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Recommendations for aortic valve replacement

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https://www.readbyqxmd.com/read/28104211/balloon-post-dilation-following-implantation-of-a-self-expanding-transcatheter-aortic-valve%C3%A2-bioprosthesis
#1
J Kevin Harrison, G Chad Hughes, Michael J Reardon, Robert Stoler, Paul Grayburn, Robert Hebeler, David Liu, Yanping Chang, Jeffrey J Popma
OBJECTIVES: This study sought to explore the impact of balloon post-dilation (BPD) on outcomes in the CoreValve US Clinical Trials. BACKGROUND: BPD following transcatheter aortic valve replacement (TAVR) has been used in selected cases to optimize hemodynamic results. METHODS: Procedural details of 3,532 patients were examined to determine whether BPD was performed after self-expanding TAVR. "Best practice" guidelines recommended BPD for treatment of suboptimal intraprocedural valve function, primarily manifested by moderate or severe residual aortic regurgitation (AR)...
January 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28050459/cardiovascular-abnormalities-in-egyptian-children-with-mucopolysaccharidoses
#2
Laila Selim, Nehal Abdelhamid, Emad Salama, Amera Elbadawy, Iman Gamaleldin, Mohamed Abdelmoneim, Abeer Selim
INTRODUCTION: The Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders. They are characterized by the progressive systemic deposition of Glycosaminoglycans (GAGs). GAGs accumulate in the myocardium and the cardiac valves. Enzyme Replacement Therapy (ERT) is available for MPS I, II, and VI. However, ERT does not appear to improve cardiac valve disease in patients with valve disease present at the start of ERT. AIM: To evaluate the cardiac involvement in Egyptian children with MPS...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28027760/ct-angiography-for-planning-transcatheter-aortic-valve-replacement-using-automated-tube-voltage-selection-image-quality-and-radiation-exposure
#3
Stefanie Mangold, Carlo N De Cecco, U Joseph Schoepf, Taylor S Kuhlman, Akos Varga-Szemes, Damiano Caruso, Taylor M Duguay, Christian Tesche, Thomas J Vogl, Konstantin Nikolaou, Daniel H Steinberg, Julian L Wichmann
PURPOSE: To assess image quality and accuracy of CT angiography (CTA) for transcatheter aortic valve replacement (TAVR) planning performed with 3rd generation dual-source CT (DSCT). MATERIAL AND METHODS: We evaluated 125 patients who underwent TAVR-planning CTA on 3rd generation DSCT. A two-part protocol was performed including retrospectively ECG-gated coronary CTA (CCTA) and prospectively ECG-triggered aortoiliac CTA using 60mL of contrast medium. Automated tube voltage selection and advanced iterative reconstruction were applied...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#4
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27990197/transcatheter-aortic-valve-implantation-for-treatment-of-aortic-valve-stenosis-a-health-technology-assessment
#5
(no author information available yet)
BACKGROUND: Surgical aortic valve replacement (SAVR) is the gold standard for treating aortic valve stenosis. It is a major operation that requires sternotomy and the use of a heart-lung bypass machine, but in appropriately selected patients with symptomatic, severe aortic valve stenosis, the benefits of SAVR usually outweigh the harms. Transcatheter aortic valve implantation (TAVI) is a less invasive procedure that allows an artificial valve to be implanted over the poorly functioning valve...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27989055/anticoagulation-after-biological-aortic-valve-replacement-is-there-an-optimal-regimen
#6
Tamer Owais, Mina Rouman, Martin Breuer, Lars Hüter, Jürgen Fuchs, Bernward Lauer, Thomas Kuntze
BACKGROUND: The anticoagulation of biological heart valves remains a 'hot spot' of discussion in various domains due to the risk of developing valve thrombosis and arterial thromboembolism. The situation has always been controversial, especially during the early postoperative phase. The American College of Cardiology/ American Heart Association and European Society of Cardiology guidelines recommend the use of warfarin for the first three months after biological aortic valve replacement (BAVR), although the American College of Chest Physicians guidelines suggest that these recommendations are experience-based and that the risk/benefit is unclear...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27988497/late-survival-after-aortic-valve-replacement-in-patients-with-moderately-reduced-kidney-function
#7
Natalie Glaser, Veronica Jackson, Martin J Holzmann, Anders Franco-Cereceda, Ulrik Sartipy
BACKGROUND: The influence of moderately reduced kidney function on late survival after surgical aortic valve replacement (AVR) is unknown. We analyzed survival after AVR in patients with moderately reduced kidney function. METHODS AND RESULTS: All patients who underwent primary AVR in Sweden 1997-2013 were identified from the Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies register...
December 17, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27977305/what-is-the-role-of-sutureless-aortic-valves-in-today-s-armamentarium
#8
Dimos Karangelis, Amine Mazine, Apostolos Roubelakis, Christos Alexiou, Socrates Fragoulis, C David Mazer, Bobby Yanagawa, David Latter, Daniel Bonneau
Sutureless and rapid-deployment aortic bioprostheses represent an emerging and promising technology for the treatment of aortic valve stenosis. Unlike traditional aortic bioprostheses, these devices are not hand-sewn, thus allowing a significant reduction in operative times, while facilitating minimally invasive surgery and complex cardiac interventions. Sutureless aortic valve replacement represents a less invasive treatment option and an excellent alternative to conventional aortic valve replacement in elderly and higher risk patients...
December 26, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27939049/impact-of-methodologic-differences-in-three-dimensional-echocardiographic-measurements-of-the-aortic-annulus-compared-with-computed-tomographic-angiography-before-transcatheter-aortic-valve-replacement
#9
Omar K Khalique, Nadira B Hamid, Jonathon M White, David J Bae, Susheel K Kodali, Tamim M Nazif, Torsten P Vahl, Jean-Michel Paradis, Isaac George, Martin B Leon, Rebecca T Hahn
BACKGROUND: Three-dimensional (3D) echocardiographic (3DE) imaging is an alternative to multi-detector row computed tomography (MDCT) for aortic annular measurement before transcatheter aortic valve replacement (TAVR). A commonly used direct planimetry from a reconstructed short-axis view has not been compared with semiautomated 3DE methods. Typically accepted optimal cutoffs for percent prosthesis-area oversizing of the balloon-expandable SAPIEN or SAPIEN XT valve to native annular size are approximately 5% to 15%...
December 6, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27931592/the-rationale-for-performance-of-coronary%C3%A2-angiography-and-stenting-before-transcatheter-aortic-valve-replacement-from-the-interventional-section-leadership-council-of-the-american-college-of-cardiology
#10
REVIEW
Stephen Ramee, Saif Anwaruddin, Gautam Kumar, Robert N Piana, Vasilis Babaliaros, Tanveer Rab, Lloyd W Klein
Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27916847/aortic-root-dilatation-in-mucopolysaccharidosis-i-vii
#11
Meena Bolourchi, Pierangelo Renella, Raymond Y Wang
The prevalence of aortic root dilatation (ARD) in mucopolysaccharidosis (MPS) is not well documented. We investigated aortic root measurements in 34 MPS patients at the Children's Hospital of Orange County (CHOC). The diagnosis, treatment status, age, gender, height, weight and aortic root parameters (aortic valve annulus (AVA), sinuses of Valsalva (SoV), and sinotubular junction (STJ)) were extracted by retrospective chart review and echocardiographic measurements. Descriptive statistics, ANOVA, and paired post-hoc t-tests were used to summarize the aortic dimensions...
November 29, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27892890/trial-design-rivaroxaban-for-the-prevention-of-major-cardiovascular-events-after-transcatheter-aortic-valve-replacement-rationale-and-design-of-the-galileo-study
#12
Stephan Windecker, Jan Tijssen, Gennaro Giustino, Ana H C Guimarães, Roxana Mehran, Marco Valgimigli, Pascal Vranckx, Robert C Welsh, Usman Baber, Gerrit-Anne van Es, Peter Wildgoose, Albert A Volkl, Ana Zazula, Karen Thomitzek, Melanie Hemmrich, George D Dangas
BACKGROUND: Optimal antithrombotic treatment after transcatheter aortic valve replacement (TAVR) is unknown and determined empirically. The direct factor Xa inhibitor rivaroxaban may potentially reduce TAVR-related thrombotic complications and premature valve failure. DESIGN: GALILEO is an international, randomized, open-label, event-driven, phase III trial in more than 1,520 patients without an indication for oral anticoagulation who underwent a successful TAVR (ClinicalTrials...
October 31, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27875347/severe-low-gradient-aortic-stenosis-with-preserved-ventricular-function-should-it-be-treated
#13
Giuseppe Di Pasquale, Gloria Vassilikì Coutsoumbas, Silvia Zagnoni
Exists a group of patients with small AVA (<0,6 cm/m), and normal LVEF (≥50%) who display a low transvalvular flow (LF) [index stroke volume (SVi)<35 ml/m2] and/or low transvalvular gradient (LG). This condition is called severe paradoxical aortic stenosis (SAO) LFLG. In many studies this condition was associated to increased mortality both with medical therapy and with surgical intervention. Crucial is define correctly the diagnostical criteria of this condition. Indeed there are several specific anatomical and functional characteristics useful in differentiating paradoxical severe aortic stenosis from the other forms of aortic stenosis...
November 19, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27823679/incidence-and-risk-factors-for-thromboembolism-and-major-bleeding-in-patients-with-mechanical-valve-prosthesis-a-nationwide-population-based-study
#14
Ashkan Labaf, Peter J Svensson, Henrik Renlund, Anders Jeppsson, Anders Själander
BACKGROUND: Risk factors of stroke/thromboembolism (TE) and major bleeding, and incidence of these events in specific age categories in warfarin-treated patients with mechanical heart valves (MHV) are uncertain. Our objective was to calculate event rates in specific age categories and identify risk factors for adverse events. METHODS AND RESULTS: We identified 4,810 treatment periods with MHV between January 2006 and December 2011 in the Auricula and Swedish Web system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies registries...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27771771/survival-after-intravenous-thrombin-prior-to-cardiopulmonary-bypass
#15
Vance G Nielsen, Samata R Paidy, Camron A Meek, Tiffany K Thornton, Scott D Lick
We present a case of a patient undergoing aortic valve replacement being inadvertently administered 5000 U of bovine thrombin instead of heparin for anticoagulation for cardiopulmonary bypass. The labeling error was made within the operating room pharmacy. The key to survival of this patient was a rapid diagnosis, administration of antithrombin and heparin, and removal of cardiac and great vessel thrombi. It is recommended that point of care anesthesia providers `prepare heparin for cardiopulmonary bypass anticoagulation, as thrombin is not used in anesthetic practice and is not contained within anesthesia cabinet medication drawers...
October 22, 2016: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/27761871/the-crucial-role-of-cardiac-imaging-in-transcatheter-aortic-valve-replacement-tavr-pre-and-post-procedural-assessment
#16
Saif Al-Najafi, Frank Sanchez, Stamatios Lerakis
Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27753861/br-02-1-management-of-hypertension-in-severe-aortic-stenosis
#17
Yong-Jin Kim
Aortic stenosis (AS) is a common valve disease, affecting nearly 5% of elderly individuals. Because most common etiology of AS is degenerative valve disease, hypertension (HT) is not rare in patients with AS. It was reported that more than 30% of patients with AS had systemic hypertension. Therefore, management of hypertension is an important issue for these patients. There are several effects of combined AS and HT. First, HT increases hemodynamic load of left ventricle and peak systolic left ventricular wall stress...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27645969/perceval-sutureless-valve-dysfunction-caused-by-valvular-thrombosis
#18
Andreas Vötsch, Wolfgang Weihs, Martin Asslaber, Otto Dapunt
Until now, to our knowledge no case of bioprosthetic valvular thrombosis after implantation of the sutureless Sorin Perceval valve has been reported. Although sutureless aortic valve replacement has become a powerful tool in our daily practice, recent guidelines from the European Society of Cardiology, the European Association for Cardio-Thoracic Surgery, the American College of Cardiology, and the American Heart Association do not give specific recommendations on postoperative anticoagulation therapy. We report the first case of valve dysfunction resulting from thrombosis 12 months after implantation with a possible link to postoperative cortisole therapy...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27643098/br-02-1-management-of-hypertension-in-severe-aortic-stenosis
#19
Yong-Jin Kim
Aortic stenosis (AS) is a common valve disease, affecting nearly 5% of elderly individuals. Because most common etiology of AS is degenerative valve disease, hypertension (HT) is not rare in patients with AS. It was reported that more than 30% of patients with AS had systemic hypertension. Therefore, management of hypertension is an important issue for these patients. There are several effects of combined AS and HT. First, HT increases hemodynamic load of left ventricle and peak systolic left ventricular wall stress...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27621906/transcatheter-aortic-valve-implantation-in-a-young-heart-transplant-recipient-crossing-the-traditional-boundaries
#20
Khalil Ahmad, Christian Juhl Terkelsen, Kim Allan Terp, Ole Norling Mathiassen, Bjarne Linde Nørgaard, Henning Rud Andersen, Steen Hvitfeldt Poulsen
Transcatheter aortic valve implantation (TAVI) is an established therapeutic alternative to surgical aortic valve replacement (SAVR) in high-risk or inoperable patients with symptomatic aortic valve stenosis. Hitherto, TAVI is not recommended in young and low-intermediate risk patients. However, TAVI may also serve as an alternative to SAVR in selected young patients, e.g., patients who have previously undergone multiple cardiac surgery procedures. We report a case of trans-femoral TAVI in a 25-year-old heart transplant (HTx) recipient with prior surgery for congenital heart disease...
August 2016: Journal of Thoracic Disease
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