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(percutaneous OR transcatheter OR transfemoral OR transapical OR transsubclavian) AND (aortic valve) AND (replacement OR implantation) AND (echocardiography)

Lorenzo Conte, Iacopo Fabiani, Nicola R Pugliese, Cristina Giannini, Salvatore La Carruba, Marco Angelillis, Paolo Spontoni, Marco De Carlo, Anna Sonia Petronio, Vitantonio Di Bello
OBJECTIVES: Assessment of the prognostic role of left ventricular stiffness (LVS) in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS: We performed a complete two-dimensional transthoracic echocardiographic study before and after TAVI in patients with severe AS at high surgical risk. In order to assess LVS, we measured LV end-diastolic pressure (EDP) invasively during TAVI and LV end-diastolic volume (EDV) by means of echocardiography...
October 25, 2016: Echocardiography
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
V J Nijenhuis, M P Huitema, V M M Vorselaars, M J Swaans, T de Kroon, J A S van der Heyden, B J W M Rensing, R Heijmen, J M Ten Berg, M C Post
AIMS: Pulmonary hypertension (PH) is associated with mortality after transcatheter aortic valve implantation (TAVI). However, diagnosis based on tricuspid regurgitant velocity (TRV) is often inaccurate and unreliable. The updated PH guidelines introduced a PH probability grading implementing additional PH signs on transthoracic echocardiography (TTE), from which we aimed to analyse its effects on clinical outcomes in patients undergoing TAVI. METHODS AND RESULTS: We included 591 consecutive patients (mean age 80...
October 6, 2016: International Journal of Cardiology
Amedeo Anselmi, Vito Giovanni Ruggieri, Bernard Lelong, Erwan Flecher, Hervé Corbineau, Thierry Langanay, Jean-Philippe Verhoye, Alain Leguerrier
OBJECTIVE: To clarify the mid-term durability of the Trifecta bioprosthesis for aortic valve replacement (AVR). METHODS: We retrospectively analyzed the prospectively collected data of 824 consecutive implants of the Trifecta valve at a single institution. A 100% complete follow-up was available (average duration, 2.2 ± 1.3 years; range, 0.03-6.9 years; 1747.6 patient-years). Echocardiography data at discharge were recorded prospectively. RESULTS: Operative mortality was 3...
August 30, 2016: Journal of Thoracic and Cardiovascular Surgery
Pranav Loyalka, Angelo Nascimbene, Michael Schechter, Marija Petrovic, Ajay Sundara Raman, Igor D Gregoric, Biswajit Kar
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic aortic valve has been successfully performed as an alternative to surgery. We describe our initial experience of valve-in-valve TAVI in five patients, using new generation Edwards Sapien 3 transcatheter heart valves implanted into degenerated 19 mm bioprosthetic valves. 20-mm Edwards S3 valves were offered for compassionate use. All patients had significant aortic valve stenosis. METHODS AND RESULTS: The main vascular access was achieved and pre-closed with two Proglide closure devices in one patient and Prostar closure devices in four patients...
October 3, 2016: Catheterization and Cardiovascular Interventions
Tarun Chakravarty, Yigal Abramowitz, Hasan Jilaihawi, Raj R Makkar
Symptomatic transcatheter heart valve (THV) thrombosis is noted in up to 1% of patients after transcatheter aortic valve replacement. Recently, hypoattenuated leaflet thickening and reduced leaflet motion of bioprosthetic aortic valves associated with normal transvalvular gradients (and possibly related to subclinical leaflet thrombosis) have been reported. While trans-thoracic echocardiography is a useful initial screening imaging modality for the detection of symptomatic THV thrombosis associated with elevated transvalvular gradients, it has limited utility in the detection of subclinical THV thrombosis...
September 18, 2016: EuroIntervention
Christian E Rex, Johan Heiberg, Kaj-Erik Klaaborg, Vibeke E Hjortdal
PURPOSE: Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to include also intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR)...
September 10, 2016: Scandinavian Cardiovascular Journal: SCJ
A A Sakrana, M M Nasr, G A Ashamallah, R A Abuelatta, H A Naeim, M E Tahlawi
AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO)...
November 2016: Clinical Radiology
Andrew K Roy, Jerome Garot, Antoinette Neylon, Marco Spaziano, Fadi J Sawaya, Thierry Lefèvre
Progressive dyspnea and hypoxaemia in the subacute phase after transcatheter aortic valve implantation (TAVI) are uncommon and warrant immediate assessment of valve and prosthesis leaflet function to exclude thrombosis, as well as investigation for other causes related to the procedure, such as left ventricular dysfunction, pulmonary embolism, and respiratory sepsis. In this case, we report the observation of a patient presenting two weeks after TAVI with arterial hypoxaemia in an upright position, relieved by lying flat, and coupled with an intracardiac shunt detected on echocardiography in the absence of pulmonary hypertension, raising the suspicion of Platypnea-Orthodeoxia Syndrome (POS)...
2016: Case Reports in Cardiology
Nicolaj C Hansson, Erik L Grove, Henning R Andersen, Jonathon Leipsic, Ole N Mathiassen, Jesper M Jensen, Kaare T Jensen, Philipp Blanke, Tina Leetmaa, Mariann Tang, Lars R Krusell, Kaj E Klaaborg, Evald H Christiansen, Kim Terp, Christian J Terkelsen, Steen H Poulsen, John Webb, Hans Erik Bøtker, Bjarne L Nørgaard
BACKGROUND: There is increasing focus on transcatheter heart valve (THV) thrombosis. However, there are limited data on incidence, clinical implications and predisposing factors of THV thrombosis following transcatheter aortic valve replacement (TAVR). OBJECTIVES: We assessed the incidence, potential predictors, and clinical implications of THV thrombosis determined by contrast-enhanced multidetector computed tomography (MDCT) after TAVR. METHODS: Among 460 consecutive patients undergoing TAVR with the Edwards Sapien XT or Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) valves, 405 (88%) underwent MDCT in addition to transthoracic and transesophageal echocardiography 1-3 months post-TAVR...
August 18, 2016: Journal of the American College of Cardiology
Hashrul N Rashid, Liam M McCormick, Robert P Gooley, Ian T Meredith
A 79-year-old man with stable chronic obstructive pulmonary disease was found to have an abdominal aortic aneurysm and worsening dyspnoea. Echocardiography demonstrated critical aortic stenosis. Simultaneous endovascular aneurysm repair (EVAR) and transcatheter aortic valve replacement (TAVR) was recommended due to high surgical risk. Procedural strategy was to perform balloon valvuloplasty (BAV), followed by EVAR then TAVR. The initial 25 mm Lotus valve adopted a barrel shape suggestive of an undersized valve and was thus replaced with a 27 mm valve...
August 30, 2016: Cardiovascular Intervention and Therapeutics
Juan A Castillo-Moreno, Irene A García-Escribano, Miryam Martínez-Pascual-de-Riquelme, Leticia Jaulent-Huertas, Derek F Dau-Villarreal, Ramón Rubio-Patón, José A Giner-Caro, Juan C Bonaque-González, Luciano Consuegra-Sánchez
The 6-minute walk test distance (6MWD) has been shown to predict prognosis in selected cohorts of patients with heart failure and outcomes after surgical or transcatheter aortic valve implantation (AVI) in patients with symptomatic severe aortic stenosis (AS). Our objective was to evaluate the association between the 6MWD and outcome in patients with severe AS while remaining under medical treatment. In a prospective observational cohort study, a total of 149 patients diagnosed with severe AS by Doppler echocardiography underwent a 6-minute walk test...
October 15, 2016: American Journal of Cardiology
Ganesh Manoharan, Axel Linke, Helge Moellmann, Simon Redwood, Christian Frerker, Jan Kovac, Thomas Walther
AIMS: The aim of this study was to evaluate the safety and performance of the resheathable and repositionable St. Jude Medical Portico self-expanding transfemoral TAVI system. METHODS AND RESULTS: This prospective, single-arm, multicentre study evaluated the 18 Fr Portico system with either a 23 or a 25 mm valve. Patient follow-up was at 30, 90, 180 days and one year. Results up to 30 days are presented. Adverse events were categorised by VARC definitions and adjudicated by an independent events committee...
August 20, 2016: EuroIntervention
Takashi Murakami, Hiromichi Fujii, Masanori Sakaguchi, Yosuke Takahashi, Yasuo Suehiro, Shinsuke Nishimura, Yoshito Sakon, Daisuke Yasumizu, Etsuji Sohgawa, Toshihiko Shibata
Transcatheter closure of paravalvular leaks requires precise assessment of the location, size, and shape of the defect. Transesophageal echocardiography plays an important role in this process. We encountered a case of a paravalvular leak at the aortic position after aortic and mitral valve replacement. It was impossible to detect the precise location of the paravalvular leak with transesophageal echocardiography because of an acoustic shadow from the mitral mechanical valve. Intraoperative use of intravascular ultrasound was useful for determining the morphology of the defect and evaluating the procedure during the operation...
August 8, 2016: General Thoracic and Cardiovascular Surgery
Henrique B Ribeiro, Stefan Orwat, Salim S Hayek, Éric Larose, Vasilis Babaliaros, Abdellaziz Dahou, Florent Le Ven, Sergio Pasian, Rishi Puri, Omar Abdul-Jawad Altisent, Francisco Campelo-Parada, Marie-Annick Clavel, Philippe Pibarot, Stamatios Lerakis, Helmut Baumgartner, Josep Rodés-Cabau
BACKGROUND: Residual aortic regurgitation (AR) following transcatheter aortic valve replacement (TAVR) is associated with greater mortality; yet, determining AR severity post-TAVR using Doppler echocardiography remains challenging. Cardiovascular magnetic resonance (CMR) is purported as a more accurate means of quantifying AR; however, no data exist regarding the prognostic value of AR as assessed by CMR post-TAVR. OBJECTIVES: This study sought to evaluate the effect of AR assessed with CMR on clinical outcomes post-TAVR...
August 9, 2016: Journal of the American College of Cardiology
Mohammad Abdelghani, Ben Ren, Ernest Spitzer, Hiroki Tateishi, Hans Jonker, Marcel L Geleijnse, Jan G Tijssen, Robbert J de Winter, Patrick W J C Serruys, Osama I I Soliman
Paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) is challenging to quantitate. Transthoracic echocardiography (TTE) is the main tool used for the assessment of PVL but is modestly reproducible. We sought to develop a reproducible echocardiographic approach to assess PVL in the post-TAVI setting. Four observers independently analyzed eleven parameters of PVL severity in 50 pre-discharge TTE studies performed after TAVI. The parameters included color-Doppler parameters [jet circumferential extent (CE) and planimetered vena contracta area in the short-axis view and jet breadth and qualitative features in the long-axis views], continuous-wave Doppler parameters [jet velocity time integral (VTI) and pressure half time (PHT)], quantitative Doppler parameters (regurgitation volume and fraction and effective regurgitant orifice area), aortic diastolic flow reversal and valve stent eccentricity...
October 2016: International Journal of Cardiovascular Imaging
Eric Van Belle, Antoine Rauch, Flavien Vincent, Emmanuel Robin, Marion Kibler, Julien Labreuche, Emmanuelle Jeanpierre, Marie Levade, Christopher Hurt, Natacha Rousse, Jean-Baptiste Dally, Nicolas Debry, Jean Dallongeville, Andre Vincentelli, Cedric Delhaye, Jean-Luc Auffray, Francis Juthier, Guillaume Schurtz, Gilles Lemesle, Thibault Caspar, Olivier Morel, Nicolas Dumonteil, Alain Duhamel, Camille Paris, Annabelle Dupont-Prado, Paulette Legendre, Frederic Mouquet, Berenice Marchant, Sylvie Hermoire, Delphine Corseaux, Karim Moussa, Aurelie Manchuelle, Jean-Jacques Bauchart, Valentin Loobuyck, Claudine Caron, Christophe Zawadzki, Fabrice Leroy, Jean-Christophe Bodart, Bart Staels, Jenny Goudemand, Peter J Lenting, Sophie Susen
BACKGROUND: Postprocedural aortic regurgitation occurs in 10 to 20% of patients undergoing transcatheter aortic-valve replacement (TAVR) for aortic stenosis. We hypothesized that assessment of defects in high-molecular-weight (HMW) multimers of von Willebrand factor or point-of-care assessment of hemostasis could be used to monitor aortic regurgitation during TAVR. METHODS: We enrolled 183 patients undergoing TAVR. Patients with aortic regurgitation after the initial implantation, as identified by means of transesophageal echocardiography, underwent additional balloon dilation to correct aortic regurgitation...
July 28, 2016: New England Journal of Medicine
Y Tayyareci, R Dworakowski, P Kogoj, J Reiken, C Kenny, P MacCarthy, O Wendler, M J Monaghan
OBJECTIVE: To assess the impact of mitral geometry, left ventricular (LV) remodelling and global LV afterload on mitral regurgitation (MR) after trans-catheter aortic valve implantation (TAVI). METHODS: In this study, 60 patients who underwent TAVI were evaluated by 3D echocardiography at baseline, 1 month and 6 months after procedure. The proportional change in MR following TAVI was determined by examining the percentage change in vena contracta (VC) at 6 months...
September 2016: Echo Research and Practice
Cenk Sarı, Tahir Durmaz, Bilge Duran Karaduman, Telat Keleş, Hüseyin Bayram, Serdal Baştuğ, Mehmet Burak Özen, Nihal Akar Bayram, Emine Bilen, Hüseyin Ayhan, Hacı Ahmet Kasapkara, Engin Bozkurt
Transcatheter aortic valve implantation (TAVI) was introduced as an alternative treatment for patients with severe symptomatic aortic stenosis for whom surgery would be high-risk. Prosthetic aortic valve endocarditis is a serious complication of surgical AVR (SAVR) with high morbidity and mortality. According to recent cases, post-TAVI prosthetic valve endocarditis (PVE) seems to occur very rarely. We present the case of a 75-year-old woman who underwent TAVI (Edwards Saphien XT) with an uneventful postoperative stay...
March 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Yusuke Shimahara, Junjiro Kobayashi
The advent of transcatheter aortic valve implantation (TAVI) has been rapidly evolving the treatment of the severe aortic stenosis in patients with comorbidities that lead to being high-risk for conventional aortic valve replacement. The patient selection for TAVI is carefully made by a multidisciplinary heart team. An accurate preoperative assessment of the computed tomography angiography and transesophageal echocardiography are necessary for procedural success. In Japan, SAPIEN XT and CoreValve are available, and Lotus Valve is under clinical trial...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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