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Steven T Lanier, Gregory A Dumanian, Sumanas W Jordan, Kyle R Miller, Nada A Ali, Stuart R Stock
: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. METHODS: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. RESULTS: One hundred and seven patients underwent a mesh sutured abdominal wall closure...
September 2016: Plastic and Reconstructive Surgery. Global Open
Brooks V Udelsman, Jessica Eaton, Ashok Muniappan, Christopher R Morse, Cameron D Wright, Douglas J Mathisen
OBJECTIVE: Patients with complicated airway defects that exceed the limits of primary repair represent a challenging clinical problem and require alternative techniques for repair. The aim of this study was to evaluate bioprosthetic reconstruction of large tracheal and bronchial defects. METHODS: Retrospective chart review of patients treated at a single tertiary center from 2008 to 2015 who underwent repair of tracheal or bronchial defects with a bioprosthetic device, namely aortic homograft or acellular dermal matrix...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Francesco Nappi, Cristiano Spadaccio, Jean Louis Sablayrolles
The recent literature on transcatheter aortic valve replacement (TAVR) is shedding new light on the perspective to extend this procedure to other lower risk-category of patients, leading in fact to a potential erosion of the current guidelines. Notwithstanding the warnings provided in the literature regarding the risk of severely impairing complications, unclear survival advantage and cost-inefficiency, many observational studies, especially performed in high-volume centers, support a general drive toward the recruitment of intermediate-low risk patients in the expectation of clinical advantages versus standard surgical replacement...
October 6, 2016: JACC. Cardiovascular Interventions
Caitlin Martin, Wei Sun
Transcatheter aortic valve (TAV) implantation within a failed bioprosthetic valve is a growing trend for high-risk patients. The non-compliant stent of the previous prosthesis may prevent full expansion of the TAV, which has been shown to distort the leaflet configuration, and has been hypothesized to adversely affect durability. In this study, TAV leaflet fatigue damage under cyclic pressurization in the setting of stent underexpansion by 0 (fully expanded), 1, 2 and 3 mm was simulated using finite element analysis to test this hypothesis...
October 12, 2016: Annals of Biomedical Engineering
Kimberly Naden Hollander, Mario Montealegre-Gallegos, Feroze Mahmood
In recent years, the use of transcatheter aortic valve replacement (TAVR) has extended beyond the treatment of native aortic valve stenosis in patients with high surgical risk. TAVR is increasingly being performed for bioprosthetic aortic valve failure, i.e., the valve-in-valve (VIV) procedure. Establishing the success of a VIV procedure can be challenging in these cases. Furthermore, the limited availability of prostheses sizes further complicates the management of these patients. We present an unusual case of a repeat TAVR in a patient who previously had a VIV procedure in an aortic homograft...
October 2016: Annals of Cardiac Anaesthesia
Liang Zhao, Kai Xu, Weifeng Jiang, Li Zhou, Yuanlong Wang, Xiaodong Zhang, Shaohui Wu, Daoliang Zhang, Xu Liu
OBJECTIVE: The long-term outcomes of catheter ablation of atrial fibrillation (AF) developing post-cardiac valve replacement (VR) remain undefined. METHODS AND RESULTS: Eighty-nine post-VR patients with AF (44% longstanding persistent AF, LSP-AF) were enrolled. Cumulative success rate of circumferential pulmonary vein ablation (CPVA for paroxysmal AF) and bidirectional block of lines and disappearance of complex fractionated atrial electrograms (CFAEs for persistent and LSP-AF) as index and repeat procedural endpoints reached 57% (mean, 1...
October 1, 2016: International Journal of Cardiology
Philipp Blanke, Jeanette Soon, Danny Dvir, Jong K Park, Christopher Naoum, Shaw-Hua Kueh, David A Wood, Bjarne L Norgaard, Kapilan Selvakumar, Jian Ye, Anson Cheung, John G Webb, Jonathon Leipsic
Valve-in-valve implantation of a transcatheter heart valve into a failed bioprosthetic heart valve has emerged as a treatment alternative to repeat conventional surgery. This requires careful pre-procedural assessment using non-invasive imaging to identify patients at risk for procedure related adverse events, such as ostial coronary occlusion. Herein we report how to comprehensively assess aortic root anatomy using computed tomography prior to transcatheter valve implantation for failed bioprosthetic aortic valves...
September 24, 2016: Journal of Cardiovascular Computed Tomography
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
Uri Landes, Alexander Sagie, Ran Kornowski
Sutureless aortic bioprostheses (SAB) are increasingly being used to provide shorter cross-clamp time. Valve-in-valve transcatheter aortic valve replacement (VIV-A) is shown to be effective and safe in the vast majority of patients with degenerated bioprosthetics, yet its' use in SAB failure is infrequent. We present a case of balloon-expandable VIV-A in an 80-year-old woman who suffered severe symptomatic aortic regurgitation in a failed Perceval S 21-mm valve. Computed tomography scan demonstrated a deformed valve...
October 3, 2016: Catheterization and Cardiovascular Interventions
Alqasem F Al Mosa, Aamir Omair, Ahmed A Arifi, Hani K Najm
OBJECTIVES: Mitral valve replacement with either a bioprosthetic or a mechanical valve is the treatment of choice for severe mitral stenosis. However, choosing a valve implant type is still a subject of debate. This study aimed to evaluate and compare the early and late outcomes of mitral valve replacement [mechanical (MMV) vs. bioprosthetic (BMV)] for severe mitral stenosis. METHODS: A retrospective cohort study was performed on data involving mitral stenosis patients who have undergone mitral valve replacement with either BMV (n = 50) or MMV (n = 145) valves from 1999 to 2012...
October 2016: Journal of the Saudi Heart Association
Farid Foroutan, Gordon H Guyatt, Kathleen O'Brien, Eva Bain, Madeleine Stein, Sai Bhagra, Daegan Sit, Rakhshan Kamran, Yaping Chang, Tahira Devji, Hassan Mir, Veena Manja, Toni Schofield, Reed A Siemieniuk, Thomas Agoritsas, Rodrigo Bagur, Catherine M Otto, Per O Vandvik
OBJECTIVE:  To determine the frequency of survival, stroke, atrial fibrillation, structural valve deterioration, and length of hospital stay after surgical replacement of an aortic valve (SAVR) with a bioprosthetic valve in patients with severe symptomatic aortic stenosis. DESIGN:  Systematic review and meta-analysis of observational studies. DATA SOURCES:  Medline, Embase, PubMed (non-Medline records only), Cochrane Database of Systematic Reviews, and Cochrane CENTRAL from 2002 to June 2016...
2016: BMJ: British Medical Journal
Silje Ekroll Jahren, Bernhard Michael Winkler, Paul Philipp Heinisch, Jessica Wirz, Thierry Carrel, Dominik Obrist
OBJECTIVES: In this study, the influence of aortic root distensibility on the haemodynamic parameters and valve kinematics of a bioprosthetic aortic valve was investigated in a controlled in vitro experiment. METHODS: An Edwards INTUITY Elite 21 mm sutureless aortic valve (Edwards Lifesciences, Irvine, CA, USA) was inserted in three transparent aortic root phantoms with different wall thicknesses (0.55, 0.85 and 1.50 mm) mimicking different physiological distensibilities...
September 28, 2016: Interactive Cardiovascular and Thoracic Surgery
Anthony P Carnicelli, Patrick T O'Gara, Robert P Giugliano
Valvular heart disease is prevalent and represents a significant contributor to cardiac morbidity and mortality. Several options for valve replacement exist, including surgical replacement and transcatheter valve implantation. Prosthetic valves lead to increased risk of thromboembolic disease; therefore, antithrombotic therapy after valve replacement is indicated. For patients with mechanical prostheses, indefinite vitamin K antagonist and antiplatelet therapy are the mainstays of treatment. There is no consensus regarding optimal antithrombotic therapy after bioprosthetic valve replacement, although vitamin K antagonist therapy of varying duration in addition to antiplatelet therapy is recommended by guidelines...
August 13, 2016: American Journal of Cardiology
Andreas Vötsch, Wolfgang Weihs, Martin Asslaber, Otto Dapunt
Until now, to our knowledge no case of bioprosthetic valvular thrombosis after implantation of the sutureless Sorin Perceval valve has been reported. Although sutureless aortic valve replacement has become a powerful tool in our daily practice, recent guidelines from the European Society of Cardiology, the European Association for Cardio-Thoracic Surgery, the American College of Cardiology, and the American Heart Association do not give specific recommendations on postoperative anticoagulation therapy. We report the first case of valve dysfunction resulting from thrombosis 12 months after implantation with a possible link to postoperative cortisole therapy...
October 2016: Annals of Thoracic Surgery
Niv Ad
No abstract text is available yet for this article.
October 2016: Journal of Thoracic and Cardiovascular Surgery
Clifford W Barlow
No abstract text is available yet for this article.
October 2016: Journal of Thoracic and Cardiovascular Surgery
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
Matheus Simonato, Ali N Azadani, John Webb, Jonathon Leipsic, Ran Kornowski, Alec Vahanian, David Wood, Nicolo Piazza, Susheel Kodali, Jian Ye, Brian Whisenant, Diego Gaia, Mina Aziz, Tilak Pasala, Julinda Mehilli, Harindra C Wijeysundera, Didier Tchetche, Neil Moat, Rui Teles, Anna Sonia Petronio, David Hildick-Smith, Uri Landes, Stephan Windecker, Yaron Arbel, Oscar Mendiz, Raj Makkar, Elaine Tseng, Danny Dvir
AIMS: Transcatheter heart valve (THV) implantation in failed bioprosthetic valves (valve-in-valve [ViV]) offers an alternative therapy for high-risk patients. Elevated post-procedural gradients are a significant limitation of aortic ViV. Our objective was to assess the relationship between depth of implantation and haemodynamics. METHODS AND RESULTS: Commercially available THVs used for ViV were included in the analysis (CoreValve Evolut, SAPIEN XT and the Portico valve)...
September 18, 2016: EuroIntervention
Rio Nomoto, Lynn A Sleeper, Michele J Borisuk, Lisa Bergerson, Frank A Pigula, Sitaram Emani, Francis Fynn-Thompson, John E Mayer, Pedro J Del Nido, Christopher W Baird
OBJECTIVES: The goal of this single-center series was to assess differences in reintervention by the type of valve used for surgical bioprosthetic pulmonary valve replacement and to identify independent predictors of reintervention. METHODS: Data were retrospectively collected for 611 patients undergoing pulmonary valve replacement from 1996 to 2014. Kaplan-Meier estimation and Cox proportional hazards regression methodologies were used. RESULTS: The median age of patients was 17...
November 2016: Journal of Thoracic and Cardiovascular Surgery
Jason R Sims, Maurice Enriquez-Sarano, Hector I Michelena
CLINICAL INTRODUCTION: A man in his 50s presented with abscessed aortic valve methicillin-sensitive Staphylococcus aureus endocarditis, received intravenous antibiotics and underwent bioprosthetic aortic valve replacement with removal of all infected tissues. He returned 18 days later with severe dyspnoea, subjective fever and bilateral lower extremity oedema. Physical examination revealed tachypnoea and tachycardia without fever, prominent neck CV waves visible at 90°, left parasternal heave, 3/6 holosystolic murmur across the precordium, lung rales and severe peripheral oedema...
September 15, 2016: Heart: Official Journal of the British Cardiac Society
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