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Surgical aortic valve replacement

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https://www.readbyqxmd.com/read/28108566/total-aortic-arch-replacement-with-the-frozen-elephant-trunk-procedure-in-acute-debakey-type-i-aortic-dissections
#1
Malakh Shrestha, Axel Haverich, Andreas Martens
OBJECTIVES: In patients with acute aortic dissection involving the arch and the descending aorta (AADA DeBakey type I), performing a total aortic arch replacement with the frozen elephant trunk (FET) procedure for supposedly better long-term results is still controversial. METHODS: From February 2004 to April 2016, 94 patients with AADA DeBakey type I had an FET procedure (80% men, age 58 ± 12 years). During the early period (Group 1, 2004-10), the FET technique was performed using non-branched grafts...
January 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28108064/stent-and-leaflet-stresses-in-a-26-mm-first-generation-balloon-expandable-transcatheter-aortic-valve
#2
Yue Xuan, Kapil Krishnan, Jian Ye, Danny Dvir, Julius M Guccione, Liang Ge, Elaine E Tseng
OBJECTIVE: Transcatheter aortic valve replacement is established therapy for high-risk and inoperable patients with severe aortic stenosis, but questions remain regarding long-term durability. Valve design influences durability. Increased leaflet stresses in surgical bioprostheses have been correlated with degeneration; however, transcatheter valve leaflet stresses are unknown. From 2007 to 2014, a majority of US patients received first-generation balloon-expandable transcatheter valves...
December 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#3
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105997/first-successful-transcatheter-double-valve-replacement-from-a-transapical-access-and-nine-month-follow-up
#4
Robert Bauernschmitt, Stefan Bauer, Christian Liewald, Ramiz Emini, Wolfgang Oechsner, Meinrad Beer, Ralf Sodian, Andreas Liebold
AIMS: While TAVI is the treatment of choice in patients with aortic stenosis considered inoperable or at high risk, interventional replacement of the mitral valve is still in the preclinical or early clinical phase. Our aim was to report on the first transcatheter double valve replacement into native valves from a transapical access. METHODS AND RESULTS: A 67-year-old, highly symptomatic female patient considered inoperable due to severe calcification of the mitral annulus and comorbidities was scheduled for transcatheter double valve replacement by the local Heart Team...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#5
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28100471/valve-thrombosis-following-transcatheter-aortic-valve-replacement-significance-of-blood-stasis-on-the-leaflets
#6
Koohyar Vahidkhah, Mohammed Barakat, Mostafa Abbasi, Shahnaz Javani, Peyman N Azadani, Anwar Tandar, Danny Dvir, Ali N Azadani
OBJECTIVES: Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and valve-in-valve (ViV) procedures has been increasingly recognized. However, the factors affecting the post-TAVR/ViV thrombosis are not fully understood. This study aimed to investigate the effect of the geometric confinement of transcatheter aortic valve (TAV) on blood residence time (BRT) on the TAV leaflets and in turn on the post-TAVR valve thrombosis. METHODS: Two computational models, representing a surgical bioprosthesis and a TAV, were developed to study the effect of the geometric confinement on BRT on the leaflets in ViV setting/TAVR Intra-annular positioning...
January 17, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28100340/-outcome-comparison-of-different-therapy-procedures-in-surgical-high-risk-elderly-patients-with-severe-aortic-stenosis
#7
Y Q Ye, Y T Wang, Z Li, M Y Wang, H Y Xu, W J Zhang, Q R Liu, G N Niu, Y J Wu
Objective: To compare the outcome of surgical high-risk elderly patients with severe aortic stenosis(SAS) treated by different therapy procedures, including transcatheter aortic valve implantation(TAVI), surgical aortic valve replacement(SAVR), and drug therapy. Methods: We retrospectively analyzed the clinical data of 242 surgical high-risk elderly (age ≥65 years old) SAS patients hospitalized in Fuwai Hospital between September 2012 and June 2015. According to the treatment method, patients were divided into TAVI group (81 cases), SAVR group (59 cases) and drug therapy group (102 cases)...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#8
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28097609/a-case-of-a-quadricuspid-aortic-valve-identified-preoperatively-using-transthoracic-echocardiography
#9
Takanori Kono, Takeshi Oda, Keiichi Akaiwa, Katsuhiko Nakamura, Hiroyuki Tanaka
Quadricuspid aortic valve is an extremely rare congenital heart anomaly that often causes valve incompetence, requiring surgical intervention. Care must be taken to avoid surgical complications in patients with quadricuspid aortic valve; thus, preoperative diagnosis is important. A 76-year-old man presented with exertional dyspnea due to aortic regurgitation. Transthoracic and transesophageal echocardiography revealed severe aortic regurgitation caused by quadricuspid aortic valve. To avoid interference with the cardiac conduction system, we performed aortic valve replacement using an ingenious technique, in which pledgeted sutures on the accessory leaflet were placed from outside the sinus of Valsalva to above the aortic annulus...
January 18, 2017: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/28097185/immediate-improvement-in-severe-mitral-regurgitation-after-aortic-valve-replacement-for-severe-aortic-insufficiency
#10
Ahmad Zeeshan, Mojun Zhu, John A Elefteriades
A 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28095748/myocardial-inactivation-of-thyroid-hormones-in-patients-with-aortic-stenosis
#11
Bruno Paolino, Pablo Maria Pomerantzeff, Luiz Alberto O Dallan, Fabio Antonio Gaiotto, Nailliw Zanini Preite, Ana Claudia Latronico, Jose Carlos Nicolau, Antonio Carlos Bianco, Roberto Giraldez
OBJECTIVE: To study myocardial thyroid hormone metabolism in patients with aortic valve stenosis (AS) undergoing aortic valve replacement and in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting surgery. CONTEXT: The human heart expresses the type 2 deiodinase (D2) that activates T4 to T3. At the same time, the inactivating type 3 deiodinase (D3) has been found in a rat model of right ventricular hypertrophy. It is not known whether the human myocardium metabolizes thyroid hormone...
January 17, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28092288/sutureless-aortic-valves-who-is-the-right-patient
#12
Amine Mazine, Christopher Bonneau, Dimos Karangelis, Bobby Yanagawa, Subodh Verma, Daniel Bonneau
PURPOSE OF REVIEW: Sutureless aortic valve replacement (AVR) has emerged as an alternative to traditional AVR for patients with aortic stenosis who present a higher surgical risk, such as the elderly, or those with small or highly calcified aortic roots. With transcatheter aortic valve implantation - the other major AVR alternative - being used in increasingly lower-risk patients, the place of sutureless valves in the AVR landscape needs to be defined. In this review, we discuss recent data and expert opinion as it pertains to the subject of sutureless AVR...
January 13, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#13
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28079786/fatal-postoperative-systemic-pulmonary-hypertension-in-benfluorex-induced-valvular-heart-disease-surgery-a-case-report
#14
Christophe Baufreton, Patrick Bruneval, Marie-Christine Rousselet, Pierre-Vladimir Ennezat, Olivier Fouquet, Raphael Giraud, Carlo Banfi
RATIONALE: Drug-induced valvular heart disease (DI-VHD) remains an under-recognized entity. PATIENT CONCERNS: This report describes a heart valve replacement which was complicated by intractable systemic pulmonary arterial hypertension in a 61-year-old female with severe restrictive mitral and aortic disease. The diagnosis of valvular disease was preceded by a history of unexplained respiratory distress. The patient had been exposed to benfluorex for 6.5 years. DIAGNOSES: The diagnostic procedure documented specific drug-induced valvular fibrosis...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#15
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079554/latest-evidence-on-transcatheter-aortic-valve-implantation-vs-surgical-aortic-valve-replacement-for-the-treatment-of-aortic-stenosis-in-high-and-intermediate-risk-patients
#16
Fabien Praz, George C M Siontis, Subodh Verma, Stephan Windecker, Peter Jüni
PURPOSE OF REVIEW: The goal of this review is to summarize the current evidence supporting the use of transcatheter aortic valve implantation (TAVI) in high and intermediate-risk patients. The focus is on the five randomized controlled trials comparing TAVI with surgical aortic valve replacement (SAVR) published to date, as well as two recent meta-analyses. RECENT FINDINGS: TAVI has profoundly transformed the treatment of elderly patients presenting with symptomatic severe aortic stenosis...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28078606/arterial-stiffness-in-aortic-stenosis-relationship-with-severity-and-echocardiographic-procedures-response
#17
Giuseppe Bruschi, Alessandro Maloberti, Paola Sormani, Giulia Colombo, Stefano Nava, Paola Vallerio, Francesca Casadei, Jolie Bruno, Antonella Moreo, Bruno Merlanti, Claudio Russo, Fabrizio Oliva, Silvio Klugmann, Cristina Giannattasio
INTRODUCTION: Aortic stenosis (AS) is more than only a degenerative disease, it could be also an atherosclerotic-like process involving the valve instead of the vessels. Little is known about the relation of arterial stiffness and AS. AIM: We sought to determine wether pulse wave velocity (PWV), is related to AS severity and to the procedures response, both as surgical aortic-valve-replacement (AVR) and trascatheter-aortic-valve-implantation (TAVI). METHODS: 30 patients with severe AS were treated (15 AVR, 15 TAVI)...
January 11, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28078447/trends-in-aortic-valve-replacement-in-germany-in-2015-transcatheter-versus-isolated-surgical-aortic-valve-repair
#18
Luise Gaede, Johannes Blumenstein, Won-Keun Kim, Christoph Liebetrau, Oliver Dörr, Holger Nef, Christian Hamm, Albrecht Elsässer, Helge Möllmann
AIMS: We analysed the number of procedures, indications, and in-hospital mortality rates of all patients undergoing isolated surgical aortic valve replacement (sAVR) or transvascular (TV-) and transapical (TA-) transcatheter aortic valve implantation (TAVI) from 2012 to 2015 in Germany. METHODS AND RESULTS: More than 31,000 aortic valve procedures were performed in 2015 in Germany, representing a total increase of 4.5% over 2014. TV-TAVI accounts for 13,108 of these procedures, with an increase of 21%, whereas the numbers of isolated sAVR and TA-TAVI decreased slightly...
January 11, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28076623/low-cost-simulator-for-heart-surgery-training
#19
Roberto Rocha E Silva, Artur Lourenção, Maxim Goncharov, Fabio B Jatene
Objective: Introduce the low-cost and easy to purchase simulator without biological material so that any institution may promote extensive cardiovascular surgery training both in a hospital setting and at home without large budgets. Methods: A transparent plastic box is placed in a wooden frame, which is held by the edges using elastic bands, with the bottom turned upwards, where an oval opening is made, "simulating" a thoracotomy. For basic exercises in the aorta, the model presented by our service in the 2015 Brazilian Congress of Cardiovascular Surgery: a silicone ice tray, where one can train to make aortic purse-string suture, aortotomy, aortorrhaphy and proximal and distal anastomoses...
November 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28076618/aortic-valve-replacement-treatment-by-sternotomy-versus-minimally-invasive-approach
#20
Renata Tosoni Rodrigues Ferreira, Roberto Rocha E Silva, Evaldo Marchi
Objective: To compare the results of aortic valve replacement with access by sternotomy or minimally invasive approach. Methods: Retrospective analysis of medical records of 37 patients undergoing aortic valve replacement by sternotomy or minimally invasive approach, with emphasis on the comparison of time of cardiopulmonary bypass and aortic clamping, volume of surgical bleeding, time of mechanical ventilation, need for blood transfusion, incidence of atrial fibrillation, length of stay in intensive care unit, time of hospital discharge, short-term mortality and presence of surgical wound infection...
November 2016: Brazilian Journal of Cardiovascular Surgery
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