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https://www.readbyqxmd.com/read/27899293/valvular-regurgitation-after-implantation-of-prostheses-secured-with-cor-knot-automated-fasteners
#1
Alexander A Brescia, Steven F Bolling, Himanshu J Patel
Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular less common. The Cor-knot automated fastener (LSI SOLUTIONS, Victor, NY, USA) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two cases in which Cor-Knot fastener orientation appeared to result in transvalvular regurgitation necessitating redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results...
November 26, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27899134/a-modified-park-s-stitch-to-correct-aortic-insufficiency-for-bioprosthetic-valve-at-time-of-left-ventricular-assist-device-implant-a-case-report
#2
Toshinobu Kazui, Nicole Sydow, Mark Friedman, Samuel Kim, Scott Lick, Zain Khalpey
BACKGROUND: Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI. CASE PRESENTATION: A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve...
November 30, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27898433/transcatheter-aortic-valve-implantation-in-nonagenarians
#3
Adam Penkalla, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, Volkmar Falk
OBJECTIVE: In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. METHODS: Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90-98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23...
November 28, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27875347/severe-low-gradient-aortic-stenosis-with-preserved-ventricular-function-should-it-be-treated
#4
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/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#5
REVIEW
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...
November 15, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27853942/course-of-early-subclinical-leaflet-thrombosis-after-transcatheter-aortic-valve-implantation-with-or-without-oral-anticoagulation
#6
Philipp Ruile, Nikolaus Jander, Philipp Blanke, Simon Schoechlin, Jochen Reinöhl, Michael Gick, Juergen Rothe, Mathias Langer, Jonathon Leipsic, Heinz-Joachim Buettner, Franz-Josef Neumann, Gregor Pache
BACKGROUND: After transcatheter aortic valve implantation, early leaflet thickening, presumably reflecting thrombus, has recently been described on computed tomography angiography (CTA) in ~10% of the patients. We sought to investigate the impact of the antithrombotic regimen on the course of leaflet thickening. METHODS: The study comprised 51 patients with leaflet thickening. Based on the time period, patients without an established indication for anticoagulation were put on phenprocoumon plus clopidogrel for at least 3 months or on dual antiplatelet therapy with aspirin and clopidogrel...
November 16, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/27746401/preclinical-determination-of-the-best-functional-position-for-transcatheter-heart-valves-implanted-in-rapid-deployment-bioprostheses
#7
Timm Schäfer, Christian Doose, Buntaro Fujita, Marc Utzenrath, Sandrine Egron, Christoph Schmitz, Smita Scholtz, Maximilian Kütting, Kavous Hakim-Meibodi, Jochen Börgermann, Jan Gummert, Ulrich Steinseifer, Stephan Ensminger
AIMS: The aim was to determine the best functional position of a transcatheter heart valve (THV) implanted as a valve-in-valve (ViV) procedure in small rapid deployment valves (RDV) in an in vitro model. METHODS AND RESULTS: A 21mm Perceval™, Enable™ or INTUITY™ RDV was mounted into a pulse duplicator and a 23mm balloon-expandable or a self-expanding THV was deployed (valve-in-valve) in two different positions. Under physiological hydrodynamic conditions, performance of the THV was characterized by mean transvalvular pressure gradient (MPG), effective orifice area (EOA) and regurgitation volume (RV)...
October 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27721950/impact-of-valvuloarterial-impedance-on-concentric-remodeling-in-aortic-stenosis-and-its-regression-after-valve-replacement
#8
Jeong Yoon Jang, Jeong-Sook Seo, Byung Joo Sun, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song
BACKGROUND: Left ventricle (LV) in patients with aortic stenosis (AS) faces a double hemodynamic load incorporating both valvular stenosis and reduced systemic arterial compliance (SAC). This study aimed to evaluate the impact of global LV afterload on LV hypertrophy (LVH) before and after aortic valve replacement (AVR). METHODS: The study cohort included 453 patients (247 males; mean age, 64 ± 11 years) who underwent AVR. Pre- and post-AVR echocardiographic examinations were retrospectively analyzed including an index of valvuloarterial impedance (ZVA) and LV mass index/LV end-diastolic volume index (LVMI/LVEDVI) as a parameter of LVH...
September 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27703574/aortic-annular-enlargement-during-aortic-valve-replacement
#9
Selman Dumani, Ermal Likaj, Laureta Dibra, Stavri Llazo, Ali Refatllari
In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27677241/first-north-american-experience-with-the-transfemoral-acurate-neo-tm-self-expanding-transcatheter-aortic-bioprosthesis
#10
Rodrigo Bagur, Patrick J Teefy, Bob Kiaii, Pantelis Diamantouros, Michael W A Chu
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative for patients presenting with severe symptomatic aortic stenosis and considered at high-surgical risk. Paravalvular leak (PVL), conduction disorders, and coronary obstruction remain unresolved procedure-related complications. The aim of this manuscript was to report the first North American experience with the ACURATE-neo(TM) aortic bioprosthesis and its ACURATE-TF(TM) delivery system (Symetis S...
September 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27640027/leaflet-motion-abnormality-after-tavi-genuine-threat-or-much-ado-about-nothing
#11
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
https://www.readbyqxmd.com/read/27638236/abnormal-ventricular-and-aortic-wall-properties-can-cause-inconsistencies-in-grading-aortic-regurgitation-severity-a-computer-simulation-study
#12
Georgina Palau-Caballero, John Walmsley, John Gorcsan, Joost Lumens, Tammo Delhaas
BACKGROUND: Assessment of aortic regurgitation (AR) severity is often based on Doppler echocardiographic imaging. Hemodynamic responses to AR are influenced by the interplay among cardiovascular properties, including left ventricular (LV) and aortic tissue properties, that cannot be measured directly. The aim of this study was to investigate how both echocardiographic measures of AR severity and the hemodynamic consequences of AR are influenced by LV and aortic stiffness. METHODS: AR was simulated using the CircAdapt computational model of the human cardiovascular system...
September 13, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27624351/transcatheter-valve-in-valve-implantation-versus-redo-surgical-aortic-valve-replacement-in-patients-with-failed-aortic-bioprostheses
#13
Miriam Silaschi, Olaf Wendler, Moritz Seiffert, Liesa Castro, Edith Lubos, Johannes Schirmer, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schäfer, Hendrik Treede, Philip MacCarthy, Lenard Conradi
OBJECTIVES: Transcatheter aortic valve-in-valve implantation (ViV) is a new treatment for failing bioprostheses (BP) in patients with high surgical risk. However, comparative data, using standard repeat surgical aortic valve replacement (redo-SAVR), are scarce. We compared outcomes after ViV with those after conventional redo-SAVR in two European centres with established interventional programmes. METHODS: In-hospital databases were retrospectively screened for patients ≥60 years, treated for failing aortic BP...
September 13, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27609634/online-cardiac-output-estimation-during-transvalvular-left-ventricular-assistance
#14
Daniel Rüschen, Miriam Rimke, Jonas Gesenhues, Steffen Leonhardt, Marian Walter
BACKGROUND AND OBJECTIVES: Sufficient cardiac output is one of the main goals of ventricular assist device therapy. To date, there is no adequate method to estimate the combined amount of blood the native heart and a continuous-flow assist device pump through the circulatory system. This paper presents an approach to estimate total cardiac output based on the signals provided by optical pressure sensors mounted on the inlet and outlet of an Abiomed Impella CP pump. METHODS: Two Kalman filters were used in parallel for joint estimation of the aortic flow rate and the hydraulic resistance of the aortic valve...
August 30, 2016: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/27592572/-hybrid-procedure-for-infants-children-treatment-with-pulmonary-stenosis-under-transesophageal-echocardiographic-guidance
#15
Li Xie, Can Huang, Sijie Wu, Wancun Jin, Lei Gao, Qin Wu, Jinfu Yang, Zhongshi Wu, Tianli Zhao, Yifeng Yang, Fenglin Song
OBJECTIVE: To investigate the outcomes of hybrid procedure in treating 10 infants/children with pulmonary stenosis under transesophageal echocardiographic guidance.
 METHODS: Between September, 2009 and December, 2015, 10 infants/children underwent hybrid procedure of transthoracic balloon pulmonary valvuloplasty for pulmonary stenosis in the Second Xiangya Hospital, Central South University. The age, height and weight at the time of admission were 0.7-42 (14...
July 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/27578840/outcomes-of-redo-transcatheter-aortic-valve-replacement-for-the-treatment-of-postprocedural-and-late-occurrence-of-paravalvular-regurgitation-and-transcatheter-valve-failure
#16
Marco Barbanti, John G Webb, Claudia Tamburino, Nicolas M Van Mieghem, Raj R Makkar, Nicolò Piazza, Azeem Latib, Jan-Malte Sinning, Kim Won-Keun, Sabine Bleiziffer, Francesco Bedogni, Samir Kapadia, Didier Tchetche, Josep Rodés-Cabau, Claudia Fiorina, Luis Nombela-Franco, Federico De Marco, Peter P de Jaegere, Tarun Chakravarty, Beatriz Vaquerizo, Antonio Colombo, Lars Svensson, Rüdiger Lange, Georg Nickenig, Helge Möllmann, Thomas Walther, Francesco Della Rosa, Yacine Elhmidi, Danny Dvir, Nedy Brambilla, Sebastiano Immè, Carmelo Sgroi, Simona Gulino, Denise Todaro, Gerlando Pilato, Anna Sonia Petronio, Corrado Tamburino
BACKGROUND: Transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. METHODS AND RESULTS: Clinical and echocardiographic outcomes of patients who underwent redo transcatheter aortic valve replacement (TAVR) procedures >2 weeks post procedure were collected from 14 centers. Among 13 876 patients, 50 (0.4%) underwent redo TAVR procedure at participating centers. Indications for redo TAVR were moderate-severe prosthetic aortic valve stenosis (n=10, 21...
September 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27573761/effects-of-leaflet-design-on-transvalvular-gradients-of-bioprosthetic-heart-valves
#17
Yaghoub Dabiri, Janet Ronsky, Imtiaz Ali, Ameen Basha, Alisha Bhanji, Kishan Narine
Bioprosthetic aortic valves (BAVs) are becoming the prostheses of choice in heart valve replacement. The objective of this paper is to assess the effects of leaflet geometry on the mechanics and hemodynamics of BAVs in a fluid structure interaction model. The curvature and angle of leaflets were varied in 10 case studies whereby the following design parameters were altered: a circular arch, a line, and a parabola for the radial curvature, and a circular arch, a spline, and a parabola for the circumferential curvature...
December 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27572071/percutaneous-treatment-of-severe-transvalvular-and-paravalvular-regurgitation-in-a-failing-surgical-aortic-valve-prosthesis-due-to-recurrent-endocarditis
#18
Ronald K Binder, Fabian Nietlispach, Tomas Holubec, Francesco Maisano
No abstract text is available yet for this article.
August 28, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27570156/pulmonary-valve-replacement-with-a-trifecta-valve-is-associated-with-reduced-transvalvular-gradient
#19
Brian C Gulack, Ehsan Benrashid, Robert D B Jaquiss, Andrew J Lodge
BACKGROUND: Outcomes after surgical pulmonary valve replacement (PVR) in patients with congenital cardiac disease are limited by long-term valve deterioration, which may be hastened by turbulent flow. The use of the Trifecta valve (St. Jude Medical, Little Canada, MN) at our institution (Duke University Medical Center, Durham, NC) appears to result in low postimplantation transvalvular gradients. This study was performed to compare the early transvalvular gradient associated with the Trifecta valve with that associated with two other valves commonly used for PVR...
August 25, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27521550/impact-of-underfilling-and-overfilling-in-balloon-expandable-transcatheter-aortic-valve-implantation-assessed-by-multidetector-computed-tomography-insights-from-the-optimized-catheter-valvular-intervention-ocean-tavi-registry
#20
Fumiaki Yashima, Masanori Yamamoto, Yusuke Watanabe, Kensuke Takagi, Yoshitake Yamada, Taku Inohara, Ryo Yanagisawa, Makoto Tanaka, Takahide Arai, Hideyuki Shimizu, Masahiro Jinzaki, Ken Kozuma, Keiichi Fukuda, Takahiko Suzuki, Kentaro Hayashida
BACKGROUND: Underfilling or overfilling of balloon-expandable transcatheter heart valves (THVs) during transcatheter aortic valve implantation (TAVI) is commonly used to improve conformity to small or calcified annuli in order to avoid serious complications. However, little is known about this technique. This study assessed the effects of underfilling and overfilling of THVs. METHODS AND RESULTS: Data from 213 consecutive TAVI patients treated with balloon-expandable THVs in 4 Japanese centers between October 2013 and December 2014 were prospectively analyzed; 23-mm and 26-mm THVs were implanted in 96 cases (56 underfilling, 22 nominal filling, and 18 overfilling) and 38 cases (23 underfilling and 15 nominal filling), respectively...
November 1, 2016: International Journal of Cardiology
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