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Transaortic valve replacement

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https://www.readbyqxmd.com/read/28797414/lower-transaortic-flow-rate-is-associated-with-increased-mortality-in-aortic-valve%C3%A2-stenosis
#1
Sahrai Saeed, Roxy Senior, Navtej S Chahal, Mai Tone Lønnebakken, John B Chambers, Edda Bahlmann, Eva Gerdts
OBJECTIVES: The association of transaortic flow rate (FR) with outcomes was tested in 1,661 patients with aortic valve stenosis (AS) in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study. BACKGROUND: Low transaortic flow may complicate grading of AS. However, the association of lower transaortic FR with adverse outcomes has not been reported. METHODS: Transaortic FR was calculated from Doppler-derived stroke volume in milliliters divided by systolic ejection time in seconds and considered low if <200 ml/s...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28774836/transcatheter-aortic-valve-replacement-through-transcaval-aortic-access-in-a-patient-with-duplicated-inferior-vena-cava-and-poor-iliofemoral-anatomy
#2
Zaher Fanari, Mohammad Al-Akchar, Hadi Mahmaljy, Sachin Goel, Nilesh J Goswami
Transthoracic (transapical and transaortic) access is inferior compared with femoral artery access. Percutaneous transcaval aortic access is a reasonable alternative approach that is being used in transcatheter aortic valve replacement (TAVR) in patients with poor iliofemoral anatomy. Duplicated Inferior vena cava (DIVC) is an uncommon abnormality. We report the case of 76-year-old lady with history of severe peripheral vascular disease, morbid obesity, diabetes, hypertension, hyperlipidemia and duplicated IVC that had severe symptomatic aortic stenosis...
July 1, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#3
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28734453/-double-stick-transsubclavian-transcatheter-aortic-valve-replacement-with-use-of-a-balloon-expandable-valve-a-less-invasive-option-for-alternative-access
#4
Craig M Jarrett, Marc Pelletier, Pinak B Shah, Tsuyoshi Kaneko
Access options for transcatheter aortic valve replacement (TAVR) currently include transfemoral, transaortic, transapical, transsubclavian, and other approaches. Transsubclavian access for balloon expandable valves is gaining popularity when transfemoral access is not suitable, given its peripheral access compared with central access. With the transsubclavian approach, second femoral or radial artery access is necessary for pigtail catheter placement. We describe a "double-stick" transsubclavian technique that eliminates secondary arterial access...
August 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28712578/outcomes-readmissions-and-costs-in-transfemoral-and-alterative-access-transcatheter-aortic-valve-replacement-in-the-us-medicare-population
#5
Fenton H McCarthy, Danielle D Spragan, Danielle Savino, Taylor Dibble, Ashley C Hoedt, Katherine M McDermott, Joseph E Bavaria, Howard C Herrmann, Saif Anwaruddin, Jay Giri, Wilson Y Szeto, Peter W Groeneveld, Nimesh D Desai
OBJECTIVE: To comprehensively evaluate and compare utilization, outcomes, and especially costs of transfemoral (TF), transapical (TA), and transaortic (TAO) transcatheter aortic valve replacement (TAVR). METHODS: All Medicare fee-for-service patients undergoing TF (n = 4065), TA (n = 691), or TAO (n = 274) TAVR between January 1, 2011, and November 30, 2012, were identified using Health Care Procedure Classification Codes present on Medicare claims. Hospital charges from Medicare claims were converted to costs using hospital-specific Medicare cost-to-charge ratios...
June 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28711323/transapical-and-transaortic-transcatheter-aortic-valve-replacement-still-part-of-the-game-and-at-what-cost
#6
EDITORIAL
Jessica Forcillo, Vinod H Thourani
No abstract text is available yet for this article.
June 9, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28676179/transaortic-edge-to-edge-mitral-valve-repair-for-moderate-secondary-functional-mitral-regurgitation-in-patients-undergoing-aortic-root-valve-intervention
#7
Shiv Kumar Choudhary, Atul Abraham, Amol Bhoje, Parag Gharde, Manoj Sahu, Sachin Talwar, Balram Airan
OBJECTIVE: The present study evaluates the feasibility, safety, and efficacy of edge-to-edge repair for moderate secondary/functional mitral regurgitation in patients undergoing aortic valve/root interventions. METHODS: Sixteen patients underwent transaortic edge-to-edge mitral valve repair. Mitral regurgitation was 2+ in 8 patients and 3+ in 6 patients. Two patients in whom cardiac arrest developed preoperatively had severe (4+) mitral regurgitation. Patients underwent operation for severe aortic regurgitation ± aortic root lesions...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28598875/early-hemodynamic-results-in-patients-with-small-aortic-annulus-after-aortic-valve-replacement
#8
Pierre Olivier Dionne, Frédéric Poulin, Denis Bouchard, Philippe Généreux, Reda Ibrahim, Raymond Cartier, Yoan Lamarche, Philippe Demers
OBJECTIVE: Patients with a small aortic annulus (≤21 mm) have an increased risk of patient-prosthesis mismatch after valve replacement. The aim of this study was to compare the early hemodynamic performance of the balloon-expandable transaortic valve implantation Edwards system (SAPIEN) and the sutureless Perceval prostheses. METHODS: Fifty patients underwent transcatheter aortic valve implantation, and 113 patients underwent sutureless aortic valve replacement...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549026/the-use-of-rapid-deployment-valves-in-combined-aortic-and-mitral-valve-surgery-one-year-clinical-and-echocardiographic-outcomes
#9
Markus Schlömicher, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine, Justus Thomas Strauch
OBJECTIVE: Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. METHODS: Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease...
May 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28516313/dynamic-changes-in-aortic-impedance-after-transcatheter-aortic-valve-replacement-and-its-impact-on-exploratory-outcome
#10
Yukari Kobayashi, Juyong B Kim, Kegan J Moneghetti, Yuhei Kobayashi, Ran Zhang, Daniel A Brenner, Ryan O'Malley, Ingela Schnittger, Michael Fischbein, D Craig Miller, Alan C Yeung, David Liang, Francois Haddad, William F Fearon
Valvulo-arterial impedance (Zva) has been shown to predict worse outcome in medically managed aortic stenosis (AS) patients. We aimed to investigate the association between Zva and left ventricular (LV) adaptation and to explore the predictive value of Zva for cardiac functional recovery and outcome after transcatheter aortic valve replacement (TAVR). We prospectively enrolled 128 patients with AS who underwent TAVR. Zva was calculated as: (systolic blood pressure + mean transaortic gradient)/stroke volume index)...
May 17, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28516100/transient-aortic-intramural-hematoma-complicating-transaortic-valve-replacement
#11
Taylor Thomas, Anil K Poulose, Kevin M Harris
Acute aortic intramural hematoma, which is a variant of acute aortic syndromes, most frequently occurs spontaneously and typically is treated similar to classic aortic dissection. Here, we describe a case in which an iatrogenic aortic intramural hematoma occurs shortly after transaortic valve replacement. The patient was managed conservatively, and the hematoma quickly resolved as demonstrated by serial imaging.
December 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28467527/association-of-transcatheter-aortic-valve-replacement-with-30-day-renal-function-and-1-year-outcomes-among-patients-presenting-with-compromised-baseline-renal-function-experience-from-the-partner-1-trial-and-registry
#12
Nirat Beohar, Darshan Doshi, Vinod Thourani, Hanna Jensen, Susheel Kodali, Feifan Zhang, Yiran Zhang, Charles Davidson, Patrick McCarthy, Michael Mack, Samir Kapadia, Martin Leon, Ajay Kirtane
Importance: The frequency of baseline renal impairment among high-risk and inoperable patients with severe aortic stenosis undergoing a transcatheter aortic valve replacement (TAVR) and the effect of TAVR on subsequent renal function are, to our knowledge, unknown. Objective: To determine the effect of TAVR among patients with baseline renal impairment. Design, Setting, and Participants: This substudy of patients with baseline renal impairment (estimated glomerular filtration rate [eGFR] ≤ 60 mL/min) and paired baseline and 30-day measures of renal function undergoing TAVR in the PARTNER 1 trial and continued access registries was conducted in 25 centers in the United States and Canada...
July 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28329159/concomitant-therapy-off-pump-coronary-revascularization-and-transcatheter-aortic-valve-implantation
#13
Samir Ahad, Kristina Wachter, Christian Rustenbach, Alina Stan, Stephan Hill, Tim Schäufele, Adrian Ursulescu, Ulrich F W Franke, Hardy Baumbach
OBJECTIVES: Significant coronary artery disease (CAD) is common among patients evaluated for transcatheter aortic valve implantation (TAVI). Only little data exist on outcome of patients undergoing concomitant off-pump coronary revascularization and TAVI. The goal of this study was to analyse the impact of concomitant off-pump revascularization on early clinical outcome and 2-year follow-up of patients undergoing TAVI. METHODS: A total of 70 patients with significant CAD and aortic valve stenosis were included between January 2011 and January 2016...
March 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28246571/avoiding-the-learning-curve-for-transcatheter-aortic-valve-replacement
#14
Sergey Gurevich, Ranjit John, Rosemary F Kelly, Ganesh Raveendran, Gregory Helmer, Demetris Yannopoulos, Timinder Biring, Brett Oestreich, Santiago Garcia
Objectives. To evaluate whether collaboration between existing and new transcatheter aortic valve replacement (TAVR) programs could help reduce the number of cases needed to achieve optimal efficiency. Background. There is a well-documented learning curve for achieving procedural efficiency and safety in TAVR procedures. Methods. A multidisciplinary collaboration was established between the Minneapolis VA Medical Center (new program) and the University of Minnesota (established program since 2012, n = 219) 1 year prior to launching the new program...
2017: Cardiology Research and Practice
https://www.readbyqxmd.com/read/28106026/successful-simultaneous-ipsilateral-stenting-of-common-iliac-artery-stenosis-and-transfemoral-aortic-valve-replacement
#15
Abdullah Nabi Aslan, Hacı Ahmet Kasapkara, Serkan Sivri, Murat Can Güney, Engin Bozkurt
Transcatheter aortic valve replacement (TAVR) was designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is most commonly performed with retrograde approach through femoral arteries. However, in up to 30% of cases, it is either not possible to use this access route or it is considered to have high risk of vascular injury. Alternative approaches have been described for patients with no suitable femoral access: trans-subclavian, transaortic, or direct aortic access; however, since the introduction of new valves deployed with low-profile delivery systems, another alternative transcatheter approach has been discovered...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28073571/early-clinical-outcomes-of-a-novel-self-expanding-transapical-transcatheter-aortic-valve-bioprosthesis
#16
Michael W A Chu, Rodrigo Bagur, Katie L Losenno, Philip M Jones, Pantelis Diamantouros, Patrick Teefy, Jill J Gelinas, Bob Kiaii
OBJECTIVE: Coronary obstruction remains a challenging complication of transcatheter aortic valve replacement; however, a new self-expanding transapical prosthesis may reduce this risk. The purpose of this study was to evaluate the early 1-year outcomes of patients with low coronary heights who received the Acurate TA bioprosthesis (Symetis, Ecublens, Switzerland). METHODS: Between May 2014 and April 2015, 30 consecutive patients (aged 85 ± 6 years, 63% were female, Society of Thoracic Surgeons score 8...
April 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28030440/subclinical-bioprosthetic-aortic-valve-thrombosis-clinical-and-translational-implications
#17
Bobby Yanagawa, Amine Mazine, Deepak L Bhatt, Marie-Annick Clavel, Nancy Côté, Asim N Cheema, Philippe Pibarot, Subodh Verma
PURPOSE OF REVIEW: A recently published study has alerted the cardiovascular community to the existence of a significant and previously unrecognized risk of subclinical valve thrombosis following implantation of surgical and catheter-based bioprosthetic valves. The purpose of this article is to review our current understanding of this new clinical entity and to identify unanswered questions and areas for future research. RECENT FINDINGS: Subclinical bioprosthetic valve thrombosis (BPVT) is a more common phenomenon than previously appreciated...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27989885/transcaval-access-and-closure-for-transcatheter-aortic-valve-replacement-a%C3%A2-prospective-investigation
#18
MULTICENTER STUDY
Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Annette M Stine, Toby Rogers, William W O'Neill, Gaetano Paone, Vinod H Thourani, Kamran I Muhammad, Robert A Leonardi, Stephen Ramee, James F Troendle, Robert J Lederman
BACKGROUND: Transcaval access may enable fully percutaneous transcatheter aortic valve replacement (TAVR) without the hazards and discomfort of transthoracic (transapical or transaortic) access. OBJECTIVES: The authors performed a prospective, independently adjudicated, multicenter, single-arm trial of transcaval access for TAVR in patients who were ineligible for femoral artery access and had high or prohibitive risk of complications from transthoracic access...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#19
RANDOMIZED CONTROLLED TRIAL
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27884356/direct-comparison-of-feasibility-and-safety-of-transfemoral-versus-transaortic%C3%A2-versus-transapical-transcatheter-aortic%C3%A2-valve-replacement
#20
Takahide Arai, Mauro Romano, Thierry Lefèvre, Thomas Hovasse, Arnaud Farge, Daniel Le Houerou, Kentaro Hayashida, Yusuke Watanabe, Philippe Garot, Hakim Benamer, Thierry Unterseeh, Erik Bouvier, Marie-Claude Morice, Bernard Chevalier
OBJECTIVES: The aim of this study was to compare outcomes among transfemoral (TF), transaortic (TAo), and transapical (TA) transcatheter aortic valve replacement (TAVR). BACKGROUND: Very few studies have investigated the differences among TF, TAo, and TA TAVR in terms of safety and feasibility. METHODS: Between January 2011 and December 2014, 467 consecutive cases of TF TAVR, 289 cases of TAo TAVR, and 42 cases of TA TAVR were analyzed. Baseline characteristics, procedural characteristics, and outcomes were compared between TF and TAo and between TAo and TA approaches...
November 28, 2016: JACC. Cardiovascular Interventions
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