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Aortic annular calcification

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https://www.readbyqxmd.com/read/29627180/transatrial-implantation-of-a-transcatheter-heart-valve-for-severe-mitral-annular-calcification
#1
Fabien Praz, Omar K Khalique, Raymond Lee, Ramesh Veeragandham, Hyde Russell, Mayra Guerrero, Ashequl M Islam, David W Deaton, Tsuyoshi Kaneko, Susheel K Kodali, Martin B Leon, Vinayak Bapat, Hiroo Takayama, Michael A Borger, Isaac George
OBJECTIVE: To assess the outcomes of transatrial implantation of a transcatheter heart valve (THV) for the treatment of mitral valve disease with severe mitral annular calcification (MAC). METHODS: Implantation of a balloon-expandable THV was performed on cardiopulmonary bypass via left atrial exposure in patients considered at risk for left ventricular outflow tract obstruction. The anterior mitral valve leaflet was systematically resected and pledgeted sutures were placed to enhance stability and reduce paravalvular leak...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29626454/-twin-icicle-calcifications-cause-aortic-annular-rupture
#2
Masato Tochii, Takashi Muramatsu, Kentaro Amano, Masato Ishikawa, Naoki Hoshino, Meiko Miyagi, Akira Yamada, Yoshiyuki Takami, Yukio Ozaki, Yasushi Takagi
Aortic annular rupture is a most fatal complication after transcatheter aortic valve implantation with high mortality. While it is quite rare and difficult to identify the mechanisms and predictors, prosthesis over-sizing and massive calcification of aortic annulus are thought to be a potential risk of this complication. A case presented here is an aortic annular rupture after transcatheter aortic valve implantation. Although there was no valve over-sizing, there were two severe calcifications of aortic annulus at nearby areas like "twin icicles", thought to be a trigger of this fatal complication...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29610444/hemodynamic-effects-of-valve-asymmetry-in-sapien-3-transcatheter-aortic-valves
#3
Daniel R Mangels, Mary Siki, Rohan Menon, Joseph Bavaria, Saif Anwaruddin, Jay Giri, Nimesh Desai, Wilson Y Szeto, Prashanth Vallabhajosyula, Howard C Herrmann
BACKGROUND: Eccentric valve deployment after transcatheter aortic valve replacement (TAVR) has been associated with abnormal leaflet shear stresses that may accelerate structural valve deterioration (SVD). This phenomenon has not been studied in patients receiving Sapien 3 prostheses (Edwards Lifesciences). METHODS: A retrospective cohort analysis of 100 patients who received Sapien 3 valves between 2013 and 2015 at a single institution was performed. Axial fluoroscopic images from the co-planar view were used to assess TAVR asymmetry, which was defined as a ratio of left-to-right valve heights ≤0...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29605597/hybrid-open-minimally-invasive-transcatheter-mitral-valve-replacement
#4
Sivan G Marcus, Vaikom S Mahadevan, Tobias Deuse
We describe a hybrid surgical-interventional technique for minimally-invasive implantation of a transcatheter aortic valve in the mitral position. This technique does not require circular mitral annular calcification and minimizes the risk for left ventricular outflow tract obstruction. We believe this technique represents a useful approach for surgeons and interventional cardiologists until specialized transcatheter mitral valve devices become available.
March 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29488887/novel-predictors-of-mild-paravalvular-aortic-regurgitation-in-sapien-3-transcatheter-aortic-valve-implantation
#5
Gilbert H L Tang, Syed Zaid, Samuel R Schnittman, Hasan Ahmad, Ryan Kaple, Cenap Undemir, Tanya Dutta, Angelica Poniros, Joanne Bennett, Cheng Feng, Martin Cohen, Steven L Lansman
AIMS: Paravalvular leak(PVL) remains an important issue in TAVI. The Edwards Sapien3(S3) valve has reduced PVL but up to one-third of patients remain with mild leak. Our study aims to identify predictors of mild PVL after TAVI with S3 valve. METHODS AND RESULTS: From 10/2015 to 5/2017, 122 consecutive patients underwent S3 TAVI for symptomatic severe aortic stenosis. 33 patients with mild PVL on transthoracic echocardiography at 30-day follow-up were compared to 89 with none/trace PVL...
February 27, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29481787/a-calcified-amorphous-tumor-originating-in-the-aortic-valve-cusp
#6
Mio Kasai, Motohiko Osako, Tomoyuki Tanino, Arafumi Maeshima
Calcified amorphous tumor (CAT) of the heart is a rare non-neoplastic cardiac tumor. The clinical features of cardiac CATs resemble those of other cardiac tumors that include symptoms related to obstruction or embolization. Cardiac CATs have been found in all chambers of the heart, but predominantly present in the left ventricle, mitral annulus, and mitral valve. Here we report an extremely rare case of CAT originating in the aortic valve cusp, which may be related to aortic annular calcification and aortic valve stenosis...
February 23, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29404354/outcomes-following-transcatheter-aortic-valve-replacement-in-patients-with-native-aortic-valve-regurgitation
#7
REVIEW
Tamunoinemi Bob-Manuel, Siri Kadire, Mark R Heckle, Jiajing Wang, Uzoma N Ibebuogu
Due to the absence of annular calcification for device anchoring, it is presumed that transcatheter aortic valve replacement (TAVR) is not suitable for the treatment of native aortic valve regurgitation (NAVR) resulting in very limited data and experience concerning its safety and efficacy. We sought to review published data on the safety and efficacy of TAVR in high-risk patients with NAVR. Studies including case reports, case series and original articles published between 2002 and 2016 on TAVR in patients with NAVR were identified with a systematic electronic search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29391929/transcatheter-aortic-valve-replacement-in-membranous-interventricular-septum-aneurysm-with-left-ventricular-outflow-tract-extension
#8
Sandeep Banga, Marco A Barzallo, Casey L Nighswonger, Sudhir Mungee
We report a challenging case of a 81-year-old male with history of severe calcific aortic valve stenosis and aneurysmal membranous interventricular septum. The presence of anomalies in the sub-annular area can lead to valve malpositioning and its consequences. transcatheter aortic valve implantation (TAVR) in patients with aneurysm of the perimembranous interventricular septum extending into the left ventricular outflow tract has not been previously reported. This case describes a successful transfemoral TAVR with an Edwards SAPIEN XT valve (Edwards Lifesciences, Irvine, CA, United States) with such anomaly...
January 26, 2018: World Journal of Cardiology
https://www.readbyqxmd.com/read/29273323/durability-of-aortic-valve-cusp-repair-with-and-without-annular-support
#9
Ahmad Zeeshan, Jay J Idrees, Douglas R Johnston, Jeevanantham Rajeswaran, Eric E Roselli, Edward G Soltesz, A Marc Gillinov, Brian Griffin, Richard Grimm, Donald F Hammer, Gösta B Pettersson, Eugene H Blackstone, Joseph F Sabik, Lars G Svensson
BACKGROUND: To determine the value of aortic valve repair rather than replacement for valve dysfunction, we assessed late outcomes of various repair techniques in the contemporary era. METHODS: From January 2001 to January 2011, aortic valve repair was planned in 1,124 patients. Techniques involved commissural figure-of-8 suspension sutures (n = 63 [6.2%]), cusp repair with commissuroplasty (n = 481 [48%]), debridement (n = 174 [17%]), free-margin plication (n = 271 [27%]) or resection (n = 75) or both, or annulus repair with resuspension (n = 230 [23%]), root reimplantation (n = 252 [25%]), or remodeling (n = 35 [3...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29174290/associations-of-mitral-and-aortic-valve-calcifications-with-complex-aortic-atheroma-in-patients-with-embolic-stroke-of-undetermined-source
#10
Kentaro Ishizuka, Takao Hoshino, Kyomi Ashihara, Kenji Mruyama, Sono Toi, Satoko Mizuno, Yuka Shirai, Nobuhisa Hagiwara, Kazuo Kitagawa
BACKGROUND: This study investigated the associations of mitral and aortic valve calcification with complex aortic atheroma among patients with embolic stroke of undetermined source. METHODS: We included 52 consecutive patients (mean age 58.1 years; 75.0% male) with embolic stroke of undetermined source. Mitral annular calcification, aortic annular calcification, and aortic valve sclerosis were assessed by transthoracic echocardiography. Complex aortic atheroma was assessed by transesophageal echocardiography and was defined as plaque protruding greater than or equal to 4 mm into the lumen or with ulcerated or mobile components...
March 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29168986/skin-aging-parameters-a-window-to-heart-block
#11
Hisham Samir Roshdy, Mohammad Hassan Soliman, Ibtesam Ibrahim El-Dosouky, Soheir Ghonemy
BACKGROUND: Skin acts as a mirror to the internal state of the body. HYPOTHESIS: We tried to find the relation between skin aging parameters and the incidence of degenerative AV block. METHODS: This study included 97 patients divided into 2 groups; group D comprised 49 patients with advanced-degree AV block, and group C comprised the 48 matched control group. All were subjected to full history taking, thorough clinical examination, calculation of intrinsic skin aging score, and resting 12-lead surface electrocardiography (ECG)...
November 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29106835/impact-of-mitral-annular-calcium-on-outcomes-after-transcatheter-aortic-valve-implantation
#12
Marco B Ancona, Francesco Giannini, Antonio Mangieri, Damiano Regazzoli, Richard J Jabbour, Akihito Tanaka, Luca Testa, Vittorio Romano, Matteo Longoni, Manuela Giglio, Francesca Besana, Michele Cacucci, Eustachio Agricola, Alaide Chieffo, Ottavio Alfieri, Matteo Montorfano, Antonio Colombo, Azeem Latib
A high prevalence of mitral annular calcium (MAC) is expected in patients undergoing transcatheter aortic valve implantation (TAVI); however, data regarding the prevalence of MAC and impact on risk of cardiovascular events are lacking. To determine the prevalence of MAC and its association with clinical outcomes in patients undergoing TAVI, we retrospectively analyzed 424 patients who underwent transfemoral TAVI from 2007 to 2015 and whose preoperative computed tomography images were available for assessment of MAC...
December 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29105964/simultaneous-transcatheter-transfemoral-aortic-and-transeptal-mitral-valve-replacement-using-edward-sapien-s3
#13
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29049564/a-new-technique-to-implant-a-transcatheter-inflatable-fully-repositionable-prosthesis-in-aortic-stenosis-with-severe-asymmetric-calcification
#14
Hasan Bushnaq, Christoph Raspé, Alper Öner, Seyrani Yücel, Hüseyin Ince, Sebastian-Patrick Sommer
OBJECTIVES: In contrast to stented transcatheter aortic valves, the Direct Flow Medical (DFM) valve is a stentless bovine aortic bioprosthesis mounted in a non-metallic inflatable frame. Hence, severe asymmetric annular calcification may result in residually elevated transaortic pressure gradients after DFM implantation. We present a novel intraprocedural dilatation (IDIL) technique for successful implantation of the DFM valve in the presence of complex annular calcification. METHODS: Between January 2014 and May 2015, 55 patients underwent DFM valve-based transcatheter aortic valve implantation at our institution...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29019612/unveiling-transthyretin-cardiac-amyloidosis-and-its-predictors-among-elderly-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#15
Adam Castaño, David L Narotsky, Nadira Hamid, Omar K Khalique, Rachelle Morgenstern, Albert DeLuca, Jonah Rubin, Codruta Chiuzan, Tamim Nazif, Torsten Vahl, Isaac George, Susheel Kodali, Martin B Leon, Rebecca Hahn, Sabahat Bokhari, Mathew S Maurer
Aims: Transthyretin cardiac amyloidosis (ATTR-CA) has been reported in patients with aortic stenosis (AS) but its prevalence and phenotype are not known. We examine elderly patients with severe symptomatic AS undergoing transcatheter aortic valve replacement (TAVR) and determine the prevalence and phenotype of ATTR-CA non-invasively. Methods and results: We performed technetium-99m pyrophosphate (99mTc-PYP) cardiac scintigraphy prospectively on patients who underwent TAVR, to screen for ATTR-CA...
October 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28982557/transcatheter-aortic-valves-for-failing%C3%A2-surgical-mitral-prostheses-and%C3%A2-mitral-annular-calcification-good-from-far-but-far-from-good
#16
EDITORIAL
Nicolo Piazza, Michele Pighi, Giuseppe Martucci
No abstract text is available yet for this article.
October 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28886071/dynamics-of-the-aortic-annulus-in-4d-ct-angiography-for-transcatheter-aortic-valve-implantation-patients
#17
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
#18
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...
January 2018: Heart and Vessels
https://www.readbyqxmd.com/read/28760473/transapical-mitral-valve-implantation-for-native-mitral-valve-stenosis-using-a-balloon-expandable-prosthesis
#19
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...
December 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
#20
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
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