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Surgical aortic valve replacement

Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
John Jose, Geetesh Manik, Mohamed Abdel-Wahab
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of elderly patients with symptomatic severe aortic stenosis in the western world. It is a valuable alternative to surgical aortic valve replacement in patients, who are inoperable or at high surgical risk due to co-morbidities. The prevalence of aortic stenosis increases sharply with age after the sixth decade and is expected to have a significant impact on the geriatric health care system of India, given the rapid increase in life expectancy in recent years...
September 2016: Indian Heart Journal
Ashvarya Mangla, Saurabh Gupta
Transcatheter aortic valve replacement (TAVR) has rapidly emerged as the standard of care for severe symptomatic aortic stenosis in patients whose comorbidities put them at prohibitive risk for surgical aortic valve replacement (SAVR). Several trials have demonstrated superior outcomes with TAVR compared to medical management alone. TAVR has also shown favorable outcomes in patients at high risk for SAVR. TAVR can be associated with significant vascular complications, which adversely impact outcomes, and operators should be cognizant of their early recognition and appropriate management...
September 2016: Indian Heart Journal
Stefan Büttner, Helge Weiler, Carolin Zöller, Benjamin Koch, Andreas Zierer, Andreas M Zeiher, Helmut Geiger, Mariuca Vasa-Nicotera, Ingeborg A Hauser, Stephan Fichtlscherer
Management of dialysis patients with valvular heart disease waitlisted for kidney transplantation is challenging. Development of severe aortic valve stenosis can lead to the exclusion from the transplant program or even death while on the waiting list. In dialysis patients, surgical aortic valve replacement is associated with a high perioperative risk with increased morbidity and mortality. In contrast, transcatheter aortic valve implantation emerges as a viable option for dialysis patients. Herein, we present the long-term follow-up of successful kidney transplantation after TAVI in a diabetic patient receiving long-term hemodialysis...
November 2016: Annals of Thoracic Surgery
Maria João Sousa, Vasco Alves, Sofia Cabral, Nuno Antunes, Luís Sousa Pereira, Filomena Oliveira, João Silveira, Severo Torres
Mitral valve aneurysms are rare and occur most commonly in association with aortic valve endocarditis. Transesophageal echocardiography is the most sensitive imaging modality for the diagnosis of this entity and its potential complications, such as leaflet rupture and mitral regurgitation, which mandate prompt surgical intervention. We present the case of a 70-year-old male patient with aortic valve endocarditis complicated with a ruptured aneurysm of the anterior mitral valve leaflet and associated severe mitral regurgitation, diagnosed by transesophageal echocardiography, with impressive images...
October 17, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Fadi J Sawaya, Ole De Backer
No abstract text is available yet for this article.
October 24, 2016: JACC. Cardiovascular Interventions
Jochen Reinöhl, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Manfred Zehender, Constantin von Zur Mühlen, Christoph Bode, Peter Stachon
OBJECTIVES: The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). BACKGROUND: A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. METHODS: In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013...
October 24, 2016: JACC. Cardiovascular Interventions
David P Seamans, Boshra F Louka, F David Fortuin, Bhavesh M Patel, John P Sweeney, Louis A Lanza, Patrick A DeValeria, Kim M Ezrre, Harish Ramakrishna
BACKGROUND: The surgical and procedural specialties are continually evolving their methods to include more complex and technically difficult cases. These cases can be longer and incorporate multiple teams in a different model of operating room synergy. Patients are frequently older, with comorbidities adding to the complexity of these cases. Recording of this environment has become more feasible recently with advancement in video and audio capture systems often used in the simulation realm...
October 2016: Annals of Cardiac Anaesthesia
Saif Al-Najafi, Frank Sanchez, Stamatios Lerakis
Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data...
December 2016: Current Treatment Options in Cardiovascular Medicine
Daniel Unic, Zeljko Sutlic, Boris Starcevic, Nikola Bradic, Davor Baric, Igor Rudez
Annular rupture presents a rare but potentially fatal complication of transcatheter aortic valve implantation (TAVI). Although it can be subtle and subclinical in presentation, most severe forms present with hemodynamic instability and represent true emergencies requiring a more invasive treatment, even conventional surgery. We present a case of successful treatment of annular rupture by left ventricular outflow tract patch and surgical aortic valve replacement.
October 19, 2016: Wiener Klinische Wochenschrift
Tyler M Gunn, Sotiris C Stamou, Nicholas T Kouchoukos, Kevin W Lobdell, Kamal Khabbaz, Lawrence H Patzelt, Robert C Hagberg
BACKGROUND: The goal of this study was to compare the early and late outcomes of different techniques of proximal root reconstruction during the repair of acute Type A aortic dissection, including aortic valve (AV) resuspension, aortic valve replacement (AVR), and a root replacement procedure. METHODS: All patients who underwent acute Type A aortic dissection repair between January 2000 and October 2010 at four academic institutions were compiled from each institution's Society of Thoracic Surgeons Database...
April 2016: Aorta (Stamford, Conn.)
Mark A Groh, Ivan Diaz, Alan M Johnson, Stephen W Ely, Oliver A Binns, Gerard L Champsaur
BACKGROUND: Patients at intermediate risk (IR) according to The Society of Thoracic Surgeons risk score are today frequently oriented toward the transfemoral aortic valve replacement (TAVR) option. Our goal was to evaluate the best treatment strategies for IR patients with severe aortic stenosis. METHODS: Of a consecutive series of 1,144 surgical aortic valve replacements (AVRs) performed in our institution between 2008 and 2014, we reviewed the early and late outcomes of two different groups: a low-risk (LR) group of 470 patients, and an IR group of 620...
October 15, 2016: Annals of Thoracic Surgery
Ravilla Mahidhar, Jon R Resar
No abstract text is available yet for this article.
September 2016: Journal of Thoracic Disease
Yoshifumi Itoda, Kan Nawata, Haruo Yamauchi, Osamu Kinoshita, Mitsutoshi Kimura, Minoru Ono
Aortic insufficiency (AI) is a significant complication of long-term support of continuous flow left ventricular assist device (CF-LVAD) for patients with end-stage heart failure. A 26-year-old female with osteogenesis imperfecta (OI) was diagnosed with dilated phase hypertrophic cardiomyopathy (d-HCM)) and was implanted with Jarvik 2000, for bridge to transplantation. AI gradually developed and surgical intervention was indicated. We performed central aortic valve closure (CAVC) instead of valve replacement 20 months after CF-LVAD implantation...
October 15, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
Giuseppe Tarantini, Marco Mojoli, Marina Urena, Alec Vahanian
Atrial fibrillation (AF) is a common arrhythmia in patients with aortic stenosis. When these patients are treated medically or by surgical aortic valve replacement, AF is associated with increased risk of adverse events including death. Growing evidence suggests a significant impact of AF on outcomes also in patients with aortic valve stenosis undergoing transcatheter aortic valve implantation (TAVI). Conversely, limited evidence is available regarding the optimal management of this condition. This review aims to summarize prevalence, pathophysiology, prognosis, and treatment of AF in patients undergoing TAVI...
October 15, 2016: European Heart Journal
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
Lars Sondergaard
During the last decade transcatheter aortic valve replacement (TAVR) has been established as a treatment for patients with severe aortic stenosis, who are at particularly high surgical risk. As compared with surgical aortic valve replacement (SAVR), TAVR has been associated with lower early risk of mortality, atrial fibrillation, acute kidney injury and bleeding. Furthermore, device and peri-procedural improvements have addressed most of the initial limitations for TAVR, including the Achilles' heel, paravalvular leakage...
October 6, 2016: JACC. Cardiovascular Interventions
Justin T Tretter, Diane E Spicer, Shumpei Mori, Sathish Chikkabyrappa, Andrew N Redington, Robert H Anderson
A comprehensive understanding of the normal and abnormal aortic root is paramount if we are to improve not only our assessment of the aortic root and its components but also the surgical approach to reconstructing this complex structure when congenitally malformed. Most anatomic and imaging-based classifications of the normal root recognize and describe the basic components, which include the shape and size of the three aortic sinuses and their three valvar leaflets, as well as the sinutubular junction and proximal ascending aorta...
October 11, 2016: Journal of the American Society of Echocardiography
Pedro A Villablanca, Verghese Mathew, Vinod H Thourani, Josep Rodés-Cabau, Sripal Bangalore, Mohammed Makkiya, Peter Vlismas, David F Briceno, David P Slovut, Cynthia C Taub, Patrick M McCarthy, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has emerged as an alternative to surgical aortic-valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at high operative risk. We sought to determine the long-term (≥1year follow-up) safety and efficacy TAVR compared with SAVR in patients with severe AS. METHODS: A comprehensive search of PubMed, EMBASE, Cochrane Central Register of Controlled Trials, conference proceedings, and relevant Web sites from inception through 10 April 2016...
October 6, 2016: International Journal of Cardiology
Pascal Augustin, Sebastien Tanaka, Vibol Chhor, Sophie Provenchère, Darko Arnaudovski, Hassan Ibrahim, Marie-Pierre Dilly, Nicolas Allou, Philippe Montravers, Ivan Philip
OBJECTIVES: Octogenarians considered for cardiac surgery encounter more complications than other patients. Postoperative complications raise the question of continuation of high-cost care for patients with limited life expectancy. Duration of hospitalization in intensive care after cardiac surgery may differ between octogenarians and other patients. The objectives were evaluating the mortality rate of octogenarians experiencing prolonged hospitalization in intensive care and defining the best cut-off for prolonged intensive care unit length of stay...
July 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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