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Surgical aortic valve replacement

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https://www.readbyqxmd.com/read/28820560/severe-valvular-aortic-stenosis-and-fixed-subvalvular-aortic-stenosis-a-rare-and-challenging-combination
#1
Ayman Elbadawi, Marwan Saad, Islam Y Elgendy, Basarat Baig, Farhad Abtahian
A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820544/use-of-adjuncts-reduces-cardiopulmonary-bypass-time-during-minimally-invasive-aortic-valve-replacement
#2
Alice Wang, Sharon L McCartney, Judson B Williams, Asvin Ganapathi, Donald D Glower, Alina Nicoara, Jeffrey G Gaca
BACKGROUND: Minimally invasive aortic valve replacement (MIAVR) through a mini-thoracotomy is comparable to AVR through a sternotomy, but may have increased surgical times. The development of adjuncts such as the automatic knot fastener and percutaneous coronary sinus (CS) catheter may reduce this disadvantage. METHODS: A retrospective review conducted between 2002 and 2015 at a single institution revealed 78 patients who underwent MIAVR with adjuncts. The automatic knot fastener was used on all patients, and a successful CS catheter was placed and confirmed by echocardiography in 67 patients (86%)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820543/minimally-invasive-versus-transcatheter-and-surgical-aortic-valve-replacement-a-propensity-matched-study
#3
Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Prakash Balan, Catalin Loghin, Daniel Ocazionez, Anthony Estrera, Carson T Hoffmann, Vasilis C Babaliaros, Joseph Lamelas, Tom C Nguyen
BACKGROUND: An increasing number of options exist for the treatment of severe symptomatic aortic stenosis. The study aim was to compare short-term outcomes in patients undergoing surgical aortic valve replacement (SAVR), minimally invasive aortic valve replacement (MIAVR), and transcatheter aortic valve replacement (TAVR). METHODS: A multi-institutional retrospective review of 2,571 patients undergoing SAVR (n = 842), MIAVR via right anterior thoracotomy (n = 699) and TAVR (n = 1,030) between 2011 and 2014 was conducted...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28818015/bioglue-associated-loss-of-aortic-valve-leaflet-motility-sonographically-masked-by-both-newly-replaced-mechanical-aortic-and-mitral-valves
#4
Alan Matthew Smeltz, Thomas G Caranasos, Emily G Teeter
BioGlue is a surgical adhesive widely used to help reinforce complex cardiac and vascular repairs. Since its introduction, several case reports have emerged revealing complications that all providers should be mindful of whenever the product is used. This report considers a unique situation where BioGlue was used after double cardiac valve repair that resulted in adhesion of the new mechanical aortic valve leaflets and was difficult to visualize with transesophageal echocardiography.
August 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28814237/statins-in-aortic-stenosis
#5
Karl Norrington, Emmanuel Androulakis, Evangelos Oikonomou, Georgia Vogiatzi, Dimitris Tousoulis
Calcific aortic stenosis (AS) is the most common form of valvular heart disease in Europe and North America. It is a progressive disease with a prolonged period of asymptomatic latency which eventually leads to critical left ventricular outflow tract obstruction necessitating surgical replacement of the valve. Statins are lipid-lowering drugs with a robust evidence base demonstrating clinical benefit in atherosclerotic coronary artery disease. There has therefore been significant interest in the potential benefit of statins in AS...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28812435/transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-patients-with-anaemia
#6
Paola D'Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco, Fulvia Seccareccia
OBJECTIVES: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. METHODS: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. RESULTS: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1...
August 16, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28805033/balloon-aortic-valvuloplasty-in-the-tavr-era-not-so-new-but-definitely-improved
#7
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/28803656/outcomes-of-transcatheter-versus-surgical-aortic-valve-implantation-for-aortic-stenosis-in-patients-with-hepatic-cirrhosis
#8
Fahad Alqahtani, Sami Aljohani, Anas Ghabra, Fares Alahdab, Akram Kawsara, David R Holmes, Mohamad Alkhouli
Current risk prediction tools for transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) do not include variables associated with clinically significant hepatic disease. Accordingly, outcome data of TAVI or SAVR in patients with liver cirrhosis are limited. We sought to assess contemporary trends and outcomes of TAVI and SAVR in patients with liver cirrhosis using a national database. The Nationwide Inpatient Sample was used to identify patients with liver cirrhosis who underwent TAVI or SAVR between 2003 and 2014...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28797431/implantation-and-30-day-follow-up-on-all%C3%A2-4-valve-sizes-within-the-portico-transcatheter-aortic-bioprosthetic-family
#9
Helge Möllmann, Axel Linke, David M Holzhey, Thomas Walther, Ganesh Manoharan, Ulrich Schäfer, Karl Heinz-Kuck, Ad J Van Boven, Simon R Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Stephen G Worthley
OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS: Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28797353/clinical-outcomes-with-a-repositionable-self-expanding-transcatheter-aortic%C3%A2-valve%C3%A2-prosthesis-the-international-forward-study
#10
Eberhard Grube, Nicolas M Van Mieghem, Sabine Bleiziffer, Thomas Modine, Johan Bosmans, Ganesh Manoharan, Axel Linke, Werner Scholtz, Didier Tchétché, Ariel Finkelstein, Ramiro Trillo, Claudia Fiorina, Antony Walton, Christopher J Malkin, Jae K Oh, Hongyan Qiao, Stephan Windecker
BACKGROUND: Clinical outcomes in large patient populations from real-world clinical practice with a next-generation self-expanding transcatheter aortic valve are lacking. OBJECTIVES: This study sought to document the clinical and device performance outcomes of transcatheter aortic valve replacement (TAVR) with a next-generation, self-expanding transcatheter heart valve (THV) system in patients with severe symptomatic aortic stenosis (AS) in routine clinical practice...
August 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#11
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28795030/comparison-of-the-outcomes-between-surgical-aortic-valve-replacement-and-transcatheter-aortic-valve-replacement-in-patients-aged-above-80
#12
Jeong-Woo Lee, Jihoon Kim, Sung-Ho Jung, Cheol Hyun Chung, Jae Won Lee
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been suggested as a less invasive treatment for high-risk patients with aortic valve disease. In this study, we compared the outcomes of conventional surgical aortic valve replacement (AVR) and TAVR in elderly patients aged over 80. METHODS: A total of 108 patients aged 80 years or older who underwent isolated AVR (n=35) or TAVR (n=73) from 2010 through 2015 at Asan Medical Center were identified. Early and late clinical outcomes, including echocardiographic findings, were evaluated in both groups...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28794053/low-flow-severe-aortic-stenosis-evolving-role-of-transcatheter-aortic-valve-replacement
#13
REVIEW
Matthew D Saybolt, Paul N Fiorilli, Zachary M Gertz, Howard C Herrmann
The definition of severe aortic stenosis has classically and retrospectively been based on the natural history of patients with medically managed aortic stenosis and preserved left ventricular function in an era where surgical aortic valve replacement was the sole therapy. We now recognize that this disease is more heterogeneous and includes important subsets of patients with low stroke volume index (low flow) and low-gradient with reduced (classical) or preserved (paradoxical) ejection fraction. These patients pose diagnostic and treatment dilemmas, requiring a comprehensive assessment with integration of multimodality imaging, testing, and clinical assessment...
August 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28790243/-valve-replacement-for-severe-aortic-stenosis-in-a-patient-with-tangier-disease
#14
Atsushi Tamura, Takamichi Yoshizaki, Sho Kusadokoro
We report a case of severe aortic valve stenosis in a patient with Tangier disease. A 64-year-old female was diagnosed with Tangier disease on the basis of gene mutation. The serum levels of total cholesterol and high-density lipoprotein were 124 mg/dl and 4.3 mg/dl, respectively. She had a symptom of dyspnea and echocardiography revealed severe aortic valve stenosis with the maximum gradient of 60.5 mmHg. Chest computed tomography showed severe calcification of the ascending aorta and the aortic root. Aortic valve replacement using a bioprosthetic valve was performed...
August 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28789675/life-threatening-subdural-hematoma-after-aortic-valve-replacement-in-a-patient-with-heyde-syndrome-a-case-report
#15
Tetsuro Uchida, Azumi Hamasaki, Eiichi Ohba, Atsushi Yamashita, Jun Hayashi, Mitsuaki Sadahiro
BACKGROUND: Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding...
August 8, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28780662/bicuspid-aortic-valvulopathy-and-associated-aortopathy-a-review-of-contemporary-studies-relevant-to-clinical-decision-making
#16
REVIEW
Michael H Kwon, Thoralf M Sundt
The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780035/dialysis-following-transcatheter-aortic%C3%A2-valve-implantation-risk%C3%A2-factors%C3%A2-and%C3%A2-outcomes-an-analysis-from-the-uk-tavi-registry-transcatheter%C3%A2-aortic%C3%A2-valve-implantation-registry
#17
Charles J Ferro, Jonathan P Law, Sagar N Doshi, Mark de Belder, Neil Moat, Mamas Mamas, David Hildick-Smith, Peter Ludman, Jonathan N Townend
OBJECTIVES: The study sought to determine the risk factors for post-transcatheter aortic valve replacement (TAVR) dialysis and to determine the impact of pre-TAVR or post-TAVR dialysis on mortality. BACKGROUND: TAVR is now established as an alternative treatment to surgical aortic valve replacement. Data examining the impact of dialysis on outcomes after TAVR are lacking. METHODS: The UK TAVI (Transcatheter Aortic Valve Implantation) Registry was established to report outcomes on all TAVR procedures performed within the United Kingdom (2007 to 2014)...
July 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28775090/missed-aortic-valve-endocarditis-resulting-in-complete-atrioventricular-block-and-redo-mechanical-valve-replacement
#18
Amer Harky, Megan Garner, Miruna Popa, Alex Shipolini
Infective endocarditis is a rare disease associated with high morbidity and mortality. As a result, early diagnosis and prompt antibiotic treatment with or without surgical intervention is crucial in the management of such condition.We report a case of missed infective endocarditis of the aortic valve. The patient underwent mechanical aortic valve replacement, with the native valve being sent for histopathological examination. On re-admission 16 months later, he presented with syncope, shortness of breathing and complete heart block...
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28761561/coronary-perforation-of-distal-diagonal-branch-followed-by-prolonged-recurrent-cardiac-tamponade-finally-resolved-with-pericardiotomy-the-potential-risk-of-hydrophilic-guide-wires
#19
Rafał Januszek, Krzysztof Bartuś, Radosław Litwinowicz, Artur Dziewierz, Łukasz Rzeszutko
PURPOSE: Coronary artery perforation (CAP) is a complication of percutaneous coronary interventions (PCIs). Hydrophilic guide-wires have been shown to increase the probability of CAP. Depending on the size of perforations we adopt different treatments. CASE: We present the case of a 73-year old male with coronary artery disease and severe aortic valve stenosis. The patient was in the process of qualifying for a transcatheter aortic valve implantation. Unfortunately, CAP of the first diagonal branch of the LAD occurred during PCI...
2017: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/28760721/transcatheter-aortic-valve-implantation-versus-re-do-surgery-for-failing-surgical-aortic-bioprosthesis-a-multi-centre-propensity-score-analysis
#20
Marco Spaziano, Darren Mylotte, Pascal Thériault-Lauzier, Ole De Backer, Lars Søndergaard, Johan Bosmans, Nicolas Debry, Thomas Modine, Marco Barbanti, Corrado Tamburino, Jan-Malte Sinning, Eberhard Grube, Georg Nickenig, Fritz Mellert, Sabine Bleiziffer, Rüdiger Lange, Benoit de Varennes, Kevin Lachapelle, Giuseppe Martucci, Nicolo Piazza
AIMS: Transcatheter aortic valve implantation for a failing surgical bioprosthesis (TAV- in-SAV) has become an alternative for patients at high risk for redo surgical aortic valve replacement (redo-SAVR). Comparisons between these approaches are non-existent. This study aims to compare clinical and echocardiographic outcomes of patients undergoing TAV-in-SAV versus redo-SAVR after accounting for baseline differences by propensity score matching. METHODS AND RESULTS: Patients from 7 centres in Europe and Canada who had undergone either TAV- in-SAV (n=79) or redo-SAVR (n=126) were identified...
August 1, 2017: EuroIntervention
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