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Transaortic valve replacement

Zahara Meghji, Anita Nguyen, Jeffrey B Geske, Hartzell V Schaff
Severe calcific mitral valve stenosis can rarely occur concomitantly with obstructive hypertrophic cardiomyopathy. In these patients, surgical decalcification of the stenotic mitral valve followed by mitral valve replacement carries significant operative risk and may result in paravalvular leakage, atrioventricular groove disruption, and excessive bleeding. We report the first 2 cases of obstructive hypertrophic cardiomyopathy with severe calcific mitral valve stenosis successfully treated with concomitant transaortic septal myectomy and bypass of the stenotic mitral valve using a valved left atrium to left ventricular conduit...
February 26, 2018: Annals of Thoracic Surgery
Pablo Codner, Daniel Pugliese, Rémi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Kyle M Eudaley, Tamim Nazif, Torsten P Vahl, Isaac George, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali, Michael Borger
BACKGROUND: Transcatheter aortic valve replacement (TAVR) provides therapy for patients with severe aortic stenosis at extreme, high, or intermediate surgical risk. Transfemoral access has been the preferred access route; however, this approach is not suitable for many TAVR candidates. A suprasternal approach may allow for earlier ambulation and shorter hospital stay as compared with other, nontransfemoral approaches. METHODS: A total of 11 patients with unsuitable transfemoral access underwent suprasternal TAVR...
February 1, 2018: Annals of Thoracic Surgery
Marc Eugène, Marina Urena, Jérémie Abtan, José-Luis Carrasco, Walid Ghodbane, Patrick Nataf, Alec Vahanian, Dominique Himbert
The prognosis of patients with cardiogenic shock (CS) or refractory pulmonary edema because of severe aortic stenosis remains poor. The purpose of this study was to assess the outcomes of rescue percutaneous balloon aortic valvuloplasty (PBAV) in the transcatheter aortic valve implantation (TAVI) era. Patients were consecutively included between 2008 and 2016. CS was defined as ≥1 sign of systemic hypoperfusion and need of catecholamines. Refractory pulmonary edema was defined as not controlled by optimal medical treatment...
December 29, 2017: American Journal of Cardiology
Roberto J Cubeddu, Hector J Crespo, Gian M Novaro
Mitral paravalvular leak (PVL) remains a well-known complication after mitral valve replacement. Since the first report over 25 years ago, several catheter-based PVL closure techniques have been described. Most of these comprise of either an antegrade transseptal approach, or a retrograde transaortic or transapical approach. We herein report a novel percutaneous mitral PVL closure technique that was safely and successfully performed after failed attempt using a conventional antegrade approach.
January 13, 2018: Catheterization and Cardiovascular Interventions
Karoline K H Fiane, Gry Dahle, Bjørn Bendz, Per Steinar Halvorsen, Michael Abdelnoor, Tom Eirik Mollnes, Erik Fosse
OBJECTIVES: The inflammatory response to on-pump cardiac surgery is well known. Systemic inflammatory response syndrome after transcatheter valve implantation (TAVI) has been reported. The objective of this study was to study the inflammatory response during TAVI, and compare with the response during surgical aortic valve replacement. METHODS: Eighteen patients undergoing transcatheter implantation, either by a transfemoral (n = 9) or transaortal (n = 9) approach were compared with eighteen patients admitted for surgical replacement...
February 2018: Scandinavian Cardiovascular Journal: SCJ
Toby Rogers, Vinod H Thourani
No abstract text is available yet for this article.
March 2018: Journal of Thoracic and Cardiovascular Surgery
Anita Nguyen, Hartzell V Schaff, Rick A Nishimura, Joseph A Dearani, Jeffrey B Geske, Brian D Lahr, Steve R Ommen
OBJECTIVES: Patients with hypertrophic obstructive cardiomyopathy and basal septal thickness <18 mm are often considered unsuitable candidates for myectomy. Mitral valve (MV) replacement is frequently performed instead. We aimed to determine whether septal thickness affects outcomes and adequacy of myectomy. METHODS: Clinical and echocardiographic data were reviewed for 1486 consecutive adult patients with hypertrophic obstructive cardiomyopathy who underwent transaortic septal myectomy from January 2005 through December 2014...
March 1, 2018: European Journal of Cardio-thoracic Surgery
Sarkis Kiramijyan, Edward Koifman, Marco A Magalhaes, Itsik Ben-Dor, Romain Didier, Zachary D Jerusalem, Sandeep Kumar, Arpi Tavil-Shatelyan, Toby Rogers, Arie Steinvil, Jiaxiang Gai, Rebecca Torguson, Lowell F Satler, Augusto D Pichard, Ron Waksman
OBJECTIVE: Evaluation of invasive hemodynamic parameters as prognostic markers of mortality in patients undergoing TAVR. BACKGROUND: The value of invasive intraprocedural hemodynamic evaluation of patients undergoing transcatheter aortic valve replacement is unclear. METHODS: Consecutive patients who underwent transfemoral TAVR and had complete prospectively collected intraprocedural invasive hemodynamic parameters were retrospectively analyzed...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Mathieu Charles Blouin, Ismail Bouhout, Philippe Demers, Michel Carrier, Louis Perrault, Yoan Lamarche, Ismail El-Hamamsy, Denis Bouchard
BACKGROUND: Sutureless aortic valve replacement (AVR) is an emerging alternative to standard AVR in elderly and high-risk patients. This procedure is associated with a high rate of postoperative permanent pacemaker implantation (PPI). The study aim was to assess the impact on the rate of PPI of implanting the Perceval prosthesis without using balloon inflation. METHODS: A total of 159 patients who underwent sutureless AVR using the Perceval prosthesis was included...
May 2017: Journal of Heart Valve Disease
Osama Shoeib, Francesco Burzotta, Cristina Aurigemma, Lazzaro Paraggio, Fausta Viccaro, Italo Porto, Antonio Maria Leone, Piergiorgio Bruno, Carlo Trani
OBJECTIVES: We sought to investigate the possible impact of transaortic valve replacement (TAVR) on common femoral artery (CFA) integrity as assessed by angiography. BACKGROUND: CFA represents the most adopted access for TAVR but various degrees of vascular damage may be induced by the procedure. METHODS: Patients underwent percutaneous transfemoral TAVR who had both pre- and post-TAVR access-site angiography were retrospectively selected...
October 25, 2017: Catheterization and Cardiovascular Interventions
Kyle D Buchanan, M Chadi Alraies, Gaby Weissman, Itsik Ben-Dor, Lowell F Satler, Ron Waksman
An 87-year-old female with symptomatic severe aortic stenosis underwent transcatheter valve replacement (TAVR) via the transfemoral approach with a 29mm self-expanding device. Moderate to severe paravalvular regurgitation led to the development of congestive heart failure and hospital readmission 1 month following TAVR. A second 29mm valve was placed to abolish the paravalvular regurgitation. Routine follow-up computed tomography (CT) imaging demonstrated leaflet thickening and decreased leaflet mobility suggesting valve thrombosis, despite adherence to Factor Xa inhibitor...
May 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Michael Caskey, Hao Pan, Merrick Kirshner, Timothy Byrne, Divya Ratan Verma, James Flaherty, Andrei Churyla
No abstract text is available yet for this article.
September 2017: Annals of Cardiothoracic Surgery
Eva Maria Delmo Walter, Mariano Francisco Javier, Roland Hetzer
BACKGROUND: Various surgical strategies designed to relieve left ventricular outflow tract obstruction (LVOTO) and correct mitral regurgitation (MR) in hypertrophic obstructive cardiomyopathy (HOCM) have evolved, yet reports on the long-term outcomes of each technique are scarce. We provide an update on over 20 years' experience at our institution in the standardized surgical treatment of HOCM. METHODS: Between April 1986 and April 2014, 320 cases of endomyocardial resection and 305 septal myectomies were performed at our institution...
July 2017: Annals of Cardiothoracic Surgery
François Huchet, Vincent Letocart, Patrice Guerin, Caroline Cueff, Julie Roy-Giocosa, Béatrice Guyomarch-Delasalle, Philippe Jaafar, Thibaut Manigold
BACKGROUND: Despite a lack of clear evidence, current European guidelines recommend antiplatelet therapy after transcatheter aortic valve replacement (TAVR). Recent investigations suggest that bioprosthesis thrombosis after TAVR is not uncommon and may be prevented by anticoagulation, but not by antiplatelet therapy. AIMS: The study objective was to assess the impact of the antithrombotic regimen on post-TAVR early haemodynamics. METHODS: Patients eligible for TAVR with an Edwards SAPIEN 3 valve were included in this prospective observational study...
September 21, 2017: Archives of Cardiovascular Diseases
Craig Basman, Yuvrajsinh J Parmar, Itzhak Kronzon
PURPOSE OF REVIEW: With an increasing number of interventional procedures performed for structural heart disease and cardiac arrhythmias each year, echocardiographic guidance is necessary for safe and efficient results. The purpose of this review article is to overview the principles of intracardiac echocardiography (ICE) and describes the peri-interventional role of ICE in a variety of structural heart disease and electrophysiological interventions. RECENT FINDINGS: Both transthoracic (TTE) and transesophageal echocardiography have limitations...
September 6, 2017: Current Cardiology Reports
Barbara E Stähli, Thomas Stadler, Erik W Holy, Thi Dan Linh Nguyen-Kim, Lisa Hoffelner, Ladina Erhart, Slayman Obeid, Markus Niemann, Rolf Jenni, Sandra Hamada, Robert Manka, Thomas F Lüscher, Francesco Maisano, Fabian Nietlispach, Thomas Frauenfelder, Felix C Tanner
BACKGROUND: The prevalence of low flow low gradient (LFLG) severe aortic stenosis (AS) may be overrated due to underestimation of stroke volume in two-dimensional (2D) echocardiography. The implications of 3D imaging on stroke volume calculation for AS classification have not been elucidated. Integrating multi-detector computed tomography (MDCT) and Doppler data may improve diagnostic accuracy in patients with LFLG AS. METHODS: A total of 186 patients with severe AS evaluated for transcatheter aortic valve replacement were classified according to indexed stroke volume (SVI, cut-off 35mL/m2) and mean transaortic pressure gradient (cut-off 40mmHg)...
November 1, 2017: International Journal of Cardiology
Byungjoon Park, Kiick Sung, Pyo Won Park
BACKGROUND: This study aimed to evaluate the safety and feasibility of transaortic mitral pannus removal (TMPR).Methods and Results:Between 2004 and 2016, 34 patients (median age, 57 years; 30 women) with rheumatic disease underwent pannus removal on the ventricular side of a mechanical mitral valve through the aortic valve during reoperation. The median time interval from the previous surgery was 14 years. TMPR was performed after removal of the mechanical aortic valve (n=21) or diseased native aortic valve (n=11)...
August 31, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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
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
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
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