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https://www.readbyqxmd.com/read/28805033/balloon-aortic-valvuloplasty-in-the-tavr-era-not-so-new-but-definitely-improved
#1
EDITORIAL
Ted Feldman, Mayra Guerrero
BAV in the TAVR era is not well studied BAV resulted in improvements in aortic valve area and transvalvular pressure gradient, and in patients with impaired left ventricle function, ejection fraction improved. These improvements diminished over time, but at one year were still improved compared to baseline. BAV resulted in changes of planned therapy more than half of the patients treated as bridge for TAVR did not ultimately undergo TAVR twice as many planned as bridge for surgical valve replacement actually had surgical valve replacement...
August 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28799521/transcatheter-mitral-valve-replacement-long-term-outcomes-of-first-in-man-experience-with-an-apically-tethered-device-a-case-series-from-a-single-centre
#2
Alison Duncan, Anan Daqa, James Yeh, Simon Davies, Anselm Uebing, Cesare Quarto, Neil Moat
AIMS: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/2-year outcomes of the 5 first-in-man patients undergoing chronic TMVR with the Tendyne device. METHODS AND RESULTS: Five patients (STS score 14%-23%) underwent TMVR using a Tendyne system under compassionate use at a single centre. 1 patient (who was noncompliant with anti-coagulation) died 9 months after TMVR following a cerebrovascular accident...
August 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28799252/the-impact-of-global-left-ventricular-afterload-on-left-ventricular-reverse-remodeling-after-aortic-valve-replacement
#3
Hisato Ito, Toru Mizumoto, Yu Shomura, Yasuhiro Sawada, Ko Kajiyama, Hideto Shimpo
BACKGROUND: Conventional indices such as prosthetic valve effective orifice area (EOA) or transvalvular pressure gradients (TPG) may be unreliable in predicting left ventricular (LV) reverse remodeling after aortic valve replacement (AVR). We hypothesized that the global LV afterload, including valvular and arterial impedance, could influence LV reverse remodeling after AVR. METHODS: Twenty-three consecutive aortic-stenosis patients (mean age, 76 ± 6.4 years) underwent isolated AVR using contemporary externally wrapped pericardial valves (19 mm, 10 patients; 21 mm 11; 23 mm, 2)...
August 11, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28797415/low-transvalvular-flow-and-prognosis-in%C3%A2-the-seas-trial
#4
EDITORIAL
Paul A Grayburn
No abstract text is available yet for this article.
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28764221/maximal-aortic-valve-cusp-separation-and-severity-of-aortic-stenosis
#5
K Jayaprakash, V P Dilu, Raju George
INTRODUCTION: An integrated approach that incorporates two dimensional, M mode and Doppler echocardiographic evaluation has become the standard means for accurate quantification of severity of valvular aortic stenosis. Maximal separation of the aortic valve cusps during systole has been shown to correlate well with the severity of aortic stenosis measured by other echocardiographic parameters. AIM: To study the correlation between Maximal Aortic valve Cusp Separation (MACS) and severity of aortic valve stenosis and to find cut-off values of MACS for detecting severe and mild aortic stenosis...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28706126/transfemoral-transcatheter-aortic-valve-in-valve-implantation-for-aortic-valve-bioprosthesis-failure-with-the-fully-repositionable-and-retrievable-lotus-valve-a-single-center-experience
#6
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
OBJECTIVE: To report a first case series of the Lotus valve (Boston Scientific) for the treatment of surgical aortic bioprosthesis failure. BACKGROUND: Valve-in-valve (VIV) transcatheter aortic valve implantation (TAVI) is an established management option for surgical aortic bioprosthesis failure. Although TAVI has proven efficacious, complications relating to suboptimal valve implantation have been reported in approximately 5% of patients. The Lotus valve is fully repositionable and retrievable, and therefore enables complete assessment of valve function prior to definitive deployment...
July 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28698291/bioprosthetic-valve-fracture-improves-the-hemodynamic-results-of-valve-in-valve-transcatheter-aortic-valve-replacement
#7
Adnan K Chhatriwalla, Keith B Allen, John T Saxon, David J Cohen, Sanjeev Aggarwal, Anthony J Hart, Suzanne J Baron, Danny Dvir, A Michael Borkon
BACKGROUND: Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) may be less effective in small surgical valves because of patient/prosthesis mismatch. Bioprosthetic valve fracture (BVF) using a high-pressure balloon can be performed to facilitate VIV TAVR. METHODS AND RESULTS: We report data from 20 consecutive clinical cases in which BVF was successfully performed before or after VIV TAVR by inflation of a high-pressure balloon positioned across the valve ring during rapid ventricular pacing...
July 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28697003/the-respect-rather-than-resect-principle-in-mitral-valve-repair-the-lateral-dislocation-of-the-p2-technique
#8
Marco Zanobini, Gabriella Ricciardi, Francesco Liborio Mammana, Samer Kassem, Paolo Poggio, Alessandro Di Minno, L Cavallotti, Matteo Saccocci
BACKGROUND: Leaflet resection represents the reference standard for surgical treatment of mitral valve (MV) regurgitation. New approaches recently proposed place emphasis on respecting, rather than resecting, the leaflet tissue to avoid the drawbacks of the 'resection' approach. OBJECTIVES: The lateral dislocation of mid portion of mitral posterior leaflet (P2) technique for MV repair is a nonresectional technique in which the prolapsed P2 segment is sutured to normal P1 segment...
September 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#9
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28655156/comparison-of-latest-generation-transfemoral-self-expandable-and-balloon-expandable-transcatheter-heart-valves
#10
Andreas Schaefer, Matthias Linder, Moritz Seiffert, Gerhard Schoen, Florian Deuschl, Niklas Schofer, Yvonne Schneeberger, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
OBJECTIVES: We herein aimed to compare acute 30-day outcomes of latest-generation self-expandable and balloon-expandable transcatheter heart valves. METHODS: From 2012 through 2016, 104 consecutive patients (study group, 69.2% female, 81.7 ± 5.5 years, logEuroSCORE I 15.9 ± 9.3%) received transfemoral transcatheter aortic valve implantation using the Symetis ACURATE neo ® transcatheter heart valve. A control group of patients after transfemoral transcatheter aortic valve implantation with the Edwards Sapien 3™ transcatheter heart valve was retrieved from our database and matched to the study group...
June 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637199/first-ex-vivo-and-preliminary-sheep-model-results-of-the-new-tribio-aortic-valve-bioprosthesis-in-small-aortic-annuli
#11
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: : Small aortic annuli are challenging in aortic valve replacement. Prosthesis-patient mismatch, accompanied by high transvalvular gradients and small orifice area, is an often faced problem impairing postoperative outcome. The new TRIBIO bioprosthesis aims to enable enhanced haemodynamics, being increasingly important with decreasing annular size. This study compares ex vivo hydrodynamics of TRIBIO with 2 established bioprostheses in small annuli at different stroke volumes, simulating 'rest' and 'exercise', and evaluates haemodynamics of TRIBIO in a sheep model...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28619122/long-term-results-of-percutaneous-balloon-valvuloplasty-in-neonatal-critical-pulmonary-valve-stenosis-a-20-year-single-centre-experience
#12
Petra Loureiro, Barbara Cardoso, Inês B Gomes, José F Martins, Fátima F Pinto
Introduction Percutaneous balloon valvuloplasty is the primary treatment for critical pulmonary valve stenosis in neonates. Thus far, a few studies have reported long-term results of this technique in neonatal critical pulmonary valve stenosis. METHODS: We carried out a retrospective study of all consecutive newborns with critical pulmonary valve stenosis subjected to percutaneous balloon valvuloplasty at a single centre, between 1994 and 2014, to assess its immediate and long-term safety and efficacy...
September 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28616543/transcatheter-aortic-valve-implantation-with-the-new-generation-evolut-r%C3%A2-comparison-with-corevalve%C3%A2-in-a-single-center-cohort
#13
Eberhard Schulz, Alexander Jabs, Tommaso Gori, Stephan von Bardeleben, Ulrich Hink, Walter Kasper-König, Christian Friedrich Vahl, Thomas Münzel
BACKGROUND: The Medtronic Evolut R (EVR) is a novel transcatheter heart valve designed to allow precise implantation at the intended position and to minimize prosthesis dysfunction as well as procedural complications. Our aim was to compare short-term functional and clinical outcomes of the new EVR with the established Medtronic CoreValve (CV) system. METHODS AND RESULTS: Of 151 patients undergoing transfemoral transcatheter aortic valve implantation with a self-expanding valve at our institution between January 2013 and January 2016, 86 were treated with EVR and 65 with CV...
September 2016: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28599829/noninvasive-coronary-flow-reserve-predicts-response-to-exercise-in-asymptomatic-severe-aortic-stenosis
#14
Patrick Meimoun, Daniel Czitrom, Jérome Clerc, Jean Christophe Seghezzi, Sonia Martis, Alain Berrebi, Frederic Elmkies
BACKGROUND: In patients with asymptomatic aortic stenosis (AS), exercise stress echocardiography (ESE) provides additional prognostic information beyond baseline. The coronary flow velocity reserve (CFVR) is impaired in AS, but its link with exertion is unknown in this setting. The aim of this study was to test the hypothesis that CFVR could predict exercise capacity and abnormal exercise test results in AS. METHODS: Noninvasive CFVR and symptom-limited semisupine ESE were prospectively performed the same day in 43 patients with asymptomatic isolated severe AS (mean age, 68...
August 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28583680/comparison-of-frequency-of-referral-to-cardiothoracic-surgery-for-aortic-valve-disease-in-blacks-hispanics-and-whites
#15
MULTICENTER STUDY
Benjamin Cruz Rodriguez, Priyanka Acharya, Christopher Salazar-Fields, Aaron Horne
Racial differences in prevalence and in intervention rate of those with severe aortic stenosis have been reported. Our objective was to evaluate health disparities in referral to cardiothoracic surgery (CTS) for aortic stenosis in black and Hispanic compared with white patients before the transcatheter aortic valve replacement program was started in our community. Using a retrospective cohort design, we identified all patients >40 years, who had been captured with aortic valve disease from January 2011 to June 2016...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28570525/full-root-aortic-valve-replacement-by-stentless-aortic-xenografts-in-patients-with-small-aortic-roots
#16
Reza Tavakoli, Peiman Jamshidi, Max Gassmann
In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial valve might not meet the functional needs. The implantation of a too-small stented pericardial valve, leading to an effective orifice area indexed to a body surface area less than 0.85 cm(2)/m(2), is regarded as prosthesis-patient mismatch (PPM). A PPM negatively affects the regression of left ventricular hypertrophy and thus the normalization of left ventricular function and the alleviation of symptoms...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28544827/procedural-techniques-for-the-management-of-severe-transvalvular-and-paravalvular-aortic-regurgitation-during-tavr
#17
Abdulla A Damluji, Carlos E Alfonso, Mauricio G Cohen
Aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) is associated with an increased risk of mortality. In severe cases, abrupt hemodynamic changes may occur with a sudden increase in left ventricular end-diastolic pressure that results in frank pulmonary edema, hypoxia, and cardiogenic shock. Here, the case is reported of a patient who developed severe AR immediately after valve deployment that led to severe hemodynamic compromise. The procedural techniques necessary for the immediate management of severe transvalvular and paravalvular AR are described...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28503752/point-of-care-diagnosis-of-cardiac-tamponade-identified-by-the-flow-velocity-paradoxus
#18
William Shyy, Roneesha S Knight, Aaron Kornblith, Nathan A Teismann
The presentation of cardiac tamponade is a spectrum from occult to extreme. The clinical history, physical exam, electrocardiogram, and radiographic findings of tamponade have poor sensitivities and even worse specificities. We use a clinical scenario to demonstrate how point-of-care cardiac ultrasound can diagnose impending cardiac tamponade in a clinically stable patient. The ultrasound finding we recommend is the flow velocity paradoxus, in which respiratory variation causes significant changes in transvalvular inflow velocities, which are exaggerated when tamponade is present...
May 15, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28491484/valvular-hemolysis-masquerading-as-prosthetic-valve-stenosis
#19
Pooja Sethi, Ghulam Murtaza, Zia Rahman, Syed Zaidi, Thomas Helton, Timir Paul
The evaluation of prosthetic valves can provide a unique challenge, and a thoughtful approach is required. High output states like anemia should be kept in the differential when evaluating elevated gradients across prosthetic valves. We present the case of a 69-year-old man with a Starr-Edwards prosthetic aortic valve who presented with symptoms of congestive heart failure and high transvalvular pressure gradients. These symptoms indicate a potential prosthetic valve stenosis. His laboratory evaluation results were consistent with valve-related hemolysis...
April 8, 2017: Curēus
https://www.readbyqxmd.com/read/28473116/elevated-mitral-valve-pressure-gradient-after-mitraclip-implantation-deteriorates-long-term-outcome-in-patients-with-severe-mitral-regurgitation-and-severe%C3%A2-heart-failure
#20
Michael Neuss, Thomas Schau, Akihiro Isotani, Markus Pilz, Maren Schöpp, Christian Butter
OBJECTIVES: This single-center study was performed to analyze the effect of an increased transvalvular gradient after the MitraClip (MC) (Abbott Laboratories, Abbott Park, Illinois) procedure on patient outcome during follow-up. BACKGROUND: Percutaneous transcatheter repair of the mitral valve with the MC device has been established as a novel technique for patients with severe mitral regurgitation and high surgical risk. This study investigated the influence of an increased pressure gradient after MC implantation on the long-term outcome of patients...
May 8, 2017: JACC. Cardiovascular Interventions
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