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Recommendations for aortic valve replacement

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https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#1
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29730841/grading-of-aortic-stenosis-severity-a-head-to-head-comparison-between-cardiac-magnetic-resonance-imaging-and-echocardiography
#2
Cesare Mantini, Gabriele Di Giammarco, Jacopo Pizzicannella, Sabina Gallina, Fabrizio Ricci, Emilia D'Ugo, Marziale Marchetti, Antonio Raffaele Cotroneo, Nauman Ahmed, Chiara Bucciarelli-Ducci, Armando Tartaro, Raffaele De Caterina
AIM: To prospectively evaluate the accuracy of cardiac magnetic resonance (cMR) imaging for the assessment of aortic valve effective orifice area (EOA) by continuity equation and anatomical aortic valve area (AVA) by direct planimetry, as compared with transthoracic (TTE) and transesophageal (TEE) two-dimensional (2D) echocardiography, respectively. METHODS AND RESULTS: A total of 31 patients (21 men, 10 women, mean age 69 ± 10 years) with moderate-to-severe aortic stenosis (AS) diagnosed by TTE and scheduled for elective aortic valve replacement, underwent both cMR and TEE...
May 5, 2018: La Radiologia Medica
https://www.readbyqxmd.com/read/29718948/impact-of-left-ventricular-diastolic-function-and-survival-in-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#3
Kimi Sato, Serge Harb, Arnav Kumar, Samir R Kapadia, Stephanie Mick, Amar Krishnaswamy, Milind Y Desai, Brian P Griffin, L Leonardo Rodriguez, E Murat Tuzcu, Lars G Svensson, Zoran B Popović
In year 2016, the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) updated Recommendations for the assessment and grading of diastolic dysfunction (DD). We aimed to assess the applicability of this DD grading method and its association with prognosis in patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI). We retrospectively identified 237 consecutive patients with severe AS who underwent trans-femoral TAVI...
2018: PloS One
https://www.readbyqxmd.com/read/29689593/transcatheter-technologies-for-valvular-replacement-an-update
#4
Antonio Nenna, Sanjeet Singh Avtaar Singh, Simone Morganti, Laura Mazzocchi, Ferdinando Auricchio, Massimo Chello, Francesco Nappi
This report provides a brief overview of the basic principles, recent advances, and recommendations for the treatment of severe aortic stenosis with transcatheter aortic valve replacement (TAVR) in adults. Approaches that avoid neurological, cardiac and peripheral vascular complications have been developed. In addition, TAVR can be performed in intermediate- and low-risk patients. However, these procedures require specialized training and may not allow for complete resolution of the underlying issue. Even if cardiologists learn to perform the procedure and despite advancements in device technology, TAVR is still susceptible to structural valve degeneration, thrombosis and late cerebral embolization...
April 23, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29678618/concomitant-surgical-atrial-fibrillation-ablation-is-safe-and-efficacious-in-patients-undergoing-double-valve-replacement-a-cohort-study
#5
Guang Tong, Hao Yu, Xuan Zhou, Ben Zhang, Shenghui Bi, Lin Luo, Tao Yan, Xianyue Wang, Hua Lu, Tao Ma, Xiaowu Wang, Zhongchan Sun, Weida Zhang
BACKGROUND: Current European Society of Cardiology Guidelines recommend concomitant atrial fibrillation (AF) ablation for all symptomatic patients undergoing other cardiac surgeries, but the safety and potential benefits of concomitant atrial fibrillation (AF) ablation at the time of double valve replacement (DVR: aortic and mitral valve replacement) remains unexamined. MATERIALS AND METHODS: We conducted a retrospective review of 238 patients with AF who underwent DVR with or without concomitant surgical ablation (Ablation group, n=113; Non-ablation group, n=125) at a single institute from April 2006 to September 2011...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29655505/midterm-outcome-of-transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-controlled-trials
#6
Yanwei Wang, Yijiang Zhou, Li Zhang, Jianhua Zhu
BACKGROUND: Current guidelines recommend transcatheter aortic valve replacement (TAVR) in patients with severe symptomatic aortic stenosis (AS) who are not suitable for conventional surgical aortic valve replacement (SAVR). In light of the recent trend in performing TAVR in patients with lower risk profile, we assessed the midterm outcome comparing TAVR and SAVR for the treatment of patients with severe AS at low to intermediate risk. METHODS: PubMed, EBSCO, and Cochrane CENTRAL were systematically searched for randomized controlled trials that reported the clinical outcomes of TAVR versus SAVR in patients at low to intermediate surgical risk with at least 2 years of follow-up...
June 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29630054/technique-and-patient-selection-criteria-of-right-anterior-mini-thoracotomy-for-minimal-access-aortic-valve-replacement
#7
Reza Tavakoli, Pascal Leprince, Max Gassmann, Peiman Jamshidi, Nassrin Yamani, Julien Amour, Guillaume Lebreton
Aortic valve stenosis has become the most prevalent valvular heart disease in developed countries, and is due to the aging of these populations. The incidence of the pathology increases with growing age after 65 years. Conventional surgical aortic valve replacement through median sternotomy has been the gold standard of patient care for symptomatic aortic valve stenosis. However, as the risk profile of patients worsens, other therapeutic strategies have been introduced in an attempt to maintain the excellent results obtained by the established surgical treatment...
March 26, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29619328/ciprofloxacin-for-the-treatment-of-cardiobacterium-hominis-prosthetic-valve-endocarditis
#8
Lisa M Avery, Catherine B Felberbaum, Muhammad Hasan
Prosthetic valve endocarditis due to Cardiobacterium hominis is rare and recommended therapy includes a third generation cephalosporin. We report a case of Cardiobacterium hominis endocarditis post transcatheter aortic valve replacement in a patient with significant beta-lactam antimicrobial sensitivities who was successfully treated with ciprofloxacin monotherapy in conjunction with surgery.
2018: IDCases
https://www.readbyqxmd.com/read/29608496/antithrombotic-management-of-patients-with-prosthetic-heart-valves
#9
Abdallah Sanaani, Srikanth Yandrapalli, Joseph Michael Harburger
Valvular heart disease is a major public health issue. The prevalence of valvular heart disease is expected to increase due to an aging population. Valve dysfunction manifests as valve stenosis, regurgitation, or both, due to various etiologies. Valve repair and replacement are the main treatment options for severe valve dysfunction. Valve replacement is achieved by using either a mechanical or a bioprosthetic valve. Mechanical valves are more durable but require lifelong anticoagulation with associated complications...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29593833/understanding-neurologic-complications-following-tavr
#10
Ghare Mohammed Imran, Lansky Alexandra
Transcatheter aortic valve replacement is a groundbreaking treatment modality for severe, symptomatic aortic stenosis. Despite the rapid progression in indications to include intermediate-risk patients, the risk of peri-procedural stroke remains, with a higher incidence rate than previously reported. Accurate assessment of peri-procedural stroke rates requires selection of careful and meaningful trial endpoints during evaluation of neuroprotective devices. In this article, we review recommendations and stroke definitions from academic research consortiums along with device trial results...
January 2018: Interventional Cardiology
https://www.readbyqxmd.com/read/29580827/dual-antiplatelet-therapy-versus-single-antiplatelet-therapy-after-transaortic-valve-replacement-meta-analysis
#11
Abdulah Alrifai, Mohamad Soud, Amjad Kabach, Yash Jobanputra, Abdulrahman Masrani, Saleh El Dassouki, M Chadi Alraies, Zaher Fanari
BACKGROUND: The current guidelines recommend empirical therapy with DAPT of aspirin and clopidogrel for six months after TAVR. This recommendation is based on expert consensus only. Giving the lack of clear consensus on treatment strategy following TAVR. Goal of this meta-analysis is to assess the efficacy and safety of mono-antiplatelet therapy (MAPT) versus dual antiplatelet therapy (DAPT) following transcatheter aortic valve replacement (TAVR). METHODS AND MATERIALS: We performed a meta-analysis from randomized clinical trials (RCTs) and prospective studies that tested DAPT vs...
March 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29546380/the-ross-procedure-in-adults-presenting-with-bicuspid-aortic-valve-and-pure-aortic-regurgitation-85-freedom-from-reoperation-at-20-years
#12
Chin L Poh, Edward Buratto, Marco Larobina, Rochelle Wynne, Michael O'Keefe, John Goldblatt, James Tatoulis, Peter D Skillington
OBJECTIVES: The Ross procedure has demonstrated excellent results when performed in patients with aortic stenosis or mixed aortic valve disease [aortic stenosis and aortic regurgitation (AR)]. However, due to its reported risk of late reoperation, it is not recommended under current guidelines for patients presenting with bicuspid aortic valve and pure AR. We have analysed our own results in light of this recommendation. METHODS: Between 1993 and 2016, 129 consecutive patients with a mean age of 34...
March 12, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29526358/patients-with-anomalous-aortic-origin-of-the-coronary-artery-remain-at-risk-after-surgical-repair
#13
Shannon N Nees, Jonathan N Flyer, Anjali Chelliah, Jeffrey D Dayton, Lorraine Touchette, David Kalfa, Paul J Chai, Emile A Bacha, Brett R Anderson
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare cardiac anomaly associated with sudden cardiac death (SCD). Single-center studies describe surgical repair as safe, although medium- and long-term effects on symptoms and risk of SCD remain unknown. We sought to describe outcomes of surgical repair of AAOCA. METHODS: We reviewed institutional records for patients who underwent AAOCA repair, from 2001 to 2016, at 2 affiliated institutions...
June 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29508124/timing-and-outcomes-of-pci-in-the-tavr-era
#14
REVIEW
Konstantinos V Voudris, Peter Petropulos, Panagiotis Karyofillis, Konstantinos Charitakis
PURPOSE OF REVIEW: Transcatheter aortic valve replacement (TAVR) has become an established therapy for patients with symptomatic severe aortic stenosis (AS). As the number of patients referred for TAVR increases, so does the prevalence of untreated obstructive coronary artery disease (CAD) in the population under evaluation. Despite the high prevalence of CAD in patients treated with TAVR, the management strategy of concomitant CAD in these patients remains an area of considerable uncertainty...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29475527/2018-canadian-cardiovascular-society-canadian-association-of-interventional-cardiology-focused-update-of-the-guidelines-for-the-use-of-antiplatelet-therapy
#15
Shamir R Mehta, Kevin R Bainey, Warren J Cantor, Marie Lordkipanidzé, Guillaume Marquis-Gravel, Simon D Robinson, Matthew Sibbald, Derek Y So, Graham C Wong, Joseph G Abunassar, Margaret L Ackman, Alan D Bell, Raymond Cartier, James D Douketis, Patrick R Lawler, Michael S McMurtry, Jacob A Udell, Sean van Diepen, Subodh Verma, G B John Mancini, John A Cairns, Jean-François Tanguay
Antiplatelet therapy (APT) has become an important tool in the treatment and prevention of atherosclerotic events, particularly those associated with coronary artery disease. A large evidence base has evolved regarding the relationship between APT prescription in various clinical contexts and risk/benefit relationships. The Guidelines Committee of the Canadian Cardiovascular Society and Canadian Association of Interventional Cardiology publishes regular updates of its recommendations, taking into consideration the most recent clinical evidence...
March 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29452115/bioprosthetic-versus-mechanical-valve-replacement-for-infective-endocarditis-focus-on-recurrence-rates
#16
Nana Toyoda, Shinobu Itagaki, Henry Tannous, Natalia N Egorova, Joanna Chikwe
BACKGROUND: Consensus guidelines for prosthesis selection in infective endocarditis recommend bioprosthetic or mechanical valve replacement based on life expectancy and comorbidity. However, contemporary outcome data are limited to institution series. METHODS: The outcomes of 3,447 patients identified from mandatory discharge databases in California and New York states who had either primary isolated mitral (n=1603) or aortic (n=1,844) valve replacement for active endocarditis between 1998 and 2010, were compared according to whether they received bioprosthetic (n=1,673, 48...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29406851/dobutamine-stress-echocardiography-for-management-of-low-flow-low-gradient-aortic-stenosis
#17
Mohamed-Salah Annabi, Eden Touboul, Abdellaziz Dahou, Ian G Burwash, Jutta Bergler-Klein, Maurice Enriquez-Sarano, Stefan Orwat, Helmut Baumgartner, Julia Mascherbauer, Gerald Mundigler, João L Cavalcante, Éric Larose, Philippe Pibarot, Marie-Annick Clavel
BACKGROUND: In the American College of Cardiology/American Heart Association guidelines, patients are considered to have true-severe stenosis when the mean gradient (MG) is ≥40 mm Hg with an aortic valve area (AVA) ≤1 cm2 during dobutamine stress echocardiography (DSE). However, these criteria have not been previously validated. OBJECTIVES: The aim of this study was to assess the value of these criteria to predict the presence of true-severe AS and the occurrence of death in patients with low-flow, low-gradient aortic stenosis (LF-LG AS)...
February 6, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29404357/permanent-pacemaker-insertion-in-patients-with-conduction-abnormalities-post-transcatheter-aortic-valve-replacement-a-review-and-proposed-guidelines
#18
REVIEW
Tamunoinemi Bob-Manuel, Amit Nanda, Samuel Latham, Issa Pour-Ghaz, William Paul Skelton, Rami N Khouzam
Conduction abnormalities are a common and serious complication of transcatheter aortic valve replacement (TAVR) with well-established predictive factors. Current guidelines are not concrete, leaving several questions unanswered about indications, timing and risks of pacemaker implantation post-TAVR. In this review article, we discuss current guidelines, predictors of pacemaker implantation, clinical implications of this procedure and our recommendations for reducing the pacemaker implantation rate post-TAVR...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29390335/fever-of-unknown-origin-and-splenomegaly-a-case-report-of-blood-culture-negative-endocarditis
#19
Maria Livia Burzo, Mariangela Antonelli, Giovanni Pecorini, Angela M R Favuzzi, Raffaele Landolfi, Andrea Flex
RATIONALE: Fever of unknown origin (FUO) can be determined by different conditions among which infectious diseases represent the main cause. PATIENT CONCERNS: A young woman, with a history of aortic stenosis, was admitted to our unit for a month of intermittent fever associated with a new diastolic heart murmur and splenomegaly. Laboratory tests were negative for infectious screening. The total body computed tomography (CT) scan excluded abscesses, occulted neoplasia, or lymphadenopathy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29345593/antithrombotic-therapy-after-tavr
#20
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
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