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TAVR AND (echocardiography) AND (left ventricular)

Vinisha Garg, Jonathan K Ho, Gabriel Vorobiof
Speckle tracking echocardiography (STE) has emerged as a novel angle-independent modality in assessing myocardial velocity, deformation, and strain. Its role in assessing change before and after aortic valve replacement in patients with aortic stenosis (AS) has recently generated interest. This review summarizes the practical utility and clinical implications of myocardial deformation by STE after surgical or transcatheter aortic valve replacement (TAVR). Overall, atrial strain and ventricular strain as measured by STE improve after surgical and transcatheter aortic intervention in short- and long-term follow-up with evidence of a more pronounced acute improvement in patients who undergo TAVR...
March 23, 2017: Echocardiography
Philippe J van Rosendael, Suzanne E van Wijngaarden, Vasileios Kamperidis, William K F Kong, Melissa Leung, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. METHODS AND RESULTS: Systolic MDCT data of 73 patients, referred for transcatheter aortic valve implantation (TAVI) who also had MR, were evaluated...
January 10, 2017: European Heart Journal
Z Li, Y Q Ye, M Y Wang, H Y Xu, S Y Teng, J Qian, W Wang, X Wang, Y J Wu
Objective: To evaluate the impact of left ventricular systolic dysfunction on all-cause mortality of 75 years old and over patients with moderate to severe aortic stenosis. Methods: Clinical data of 301 consecutive aged (≥75 years old) patients with a diagnosis of non-rheumatic moderate to severe aortic stenosis by echocardiography between January 1, 2008 and January 1, 2015 in our hospital were retrospectively analyzed. According to the LVEF, patients were divided into normal LVEF subjects and low LVEF subjects, and the low LVEF level was set at below 60%(≤60%(n=171)vs...
October 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
January 2017: Journal of Cardiology
Lars Grønlykke, Nikolaj Ihlemann, Anh Thuc Ngo, Hans Gustav Hørsted Thyregod, Jesper Kjaergaard, André Korshin, Finn Gustafsson, Christian Hassager, Jens Christian Nilsson, Lars Søndergaard, Hanne Berg Ravn
OBJECTIVES: Describe changes in measures of right ventricular (RV) function in patients treated for aortic stenosis using open-chest surgery (SAVR) or transcatheter treatment (TAVR). METHODS: Patients in the Nordic Aortic Valve Intervention (NOTION) trial were randomized 1:1 to TAVR (n = 114) or SAVR (n = 106). Echocardiography was performed at baseline and 3 and 12 months post-procedure. Tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (RVFAC) were used as measures of longitudinal and transverse RV contraction...
November 3, 2016: Interactive Cardiovascular and Thoracic Surgery
Jose F Condado, Stamatios Lerakis, James Stewart, Hanna Jensen, Travis S Henry, Sung Min Ko, Arthur Stillman, Mohammad H Rajaei, Kreton Mavromatis, Chandan Devireddy, Eric Sarin, Brad Leshnower, Robert Guyton, Brian Kaebnick, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To evaluate the role of balloon annular sizing in transcatheter aortic valve replacement (TAVR). BACKGROUND: Multidetector cardiac computed tomography (MDCT) is the gold standard for aortic annular sizing in TAVR. Balloon sizing is increasingly used in patients with borderline annular size and severe calcification. A comparison between these two techniques is needed. METHODS: We retrospectively compared baseline characteristics and 30-day outcomes of patients undergoing balloon-expandable TAVR using annular MDCT or balloon sizing...
July 2016: Journal of Invasive Cardiology
Hiroto Utsunomiya, Hirotsugu Mihara, Yuji Itabashi, Sayuki Kobayashi, Robert J Siegel, Tarun Chakravarty, Hasan Jilaihawi, Raj R Makkar, Takahiro Shiota
AIMS: Prosthesis-patient mismatch (PPM) after transcatheter aortic valve replacement (TAVR) leads to increased mortality. However, its peri-procedural determinants remain unknown. We investigated geometric changes in aortic annulus (AoA) and left ventricular outflow tract (LVOT) during TAVR by three-dimensional transoesophageal echocardiography (3D-TEE) and its association with post-procedural PPM. METHODS AND RESULTS: A total of 131 patients with severe aortic stenosis underwent intraprocedural 3D-TEE during balloon-expandable TAVR...
January 2017: European Heart Journal Cardiovascular Imaging
Sarkis Kiramijyan, Edward Koifman, Federico M Asch, Marco A Magalhaes, Romain Didier, Ricardo O Escarcega, Smita I Negi, Nevin C Baker, Zachary D Jerusalem, Jiaxiang Gai, Rebecca Torguson, Petros Okubagzi, Zuyue Wang, Christian C Shults, Itsik Ben-Dor, Paul J Corso, Lowell F Satler, Augusto D Pichard, Ron Waksman
The impact of the specific etiology of mitral regurgitation (MR) on outcomes in the transcatheter aortic valve replacement (TAVR) population is unknown. This study aimed to evaluate the longitudinal changes in functional versus organic MR after TAVR in addition to their impact on survival. Consecutive patients who underwent TAVR from May 2007 to May 2015 who had baseline significant (moderate or greater) MR were included. Transthoracic echocardiography was used to evaluate the cohort at baseline, post-procedure, 30-day, 6-month, and 1-year follow-up...
March 1, 2016: American Journal of Cardiology
Frédéric Poulin, Teerapat Yingchoncharoen, William M Wilson, Eric M Horlick, Philippe Généreux, E Murat Tuzcu, William Stewart, Mark D Osten, Anna Woo, Paaladinesh Thavendiranathan
BACKGROUND: The aim of this study was to compare left ventricular (LV) remodeling using myocardial strain between patients with severe aortic stenosis (AS) treated with transcatheter aortic valve replacement (TAVR) with and without prosthesis-patient mismatch (PPM). METHODS AND RESULTS: In a retrospective study, speckle-tracking echocardiography was used to measure global longitudinal strain (GLS) and strain rate (GLSR), circumferential strain, and rotation before and at mid-term follow-up post-TAVR...
February 8, 2016: Journal of the American Heart Association
Henrique B Ribeiro, Luis Nombela-Franco, Antonio J Muñoz-García, Pedro Alves Lemos, Ignacio Amat-Santos, Vicenç Serra, Fabio S de Brito, Alexandre Abizaid, Rogério Sarmento-Leite, Rishi Puri, Asim N Cheema, Marc Ruel, Fabian Nietlispach, Francesco Maisano, Cesar Moris, Raquel Del Valle, Marina Urena, Omar Abdul Jawad Altisent, Maria Del Trigo, Francisco Campelo-Parada, Pilar Jimenez Quevedo, Juan H Alonso-Briales, Hipólito Gutiérrez, Bruno García Del Blanco, Marco Antonio Perin, Dimytri Siqueira, Guilherme Bernardi, Éric Dumont, Melanie Côté, Philippe Pibarot, Josep Rodés-Cabau
BACKGROUND: Cardiac biomarker release signifying myocardial injury post-transcatheter aortic valve replacement (TAVR) is common, yet its clinical impact within a large TAVR cohort receiving differing types of valve and procedural approaches is unknown. OBJECTIVES: This study sought to determine the incidence, clinical impact, and factors associated with cardiac biomarker elevation post TAVR. METHODS: This multicenter study included 1,131 consecutive patients undergoing TAVR with balloon-expandable (58%) or self-expandable (42%) valves...
November 10, 2015: Journal of the American College of Cardiology
Hirotsugu Mihara, Kentaro Shibayama, Hasan Jilaihawi, Yuji Itabashi, Javier Berdejo, Hiroto Utsunomiya, Robert J Siegel, Raj R Makkar, Takahiro Shiota
OBJECTIVES: The purpose of this study was to determine which echocardiographic parameters, including holodiastolic flow reversal (HDFR) in the descending aorta, were useful for grading of post-procedural aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR) using intraprocedural transesophageal echocardiography. BACKGROUND: Reliable assessment of PAR in a catheterization laboratory is essential for an optimal outcome after TAVR; however, such an assessment has not been determined...
September 2015: JACC. Cardiovascular Imaging
Wenzhi Pan, Mingfei Li, Daxin Zhou, Lihua Guan, Leilei Cheng, Junbo Ge
OBJECTIVE: To evaluate the accuracy of echocardiography in identifying aortic valve structures and determine the prevalence of bicuspid aortic valves (BAV) in severe aortic stenosis (AS) population to provide useful information for transcatheteraortic valve replacement (TAVR). METHODS: A total of 300 AS patients undergoing surgical aortic valve replacement were included to determine the accuracy of transthoracic echocardiography in indentifying BAV from January 2009 to July 2013...
March 2015: Zhonghua Xin Xue Guan Bing za Zhi
Julian L Wichmann, Akos Varga-Szemes, Pal Suranyi, Richard R Bayer, Sheldon E Litwin, Carlo N De Cecco, Stefanie Mangold, Giuseppe Muscogiuri, Stephen R Fuller, Thomas J Vogl, Daniel H Steinberg, U Joseph Schoepf
Transcatheter aortic valve replacement (TAVR) is an increasingly used alternative to surgical aortic valve replacement in patients with severe aortic stenosis and prohibitive perioperative risk. Several studies have shown an improved clinical outcome and lower rate of complications with TAVR in this patient population. Furthermore, TAVR has shown promising results in patients at elevated risk from surgical aortic valve replacement. Because of the endovascular nature of this technique, comprehensive preprocedural assessment of the aortic root and vascular access path is crucial...
November 2015: Journal of Thoracic Imaging
Michael R Klein, Frida Sundh, Jacob Simlund, J Kevin Harrison, Kevin P Jackson, G Chad Hughes, Galen S Wagner, Niels Risum, Peter Søgaard, David G Strauss, Joseph Kisslo
INTRODUCTION: Left bundle branch block (LBBB) is a known complication of transcatheter aortic valve replacement (TAVR) and has been shown to predict worsened outcomes in TAVR patients. A regional longitudinal strain pattern, termed the "classic" pattern of left ventricular (LV) dyssynchrony, which is thought to be due to LBBB, is highly predictive of response to cardiac resynchronization therapy. Whether LBBB causes this "classic" pattern is not known. METHODS: We retrospectively studied patients undergoing TAVR who also underwent pre- and post-TAVR strain analysis to determine if the "classic" pattern arose in those who developed TAVR-induced true LBBB...
July 2015: Journal of Electrocardiology
Florent Le Ven, Christophe Thébault, Abdellaziz Dahou, Henrique B Ribeiro, Romain Capoulade, Haïfa Mahjoub, Marina Urena, Luis Nombela-Franco, Ricardo Allende Carrera, Marie-Annick Clavel, Éric Dumont, Jean Dumesnil, Robert De Larochellière, Josep Rodés-Cabau, Philippe Pibarot
OBJECTIVE: Low flow (LF), defined as stroke volume index (SVi) <35 mL/m(2), prior to the procedure has been recently identified as a powerful independent predictor of early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). The objectives of this study were to determine the evolution of SVi following TAVR and to assess the determinants and impact on mortality of early postprocedural SVi (EP-SVi). METHODS: We retrospectively analysed the clinical, Doppler echocardiographic and outcome data prospectively collected in 255 patients who underwent TAVR...
August 2015: Heart: Official Journal of the British Cardiac Society
Laura G J Hannink, Galen S Wagner, Joseph Kisslo, Fawaz Abdulaziz M Alenezi, Linda K Shaw, Paul Hofmann, Robbert Zusterzeel, Matthew Phelan, Eric J Velazquez, Anton P M Gorgels
BACKGROUND: New-onset left bundle branch block (LBBB) is a known complication during Transcatheter Aortic Valve Replacement (TAVR). This study evaluated the influence of pre-TAVR cardiac conditions on left ventricular functions in patients with new persistent LBBB post-TAVR. METHODS: Only 11 patients qualified for this study because of the strict inclusion criteria. Pre-TAVR electrocardiograms were evaluated for Selvester QRS infarct score and QRS duration, and left ventricular end-systolic volume (LVESV) was used as outcome variable...
July 2015: Journal of Electrocardiology
Siri Sjöberg, Frida Sundh, Todd Schlegel, Charles Maynard, Andreas Rück, Galen Wagner, Martin Ugander
INTRODUCTION: Calcific aortic stenosis (AS) is a common valvular disease among the elderly. Often, AS leads to left ventricular hypertrophy (LVH) and symptoms of heart failure. Severe AS can be treated by transcatheter aortic valve replacement (TAVR). Previous studies have shown that electrocardiogram (ECG) criteria for LVH correlate poorly with left ventricular mass (LVM) in echocardiography. However, such correlations have not been studied in TAVR patients. AIMS: To evaluate ECG LVH criteria as a method of diagnosing and quantifying LVH in patients with AS undergoing TAVR...
July 2015: Journal of Electrocardiology
Dominique Himbert, Alec Vahanian
Older patients suffering severe heart failure related to aortic stenosis (AS) undergo transcatheter aortic valve replacement (TAVR), owing to their high surgical risk. The diagnosis is made based on echocardiographic examination, but may require a multimodality imaging approach in patients with low gradients. In severely decompensated heart failure or cardiogenic shock, rescue percutaneous balloon aortic valvuloplasty as a bridge to TAVR seems reasonable. Emergent TAVR has been reported. Efforts should be made to avoid late diagnosis or referring patients with severe AS to offer them timely interventions, reduce the risk of TAVR, and predict whether left ventricular function will improve...
April 2015: Heart Failure Clinics
Yuji Itabashi, Kentaro Shibayama, Hirotsugu Mihara, Hiroto Utsunomiya, Javier Berdejo, Reza Arsanjani, Robert Siegel, Tarun Chakravarty, Hasan Jilaihawi, Raj R Makkar, Takahiro Shiota
BACKGROUND: Reduction in mitral regurgitation (MR) after transcatheter aortic valve replacement (TAVR) has previously been reported. However, the hemodynamic effects of TAVR in patients with MR have not been previously evaluated. METHODS: We analyzed 571 patients who underwent TAVR from December 2010 to December 2013. We studied 20 patients with moderate or severe preprocedural functional mitral regurgitation (FMR) who also had a follow-up transthoracic echocardiography (TTE) examination between 90 and 360 days (median 213 days) after TAVR (Significant FMR Group)...
November 2015: Echocardiography
Hirotsugu Mihara, Kentaro Shibayama, Javier Berdejo, Kenji Harada, Yuji Itabashi, Robert J Siegel, Mohammad Kashif, Hasan Jilaihawi, Raj R Makkar, Takahiro Shiota
BACKGROUND: Determinants of paravalvular regurgitation after transcatheter aortic valve replacement (TAVR) remain unclear. The purpose of this study was to investigate the impact of aortic valve calcification (AVC) on paravalvular regurgitation after TAVR using real-time three-dimensional transesophageal echocardiography. METHODS: A total of 227 patients with severe aortic stenosis who underwent TAVR using the Edwards SAPIEN or SAPIEN XT valve were retrospectively analyzed...
April 2015: Journal of the American Society of Echocardiography
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