatable support structure. METHODS: Patients were divided in two groups according to preoperative cardiac computed tomography (CT): group I moderate calcification and group II heavy calcification of the total AV area...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27678337/surgical-antegrade-transcatheter-mitral-valve-implantation-for-symptomatic-mitral-valve-disease-and-heavily-calcified-annulus
#14
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27612848/paravalvular-leak-after-transcatheter-aortic-valve-implantation-is-it-anatomically-predictable-or-procedurally-determined-mdct-study
#15
A A Sakrana, M M Nasr, G A Ashamallah, R A Abuelatta, H A Naeim, M E Tahlawi
AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO)...
November 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27567138/mitral-annular-calcium-and-mitral-stenosis-determined-by-multidetector-computed-tomography-in-patients-referred-for-aortic-stenosis
#16
Simon Mejean, Erik Bouvier, Vincent Bataille, Patrick Seknadji, Dominique Fourchy, Jean-Yves Tabet, Olivier Lairez, Bertrand Cormier
Mitral annular calcium (MAC) is a common finding in older patients referred for transcatheter aortic valve implantation (TAVI). Multidetector computed tomography (MDCT) allows fine quantification of the calcific deposits. Our objective was to estimate the prevalence of MAC and associated mitral stenosis (MS) in patients referred for TAVI using MDCT. A cohort of 346 consecutive patients referred for TAVI evaluation was screened by MDCT for MAC: 174 had MAC (50%). Of these patients, 165 patients (95%) had mitral valve area (MVA) assessable by MDCT planimetry (age 83...
October 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27521222/relation-between-epicardial-adipose-and-aortic-valve-and-mitral-annular-calcium-determined-by-computed-tomography-in-subjects-aged-%C3%A2-65%C3%A2-years
#17
Talal S Alnabelsi, Yaser Alhamshari, Ramzi H Mulki, Jose N Codolosa, Nikoloz Koshkelashvili, Igor Goykhman, Gregg S Pressman, Abel Romero-Corral
Epicardial adipose tissue (EAT) has been linked to coronary artery calcium deposits and atherosclerotic disease. Mitral annular (MAC) and aortic valve calcium (AVC) have also been associated with atherosclerosis. This study examined the possible relation between EAT thickness and valvular calcium deposits. We included 294 patients aged ≥65 years who had noncontrast computed tomography scans of the chest. Mean age was 76 ± 7 years; 47% were men. Using reconstructed images, EAT thickness was measured at various locations...
October 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27491611/mitral-regurgitation-after-transcatheter%C3%A2-aortic%C3%A2-valve-replacement-prognosis-imaging-predictors-and-potential-management
#18
Carlos Cortés, Ignacio J Amat-Santos, Luis Nombela-Franco, Antonio J Muñoz-Garcia, Enrique Gutiérrez-Ibanes, José M De La Torre Hernandez, Juan G Córdoba-Soriano, Pilar Jimenez-Quevedo, José M Hernández-García, Ana Gonzalez-Mansilla, Javier Ruano, Jesús Jimenez-Mazuecos, Javier Castrodeza, Javier Tobar, Fabian Islas, Ana Revilla, Rishi Puri, Ana Puerto, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: This study sought to analyze the clinical impact of the degree and improvement of mitral regurgitation in TAVR recipients, validate the main imaging determinants of this improvement, and assess the potential candidates for double valve repair with percutaneous techniques. BACKGROUND: Many patients with severe aortic stenosis present with concomitant mitral regurgitation (MR). Cardiac imaging plays a key role in identifying prognostic factors of MR persistence after transcatheter aortic valve replacement (TAVR) and for planning its treatment...
August 8, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27440021/-minimally-invasive-aortic-valve-replacement-via-right-mini-thoracotomy
#19
Toshinori Totsugawa
Here we demonstrate our surgical procedure of minimally invasive aortic valve replacement through right anterolateral mini-thoracotomy. Preoperative evaluation of the whole aorta by contrast-enhanced computed tomography scan is important to prevent cerebrovascular complications. The patient is set in a mild left lateral decubitus position. A skin incision is made along the anterior axillary line to the inframammary fold and the chest is opened at the 3rd or 4th intercostal space. Cardiopulmonary bypass is usually established by femoro-femoral bypass...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27412343/subannular-perforation-of-left-ventricular-outflow-tract-associated-with-transcatheter-valve-implantation-pathophysiological-background-and-clinical-implications
#20
Evaldas Girdauskas, Tamer Owais, Beatrix Fey, Florian Kuntze, Bernward Lauer, Michael A Borger, Lenard Conradi, Hermann Reichenspurner, Thomas Kuntze
OBJECTIVES: Perforation of the subannular left ventricular outflow tract (LVOT) represents an uncommon but almost invariably fatal transcatheter aortic valve implantation (TAVI)-associated complication. The risk factors to predict the occurrence of this devastating complication, particularly in relation to specific LVOT anatomy, have not yet been systematically analysed. We aimed to evaluate the pathophysiological background and possible risk factors for the occurrence of subannular LVOT perforation...
January 2017: European Journal of Cardio-thoracic Surgery
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