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https://www.readbyqxmd.com/read/28544827/procedural-techniques-for-the-management-of-severe-transvalvular-and-paravalvular-aortic-regurgitation-during-tavr
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28457092/transcatheter-tricuspid-valve-in-valve-implantation-in-patients-with-tricuspid-bioprosthetic-valve-degeneration-at-high-surgical-risk-a-multicenter-case-series
#5
Uri Landes, Arthur Kerner, Amit Segev, Haim Danenberg, Yaron Shapira, Ariel Finkelstein, Ran Kornowski
BACKGROUND: Transcatheter tricuspid valve-in-valve implantation (TVIV) is an attractive yet under-explored alternative to redo valve surgery. OBJECTIVES: To report the multicenter TVIV experience in Israel. METHODS: We approached multiple centers and collected data regarding seven TVIV cases. RESULTS: The study group comprised seven participants: five females and two males, with a mean age of 63 ± 12 years and EuroSCORE-II 13...
March 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28438326/transapical-transcatheter-aortic-valve-implantation-using-the-j-valve-system-a-1-year-follow-up-study
#6
Xiang Luo, Xu Wang, Xuan Li, Xin Wang, Fei Xu, Mingzheng Liu, Bing Yu, Fei Li, Minghui Tong, Wei Wang
OBJECTIVE: Transcatheter aortic valve implantation has become a routine procedure to treat screened inoperable or high-risk patients. In this study, we present the first outcome of echocardiographic midterm using a new second-generation transcatheter aortic valve implantation system, the J-Valve system (Jie Cheng Medical Technologies, Suzhou, China), in patients with aortic stenosis or aortic regurgitation. METHODS: From July 2014 to June 2015, 21 patients with isolated aortic valve disease at high risk for open surgery received transapical transcatheter aortic valve implantation using the J-Valve system...
March 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28390678/effect-of-renin-angiotensin-blockers-on-left-ventricular-remodeling-in-severe-aortic-stenosis
#7
Serene Si-Ning Goh, Ching-Hui Sia, Nicholas Jinghao Ngiam, Benjamin Yong-Qiang Tan, Poay Sian Lee, Edgar Lik-Wui Tay, William Kok-Fai Kong, Tiong Cheng Yeo, Kian-Keong Poh
Studies have shown that medical therapy with renin-angiotensin blockers (RABs) may benefit patients with aortic stenosis (AS). However, its use and efficacy remains controversial, including in patients with low flow (LF) with preserved left ventricular ejection fraction (LVEF). We examined the effects of RAB use on LV remodeling in patients with severe AS with preserved LVEF, analyzing the differential effects in patients with LF compared with normal flow (NF). This is a retrospective study of 428 consecutive subjects from 2005 to 2014 with echocardiographic diagnosis of severe AS and preserved LVEF...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28390080/changes-in-acute-pulmonary-vascular-responsiveness-to-hypoxia-during-a-progressive-ascent-to-high-altitude-5300%C3%A2-m
#8
Andrew M Luks, Denny Levett, Daniel S Martin, Christopher H Goss, Kay Mitchell, Bernadette O Fernandez, Martin Feelisch, Michael P Grocott, Erik R Swenson
What is the central question of this study? Do the pulmonary vascular responses to hypoxia change during progressive exposure to high altitude and can alterations in these responses be related to changes in concentrations of circulating biomarkers that affect the pulmonary circulation? What is the main finding and its importance? In our field study with healthy volunteers, we demonstrate changes in pulmonary artery pressure suggestive of remodelling in the pulmonary circulation, but find no changes in the acute responsiveness of the pulmonary circulation to changes in oxygenation during 2 weeks of exposure to progressive hypoxia...
April 8, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28388992/long-term-outcomes-of-560-consecutive-patients-treated-with-transcatheter-aortic-valve-implantation-and-propensity-score-matched-analysis-of-early-versus-new-generation-valves
#9
Amos Levi, Uri Landes, Abid R Assali, Katia Orvin, Ram Sharony, Hanna Vaknin-Assa, Ashraf Hamdan, Yaron Shapira, Shmuel Schwartzenberg, Pablo Codner, Aviv A Shaul, Mordechai Vaturi, Ariel Gutstein, Alexander Sagie, Ran Kornowski
Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis in patients at high or prohibitive surgical risk. Nevertheless, long-term clinical and echocardiographic data are still lacking. We carried out an analysis of 560 consecutive patients who underwent TAVI at our institution from 2008 to 2016 to evaluate temporal changes in TAVI characteristics, predictors of 1-year and long-term outcomes, and to compare the performance of the early- and new-generation valve systems...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28385406/clinical-bioprosthetic-heart-valve-thrombosis-after-transcatheter-aortic%C3%A2-valve-replacement-incidence-characteristics-and-treatment-outcomes
#10
John Jose, Dmitriy S Sulimov, Mohamed El-Mawardy, Takao Sato, Abdelhakim Allali, Erik W Holy, Björn Becker, Martin Landt, Julia Kebernik, Bettina Schwarz, Gert Richardt, Mohamed Abdel-Wahab
OBJECTIVES: The aim of this study was to determine the incidence, characteristics, and treatment outcomes of patients diagnosed with clinical transcatheter heart valve thrombosis. BACKGROUND: Limited data exists on clinical or manifest transcatheter heart valve thrombosis. Prior studies have focused on subclinical thrombosis. METHODS: A retrospective analysis was conducted of prospectively collected data from a single-center registry that included 642 consecutive patients who underwent transcatheter aortic valve replacement between 2007 and 2015 (305 patients had self-expanding valves; balloon-expandable, n = 281; mechanically expanding, n = 56)...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28369242/transcatheter-aortic-valve-thrombosis-the-relation-between-hypo-attenuated-leaflet-thickening-abnormal-valve-haemodynamics-and-stroke
#11
E Mara Vollema, William K F Kong, Spyridon Katsanos, Vasileios Kamperidis, Philippe J van Rosendael, Frank van der Kley, Arend de Weger, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Aims: The presence of hypo-attenuated leaflet thickening (HALT) and/or reduced leaflet motion on multi-detector row computed tomography (MDCT) has been proposed as a possible marker for early transcatheter aortic valve thrombosis. However, its association with abnormal valve haemodynamics on echocardiography (another potential marker of thrombosis) and clinical outcomes (stroke) remains unclear. The present study evaluated the prevalence of HALT on MDCT and abnormal valve haemodynamics on echocardiography...
March 27, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28359486/intraoperative-bioprosthetic-valve-dysfunction-causing-severe-mitral-regurgitation
#12
Philip Y K Pang, Susan Garwood, Sabet W Hashim
Structural degeneration of bioprosthetic valves usually occurs gradually over time. Failure of a bioprosthetic valve immediately after implantation is extremely rare. Possible causes include obstruction of valve leaflets from preserved subvalvular tissue during chordal-sparing mitral valve replacement (MVR) or strut entrapment by suture loops. We report 2 cases of acute bioprosthetic mitral valve (MV) dysfunction involving newly implanted Perimount Theon (Edwards Lifesciences, Irvine, CA) bioprostheses, causing severe transvalvular mitral regurgitation (MR)...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28344201/stenotic-bicuspid-and-tricuspid-aortic-valves%C3%A3-micro-computed-tomography-and-biological-indices-of-calcification
#13
Piotr Mazur, Ewa Wypasek, Bogusław Gawęda, Dorota Sobczyk, Przemysław Kapusta, Joanna Natorska, Krzysztof Piotr Malinowski, Jacek Tarasiuk, Maciej Bochenek, Sebastian Wroński, Katarzyna Chmielewska, Bogusław Kapelak, Anetta Undas
BACKGROUND: Valve calcification is well estimated by ex-vivo micro-computed tomography (micro-CT). The objective of this study was to investigate the associations between micro-CT findings and biological indices of calcification in aortic stenosis (AS), as well as differences between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV).Methods and Results:Aortic valves and plasma were obtained from patients undergoing valve surgery. Valves were dissected and underwent micro-CT, genetic analyses, and calcium content assessment...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28336114/paradoxical-aortic-stenosis-a-systematic-review
#14
Rita Cavaca, Rogério Teixeira, Maria João Vieira, Lino Gonçalves
Aortic stenosis (AS) is a complex systemic valvular and vascular disease with a high prevalence in developed countries. The new entity "paradoxical low-flow, low-gradient aortic stenosis" refers to cases in which patients have severe AS based on assessment of aortic valve area (AVA) (≤1 cm(2)) or indexed AVA (≤0.6 cm(2)/m(2)), but paradoxically have a low mean transvalvular gradient (<40 mmHg) and a low stroke volume index (≤35 ml/m(2)), despite preserved left ventricular ejection fraction (≥50%)...
April 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28332088/simple-technique-of-repair-for-barlow-syndrome-with-posterior-resection-and-chordal-transfer-via-minimally-invasive-approach-primary-experience-in-a-consecutive-series-of-22-patients
#15
H Kamiya, Payam Akhyari, J-P Minol, A C Ites, T Weinreich, S Sixt, P Rellecke, U Boeken, A Albert, A Lichtenberg
OBJECTIVE: Current techniques for mitral valve repair (MVR) in Barlow's disease require high level of surgical expertise due to a complex anatomy. A novel and simple standardized technique that particularly considers the pathological changes of the mitral valve in Barlow's disease has been developed. METHODS: Between 2009 and 2013, 22 patients underwent minimally invasive MVR for Barlow's disease and severe mitral regurgitation (MR). A simple, standardized technique was applied, including resection of P2 segment of posterior mitral leaflet (PML) with preservation of the shortest chordae, transfer of the preserved chordae to A2, and implantation of a semi-rigid open ring...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28329312/first-experience-with-transfemoral-transcatheter-aortic-valve-implantation-without-prior-balloon-pre-dilatation-using-a-latest-generation-repositionable-and-retrievable-transcatheter-heart-valve%C3%A2
#16
Andreas Schaefer, Eva Harmel, Moritz Seiffert, Daniel Reichart, Florian Deuschl, Niklas Schofer, Yvonne Schneeberger, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
OBJECTIVES: : The aim of this study was to prove technical feasibility and document haemodynamic and clinical outcomes of transcatheter aortic valve implantation (TAVI) with the latest generation repositionable and retrievable Lotus™ transcatheter heart valve (THV) without prior balloon-aortic valvuloplasty (BAV). It has been demonstrated for self-expandable and balloon-expandable THV that implantation without prior BAV is not only feasible and safe but also results in lower fluoroscopy times and amounts of contrast agent while yielding non-inferior haemodynamic and clinical outcome...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329206/precise-moulded-autologous-pericardial-configurations-for-aortic-cusp-reconstruction
#17
Mohammad Bashar Izzat, Khaled Hamzeh, Farouk Almohammad
OBJECTIVES: In order to facilitate surgical repair of complex aortic cusp deformities and restoration of aortic valve competence, new moulds were developed to shape the glutaraldehyde-treated autologous pericardium into precise cusp-like configurations that can be used in aortic cusp reconstruction. METHODS: The new moulds embodied the natural geometry of single aortic cusps, and a series of moulds were made available to correspond with all potential aortic cusp sizes...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28293311/aortic-annulus-enlargement-early-and-long-terms-results
#18
Selman Dumani, Ermal Likaj, Laureta Dibra, Vera Beca, Saimir Kuci, Ali Refatllari
AIM: Patient-prosthesis mismatch (PPM) is a common occurrence in aortic valve surgery. Even the discussions about the impact of this phenomenon on the results of aortic valve surgery, the management of this problem remain one of the main topics in this kind of surgery. One of the ways of a solution is aortic annulus enlargement. The main topic of this study is to evaluate the early and longterm results of this technique in our country. METHODS: During the period January 2010 -January 2015, 641 patients performed aortic valve surgery...
March 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28292302/impact-of-left-ventricular-outflow-tract-ellipticity-on-the-grading-of-aortic-stenosis-in-patients-with-normal-ejection-fraction
#19
Frédéric Maes, Sophie Pierard, Christophe de Meester, Jamila Boulif, Mihaela Amzulescu, David Vancraeynest, Anne-Catherine Pouleur, Agnès Pasquet, Bernhard Gerber, Jean-Louis Vanoverschelde
BACKGROUND: The pathophysiology of paradoxical low-gradient (LG) severe aortic stenosis (SAS) remains controversial. As low transvalvular flow has been implicated, we sought to investigate the impact of left ventricular outflow tract (LVOT) ellipticity on the estimation of the LV stroke volume, the calculation of the aortic valve area (AVA) by use of the continuity equation and on AS severity grading. METHODS: We studied 190 consecutive patients (mean age: 72 ± 13 years; male: 57%) with SAS (indexed AVA < 0...
March 15, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28290166/long-term-outcome-of-the-sorin-freedom-solo-stentless-aortic-valve
#20
Torsten Christ, Benjamin Claus, Christina Zielinski, Volkmar Falk, Herko Grubitzsch
BACKGROUND: The Sorin Freedom SOLO valve is a third-generation stentless aortic valve which shows beneficial hemodynamic performance compared to stented bioprostheses. Long-term results regarding hemodynamics, the durability of the valve, and patient outcome are scarce, and their acquisition was the aim of this single-center study. METHODS: Between 2005 and 2006, a total of 68 consecutive patients (30 males, 38 females; mean age at surgery 76.1 ± 6.3 years) underwent aortic valve replacement with a Sorin Freedom SOLO prosthesis...
November 2016: Journal of Heart Valve Disease
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