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Recommendations for aortic valve replacement

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https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#1
Tobias Geisler, Michal Droppa, Karin Mueller, Oliver Borst
Transvascular aortic valve replacement (TAVR) has emerged as a treatment option in patients with severe aortic stenosis who are inoperable and has recently been evaluated in patients with intermediate surgical risk. The number of procedures is increasing worldwide in parallel with the demographic changes in industrial countries. The risk for cerebral embolism is of main concern and represents a major determinant for prognosis and quality of live after TAVR. The empiric antithrombotic therapy consists of dual antiplatelet therapy (DAPT); however the risk-benefit of this approach is lacking evidence from randomized, placebo-controlled trials regarding choice and duration of antithrombotic treatment...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29338037/stentless-vs-stented-bioprosthesis-for-aortic-valve-replacement-a-case-matched-comparison-of-long-term-follow-up-and-subgroup-analysis-of-patients-with-native-valve-endocarditis
#2
Andreas Schaefer, Jannis Dickow, Gerhard Schoen, Sumi Westhofen, Lisa Kloss, Tarik Al-Saydali, Hermann Reichenspurner, Sebastian A Philipp, Christian Detter
BACKGROUND: Current retrospective evidence suggests similar clinical and superior hemodynamic outcomes of the Sorin Freedom Solo stentless aortic valve (SFS) (LivaNova PLC, London, UK) compared to the Carpentier Edwards Perimount stented aortic valve (CEP) (Edwards Lifesciences Inc., Irvine, California, USA). To date, no reports exist describing case-matched long-term outcomes and analysis for treatment of native valve endocarditis (NVE). METHODS: From 2004 through 2014, 77 consecutive patients (study group, 59...
2018: PloS One
https://www.readbyqxmd.com/read/29325012/systematic-review-of-the-cost-effectiveness-of-transcatheter-interventions-for-valvular-heart-disease
#3
Gialama Fotini, Prezerakos Panagiotis, Apostolopoulos Vasilis, Nikolaos Maniadakis
Objectives: Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. Methods: The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#4
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29290898/first-in-man-implantation-of-the-retrievable-and-repositionable-venusa-plus-valve
#5
Xian-Bao Liu, Yu-Xin He, Chun-Hui Liu, Li-Han Wang, Feng Gao, Lei Yu, Ai-Qiang Dong, Min-Jian Kong, Ji-Fang Chen, Yong Xu, Qi-Jing Zhou, Min Yan, Jian-An Wang
BACKGROUND: No retrievable and repositionable second generation transcatheter aortic valve is available in China. Here, we report the first-in-man implantation of the retrievable and repositionable VenusA-Plus valve. METHODS: A 76-year-old patient with symptomatic severe aortic stenosis and high surgical risk (STS 13.8%) was recommended for transcatheter aortic valve replacement (TAVR) by heart valve team. Type 0 bicuspid aortic valve with asymmetric calcification was identified by dual source computed tomography, and the unfavorable anatomies increased the possibility of malposition and paravalvular leakage during TAVR...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29281610/aortic-replacement-in-cardiac-surgery
#6
REVIEW
Eric E Roselli
The number of aorta procedures performed annually in the United States has grown substantially during the past decade. Cleveland Clinic is a leader in research on the risk of aortic dissection in patients with a bicuspid or tricuspid aortic valve and associated aneurysm, which has led to changes in the recommendations of when to operate. Safety and efficacy data support more proactive treatment for most patients with thoracic aortic aneurysm and/or dissection with a growing emphasis on the need to provide life-long care to patients with aortic conditions...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29277298/a-pilot-analysis-of-the-association-between-types-of-monitored-anesthesia-care-drugs-and-outcomes-in-transfemoral-aortic-valve-replacement-performed-without-general-anesthesia
#7
Eric Y Chen, Nitin Sukumar, Feng Dai, Shamsuddin Akhtar, Robert B Schonberger
OBJECTIVE: The types of agents used for monitored anesthesia care (MAC) and their possible differential effects on outcomes have received less study despite increased use over general anesthesia (GA) in transfemoral aortic valve replacements (TAVRs). In this pilot analysis of patients undergoing TAVR using MAC, the authors described the anesthetic agents used and sought to investigate the possible association of anesthetic agent choice with outcomes and the extent to which total weight and time-adjusted doses of anesthetics declined with increasing 10-year age increments...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29223748/is-tricuspid-annuloplasty-increasing-surgical-mortality-and-morbidity-during-mitral-valve-replacement-a-single-centre-experience
#8
Constance Verdonk, Arthur Darmon, Claire Cimadevilla, Laurent Lepage, Richard Raffoul, Patrick Nataf, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: Performance of tricuspid annuloplasty (TA) in patients undergoing mitral valve surgery is recommended based on the degree of tricuspid regurgitation and tricuspid annulus size, but is often underused. AIM: To evaluate the impact of combined TA on in-hospital outcome in patients undergoing mitral valve replacement (MVR). METHODS: We selected all consecutive patients who underwent MVR for native valve disease. Clinical, echocardiographic and in-hospital complications were obtained from chart review...
December 6, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29221290/should-sinus-of-valsalva-be-preserved-in-patients-with-bicuspid-aortic-valve-and-aortic-dilation
#9
Yulin Wang, Yi Lin, Kanhua Yin, Kai Zhu, Zhaohua Yang, Yongxin Sun, Hao Lai, Chunsheng Wang
Background: It is recommended that dilated ascending aortas (≥45 mm) should be replaced at the time of aortic valve replacement (AVR) for bicuspid aortic valve (BAV). The risk of progressive sinus of Valsalva dilatation after AVR and ascending aorta replacement is less clear. Methods: We identified 156 patients (age 56.2±10.8 years, 46 females) who underwent AVR and ascending aorta replacement in our institution from 2010-2014, 124 (79%) of whom had BAV. Aortic root and ascending aorta sizes were determined from preoperative and the most recent echocardiograms...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217244/intraoperative-transesophageal-and-postoperative-transthoracic-echocardiographic-evaluation-of-a-mechanical-heart-valve-prosthesis-implanted-at-aortic-position
#10
Saravana Babu, Rupa Sreedhar, Shrinivas V Gadhinglajkar, Prasanta Kumar Dash, Subin Sukesan, Vivek Pillai, Varghese T Panicker, Lovhale Pravin Shriram, Neelam Aggarwal
OBJECTIVE: The aims of this study were to evaluate the intraoperative transesophageal echocardiographic (iTEE) characteristics and Doppler flow profile of aortic Chitra heart valve prosthesis (CHVP) under stable hemodynamic and loading conditions, and to compare and correlate the iTEE data with the postoperative transthoracic echocardiography (TTE) data obtained at 48 hours (TTE1) and 3 months (TTE2) after the surgery. DESIGN: Prospective, observational study. SETTING: University-level tertiary referral hospital...
September 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29188357/-management-of-valvular-heart-disease-esc-eacts-guidelines-2017
#11
REVIEW
M Haude
After 5 years the European Society of Cardiology and the European Association for Cardio-Thoracic Surgery have released an update on the guidelines for the management of valvular heart diseases. In recent years published results of randomized trials in patients with aortic valve stenosis have resulted in updated recommendations for catheter-based prosthesis implantation (TAVI), which is now extended to patients presenting without a low risk for conventional surgical valve replacement. In mitral or tricuspid valvular disease, the recommendations for catheter-based therapies are less strong because of a lack of supportive scientific data...
December 2017: Herz
https://www.readbyqxmd.com/read/29174327/a-case-of-cardiac-arrest-associated-with-aortic-valve-regurgitation
#12
Hyun Suk Chai, Suk Woo Lee, Jung Soo Park, Sang Chul Kim, Ji Han Lee, Hoon Kim
Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29171730/the-jupiter-registry-one-year-outcomes-of-transapical-aortic-valve-implantation-using-a-second-generation-transcatheter-heart-valve-for-aortic-regurgitation
#13
Miriam Silaschi, Lenard Conradi, Olaf Wendler, Friederike Schlingloff, Utz Kappert, Ardawan J Rastan, Hardy Baumbach, David Holzhey, Walter Eichinger, Ralf Bader, Hendrik Treede
OBJECTIVES: We present 1-year outcomes of the post-market registry of a next-generation transcatheter heart valve used for aortic regurgitation (AR). BACKGROUND: Transcatheter aortic valve replacement (TAVR) is routine in high-risk patients with aortic stenosis but is not recommended for AR. The JenaValve™ (JenaValve Technology GmbH, Munich, Germany) overcomes technical challenges in AR patients through a leaflet clipping mechanism. METHODS: The JenaValve EvalUation of Long Term Performance and Safety In PaTients with SEvere Aortic Stenosis oR Aortic Insufficiency (JUPITER) Registry is a European study to evaluate safety and effectiveness of this THV...
November 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29168984/transcatheter-vs-surgical-aortic-valve-replacement-in-low-to-intermediate-surgical-risk-candidates-a-meta-analysis-and-systematic-review
#14
REVIEW
Safi U Khan, Ahmad N Lone, Muhammad A Saleem, Edo Kaluski
The American and European expert documents recommend transcatheter aortic valve replacement (TAVR) for inoperable or high-surgical-risk patients with severe aortic stenosis. In comparison, efficacy of TAVR is relatively less studied in low- to intermediate-surgical-risk patients. We sought to discover whether TAVR can be as effective as surgical aortic valve replacement (SAVR) in low- to intermediate-surgical-risk candidates. Four randomized clinical trials (RCTs) and 8 prospective matched studies were selected using PubMed/MEDLINE, Embase, and Cochrane Library (inception: March 2017)...
November 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29153618/advantages-of-a-prospective-multidisciplinary-approach-in-transcatheter-aortic-valve-implantation-eight-years-of-experience
#15
Cátia Costa, Rui Campante Teles, João Brito, José Pedro Neves, Henrique Mesquita Gabriel, Miguel Abecassis, Regina Ribeiras, João Abecasis, Tiago Nolasco, Maria da Conceição Furstenau, Nélson Vale, António Tralhão, Sérgio Madeira, João Mesquita, Carla Saraiva, Rita Calé, Manuel Almeida, Ana Aleixo, Miguel Mendes
INTRODUCTION: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008...
November 15, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29149323/should-the-dilated-ascending-aorta-be-repaired-at-the-time-of-bicuspid-aortic-valve-replacement
#16
Tsuyoshi Kaneko, Prem Shekar, Vladimir Ivkovic, Nicholas T Longford, Chuan-Chin Huang, Martin I Sigurdsson, Robert C Neely, Maroun Yammine, Julius I Ejilofor, Vanessa Montiero Vieira, Jasmine T Shahram, Karam M Habchi, Gregory W Malzberg, Peter S Martin, Jordan Bloom, Eric M Isselbacher, J Daniel Muehlschlegel, Thoralf M Sundt, Simon C Body
OBJECTIVES: Bicuspid aortic valve (BAV) is the most common congenital valvular abnormality and frequently presents with accelerated calcific aortic valve disease, requiring aortic valve replacement (AVR) and thoracic aortic aneurysm and dissection. Supporting evidence for Association Guidelines of aortic dimensions for aortic resection is sparse. We sought to determine whether concurrent repair of dilated or aneurysmal aortic disease during AVR in patients with BAV substantially improves morbidity and mortality outcomes...
November 14, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29130587/pushing-boundaries-implantation-of-the-34-mm-medtronic-corevalve-in-patients-with-a-large-aortic-annulus
#17
Adham Elmously, Berhane Worku, S Chiu Wong, Arash Salemi
The relationship between adherence to the recommended CoreValve sizing parameters and clinical outcomes is not well known for the recently released 34 mm valve, which is currently the largest available transcatheter valve. There is a presumed temporal reduction in paravalvular regurgitation in patients who receive an in-range valve, however, certain patients possess annular dimensions that are too large. We therefore describe two patients with annular dimensions larger than the manufacturer recommended range for the 34 mm CoreValve, who despite this underwent transcatheter aortic valve replacement with excellent clinical outcomes...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#18
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29064293/transcatheter-aortic-valve-implantation-where-are-we-now
#19
Mark Mariathas, John Rawlins, Nick Curzen
Transcatheter aortic valve implantation (TAVI) was first used in clinical practice in 2002. Since 2002, there has been a rapid increase in TAVI activity in patients with symptomatic severe aortic stenosis. This has been supported by systematic randomized data comparing TAVI against the gold standard treatment for the last 50 years' surgical aortic valve replacement. TAVI is now currently a recommended therapeutic intervention in the treatment of severe aortic stenosis patients who are deemed either high risk or inoperable...
October 24, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29029058/inter-ethnic-differences-in-valve-morphology-valvular-dysfunction-and-aortopathy-between-asian-and-european-patients-with-bicuspid-aortic-valve
#20
William K F Kong, Madelien V Regeer, Kian K Poh, James W Yip, Philippe J van Rosendael, Tiong C Yeo, Edgar Tay, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Background: Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR...
October 6, 2017: European Heart Journal
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