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Surgical aortic valve replacement

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https://www.readbyqxmd.com/read/27914653/antithrombotic-therapy-after-bioprosthetic-aortic-valve-implantation-warfarin-versus-aspirin-a-randomized-controlled-trial
#1
Sulman Rafiq, Daniel Andreas Steinbrüchel, Nikolaj Bang Lilleør, Christian Holdflod Møller, Jens Teglgaard Lund, Jens Juel Thiis, Lars Køber, Peter Skov Olsen
BACKGROUND: The optimal medical strategy for prevention of thromboembolic events after surgical bioprosthetic aortic valve replacement (BAVR) is still debated. The objective of this study was to compare warfarin therapy (target INR of 2.0 to 3.0) with aspirin 150mg daily as antithrombotic therapy for the first three months after BAVR with or without concomitant coronary artery bypass grafting (CABG). The aim was to evaluate thromboembolic complications, major bleeding complications and death...
November 25, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27911025/effect-of-balloon-expandable-transcatheter-aortic-valve-replacement-positioning-a-patient-specific-numerical-model
#2
Matteo Bianchi, Gil Marom, Ram P Ghosh, Harold A Fernandez, James R Taylor, Marvin J Slepian, Danny Bluestein
Transcatheter aortic valve replacement (TAVR) has emerged as a life-saving and effective alternative to surgical valve replacement in high-risk, elderly patients with severe calcific aortic stenosis. Despite its early promise, certain limitations and adverse events, such as suboptimal placement and valve migration, have been reported. In the present study, it was aimed to evaluate the effect of various TAVR deployment locations on the procedural outcome by assessing the risk for valve migration. The deployment of a balloon-expandable Edwards SAPIEN valve was simulated via finite element analysis in a patient-specific calcified aortic root, which was reconstructed from CT scans of a retrospective case of valve migration...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27900928/-is-transcatheter-aortic-valve-implantation-superior-to-surgical-valve-replacement
#3
Y Schoon
Severe aortic valve stenosis is treated traditionally with surgical valve replacement. Transcatheter aortic valve implantation (TAVI) has experienced a rapid development in the last decade. Indications for TAVI have been broadened from inoperable and high surgical risk patients to intermediate-risk patients. Mortality rates are identical after TAVI compared with surgical valve replacement in intermediate-risk patients. However, mortality is not an appropriate outcome measure for a frail older person. Quality of life, autonomy and functioning independently are probably more suitable outcomes in this frail older population...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27898502/-full-metal-jacket-treatment-of-multiple-paravalvular-leaks
#4
Giuseppe Santoro, Giancarlo Scognamiglio, Maria T Palladino, Carola Iacono, Giampiero Gaio, Maria G Russo
A 40-year-old man with osteogenesis imperfecta type I submitted to multiple procedures of surgical mitral and aortic valve replacement was referred for refractory congestive heart failure due to significant paravalvular leaks (PVLs) of both mitral and aortic prostheses. Due to perceived very high risk of a further mitroaortic surgery, transcatheter closure of PVLs under three-dimensional echocardiographic guide was performed. Thus, four Amplatzer Vascular Plug type II (St. Jude Medical Corp, St. Paul, Minnesota, USA) devices were implanted into the aortic PVLs, and three Amplatzer Vascular Plug type II devices were used to occlude a huge mitral PVL...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27898500/patterns-and-trends-of-transcatheter-aortic-valve-implantation-in-italy-insights-from-rispeva
#5
Arturo Giordano, Nicola Corcione, Giuseppe Biondi-Zoccai, Sergio Berti, Anna Sonia Petronio, Carlo Pierli, Patrizia Presbitero, Pietro Giudice, Gennaro Sardella, Antonio L Bartorelli, Roberto Bonmassari, Ciro Indolfi, Alfredo Marchese, Elvis Brscic, Alberto Cremonesi, Luca Testa, Nedy Brambilla, Francesco Bedogni
AIMS: Clinical trials have shown that transcatheter aortic valve implantation for aortic stenosis compares favorably to surgical replacement in high-risk patients and is superior to medical therapy in those at prohibitive risk. There is uncertainty however on patterns and trends in transcatheter aortic valve implantation, especially focusing on Italy. METHODS: The RISPEVA study is a prospective Italian registry including 21 institutions. Patients have been enrolled since late 2012, and data collection includes several baseline, procedural, in-hospital, and follow-up details...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27888494/patient-specific-computer-modelling-its-role-in-the-planning-of-transcatheter-aortic-valve-implantation
#6
REVIEW
N El Faquir, B Ren, N M Van Mieghem, J Bosmans, P P de Jaegere
Transcatheter aortic valve implantation is increasingly used to treat patients with severe aortic stenosis who are at increased risk for surgical aortic valve replacement and is projected to be the preferred treatment modality. As patient selection and operator experience have improved, it is hypothesised that device-host interactions will play a more dominant role in outcome. This, in combination with the increasing number of valve types and sizes, confronts the physician with the dilemma to choose the valve that best fits the individual patient...
November 25, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27886617/transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-and-observational-studies
#7
Yijiang Zhou, Yanwei Wang, Yutao Wu, Jianhua Zhu
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the treatment of choice for patients with aortic stenosis and the preferred alternative for high surgical risk patients. However, TAVR's suitability for patients at low to intermediate risk still remains controversial. METHODS: PubMed, MEDLINE and Clinical trials were systematically searched for randomized control trials and observational cohort studies which reported the clinical outcomes of TAVR versus surgical aortic valve replacement (SAVR) in patients at low to intermediate surgical risk...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27878547/transcatheter-closure-of-paravalvular-leaks-state-of-the-art
#8
I Cruz-Gonzalez, J C Rama-Merchan, J Rodríguez-Collado, J Martín-Moreiras, A Diego-Nieto, M Barreiro-Pérez, P L Sánchez
Paravalvular leak (PVL) is a serious complication after surgical valve replacement or after transcatheter aortic valve replacement. Approximately 1-5% of PVLs can lead to serious clinical consequences, including congestive heart failure and/or haemolytic anaemia. For years, surgical re-intervention has been considered the treatment of choice for symptomatic patients with PVLs. However, surgical re-intervention is associated with a high risk of morbidity and mortality. Transcatheter PVL (TPVL) closure is a less invasive alternative to surgical re-intervention...
November 22, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27875347/severe-low-gradient-aortic-stenosis-with-preserved-ventricular-function-should-it-be-treated
#9
Giuseppe Di Pasquale, Gloria Vassilikì Coutsoumbas, Silvia Zagnoni
Exists a group of patients with small AVA (<0,6 cm/m), and normal LVEF (≥50%) who display a low transvalvular flow (LF) [index stroke volume (SVi)<35 ml/m2] and/or low transvalvular gradient (LG). This condition is called severe paradoxical aortic stenosis (SAO) LFLG. In many studies this condition was associated to increased mortality both with medical therapy and with surgical intervention. Crucial is define correctly the diagnostical criteria of this condition. Indeed there are several specific anatomical and functional characteristics useful in differentiating paradoxical severe aortic stenosis from the other forms of aortic stenosis...
November 19, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27873284/a-case-of-acute-myocardial-infarction-due-to-cardiovascular-syphilis-with-aortic-regurgitation-and-bilateral-coronary-ostial-stenosis
#10
Mutsuo Tanaka, Minoru Okamoto, Toshihiko Murayama
We report an interesting case of a 66-year-old man with acute myocardial infarction (AMI) with bilateral coronary ostial stenosis cardiovascular syphilis complicated by aortic regurgitation (AR). A 12-lead electrocardiogram and blood tests on arrival suggested AMI, and echocardiography showed moderate AR. Emergency coronary angiography showed bilateral coronary ostial stenosis. The patient underwent emergency surgical treatment, coronary artery bypass grafting, and aortic valve replacement with a bioprosthetic valve...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27873180/pledget-armed-sutures-affect-the-haemodynamic-performance-of-biologic-aortic-valve-substitutes-a-preliminary-experimental-and-computational-study
#11
Claudio Capelli, Chiara Corsini, Dario Biscarini, Francesco Ruffini, Francesco Migliavacca, Alfred Kocher, Guenther Laufer, Andrew M Taylor, Silvia Schievano, Martin Andreas, Gaetano Burriesci, Claus Rath
Surgical aortic valve replacement is the most common procedure of choice for the treatment of severe aortic stenosis. Bioprosthetic valves are traditionally sewed-in the aortic root by means of pledget-armed sutures during open-heart surgery. Recently, novel bioprostheses which include a stent-based anchoring system have been introduced to allow rapid implantation, therefore reducing the duration and invasiveness of the intervention. Different effects on the hemodynamics were clinically reported associated with the two technologies...
November 21, 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27873174/prognostic-value-of-exercise-left-ventricular-end-systolic-volume-index-in-patients-with-asymptomatic-aortic-regurgitation-an-exercise-echocardiography-study
#12
Yukio Sato, Masaki Izumo, Kengo Suzuki, Seisyou Kou, Kihei Yoneyama, Maya Tsukahara, Kanako Teramoto, Keisuke Minami, Shingo Kuwata, Ryo Kamijima, Kei Mizukoshi, Akio Hayashi, Sachihiko Nobuoka, Eiji Ohtaki, Tomoo Harada, Yoshihiro J Akashi
BACKGROUND: Surgical timing of chronic aortic regurgitation (AR) remains a matter of debate because of limited data. This study assessed the prognostic value of exercise echocardiography in asymptomatic AR. METHODS: This prospective study included 60 consecutive asymptomatic patients with isolated moderate or severe AR (mean regurgitant volume 56.7 ± 11.8 ml) and preserved ejection fraction who underwent exercise echocardiography. The clinical outcomes were defined by the presence of major adverse cardiovascular events (MACE) and the indication for aortic valve replacement (AVR) with class I or IIa classification in the current guidelines...
November 21, 2016: Journal of Echocardiography
https://www.readbyqxmd.com/read/27867654/patient-prosthesis-mismatch-surgical-aortic-valve-replacement-versus-transcatheter-aortic-valve-replacement-in-high-risk-patients-with-aortic-stenosis
#13
COMMENT
Ravi K Ghanta, Irving L Kron
Patient prosthesis mismatch (PPM) can occur when a prosthetic aortic valve has an effective orifice area (EOA) less than that of a native valve. A recent study by Zorn and colleagues evaluated the incidence and significance of PPM in high risk patients with severe aortic stenosis who were randomized to transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). TAVR is associated with decreased incidence of severe PPM compared to traditional SAVR valves. Severe PPM increases risk for death at 1 year postoperatively in high risk patients...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27867590/prosthetic-valve-endocarditis-after-transcatheter-aortic-valve-implantation-diagnostic-and-surgical-considerations
#14
Khalil Ahmad, Kaj Erik Klaaborg, Vibeke Hjortdal, Bjarne Linde Nørgaard, Christian Juhl Terkelsen, Kaare Jensen, Evald Høj Christiansen, Kim Allan Terp, Gratien Andersen, Steen Hvitfeldt, Henning Rud Andersen
Prosthetic valve endocarditis (PVE) after transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR) is a potential life threatening complication. Better understanding of the incidence, predictors, clinical presentation, diagnostic measures, complications and management of PVE may help improve TAVI long-term outcome. We report a case of TAVI-PVE in an 80-year-old high risk patient in whom SAVR was successfully performed. We have reviewed literature regarding TAVI-PVE.
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27865711/use-of-an-eptfe-covered-nitinol-self-expanding-stent-graft-for-the-treatment-off-pre-closure-device-failure-during-transcatheter-aortic-valve-replacement
#15
Arie Steinvil, Nelson Bernardo, Toby Rogers, Edward Koifman, Kyle Buchanan, M Chadi Alraies, Christian Shults, Rebecca Torguson, Petros G Okubagzi, Augusto D Pichard, Lowell F Satler, Itsik Ben-Dor, Ron Waksman
OBJECTIVES: Our aim was to describe our experience with the use of an ePTFE-covered nitinol self-expanding stent graft (GORE® VIABAHN® Endoprosthesis, Gore Medical, USA) placed in the common femoral artery for the treatment of suture-mediated pre-closure device failure following transcatheter aortic valve replacement (TAVR). BACKGROUND: Access site-related vascular complications (VC) following sheath removal related to pre-closure device failure during TAVR are common and treatment options may vary...
October 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27865184/changes-of-left-ventricular-mechanics-after-trans-catheter-aortic-valve-implantation-and-surgical-aortic-valve-replacement-for-severe-aortic-stenosis-a-tissue-tracking-cardiac-magnetic-resonance-study
#16
Gaetano Nucifora, John-Paul Tantiongco, Gareth Crouch, Jayme Bennetts, Ajay Sinhal, Phillip J Tully, Craig Bradbrook, Robert A Baker, Joseph B Selvanayagam
BACKGROUND: Left ventricular (LV) mechanics are impaired in patients with severe aortic stenosis (AS). The aim of the present study was to assess their changes early and late after trans-catheter aortic valve implantation (TAVI) and surgical aortic valve replacement (AVR) using cardiac magnetic resonance (CMR) tissue-tracking imaging. METHODS: In 59 patients with severe AS undergoing either TAVI (n=35) or surgical AVR (n=24), CMR with late gadolinium enhancement (LGE) imaging was performed before and early post-procedure to evaluate LV function and mass, and presence/extent of LGE...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863733/impact-of-left-ventricular-systolic-function-on-outcome-of-correction-of-chronic-severe-aortic-valve-regurgitation-implications-for-timing-of-surgical-intervention
#17
Takashi Murashita, Hartzell V Schaff, Rakesh M Suri, Richard C Daly, Zhuo Li, Joseph A Dearani, Kevin L Greason, Rick A Nishimura
BACKGROUND: The timing of valve repair or replacement in patients with severe aortic valve regurgitation (AR) is controversial. We investigated the effect of left ventricular (LV) function on survival and recovery of LV performance and dimensions after correction of chronic severe AR. METHODS: We reviewed 530 consecutive patients who underwent aortic valve repair or replacement for severe AR between January 1, 2004, and June 30, 2014. RESULTS: The 30-day mortality was 0...
November 15, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27855225/incidence-predictors-and-clinical-outcomes-of-postoperative-cardiac-tamponade-in-patients-undergoing-heart-valve-surgery
#18
Seng Chan You, Chi Young Shim, Geu-Ru Hong, Darae Kim, In Jeong Cho, Sak Lee, Hyuck-Jae Chang, Jong-Won Ha, Byung-Chul Chang, Namsik Chung
This study aimed to investigate the incidence, predictors, and clinical outcomes of cardiac tamponade after heart valve surgery. A total of 556 patients who underwent heart valve surgery in a single tertiary center between January 2010 and March 2012 were studied. All patients underwent transthoracic echocardiography (TTE) about 5 days after surgery and TTE was repeated regularly. Patients with suspected acute pericardial hemorrhage were excluded. Cardiac tamponade occurred in twenty-four (4.3%) patients and all underwent surgical or percutaneous pericardial drainage...
2016: PloS One
https://www.readbyqxmd.com/read/27847073/impingement-of-single-tilting-disc-mitral-prosthesis-during-transcatheter-aortic-valve%C3%A2-replacement
#19
John J Squiers, Katherine R Hebeler, J Michael DiMaio, Patrick Ogbue, Molly Szerlip, William T Brinkman
An 80-year-old woman with a medical history of mitral valve replacement with single-tilting disc prosthesis underwent transcatheter aortic valve replacement (TAVR). The tilting disc was noted to have abnormal motion after re-ballooning of the TAVR valve. Cardiopulmonary bypass was initiated, and the procedure was converted to surgical aortic valve replacement. After removal of the TAVR valve, the tilting disc moved freely. Although TAVR in patients with mitral prostheses is technically feasible, particular caution is necessary, and postdeployment dilation should be avoided...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27847071/evolut-r-implantation-to-treat-severe-pure-aortic-regurgitation-in-a-patient-with-mitral-bioprosthesis
#20
Giuseppe Bruschi, Paola Colombo, Stefano Nava, Francesco Musca, Bruno Merlanti, Oriana Belli, Francesco Soriano, Luca Botta, Danile De Caria, Cristina Giannattasio, Claudio F Russo
Transcatheter aortic valves have been designed to treat high-risk surgical candidates affected by severe aortic stenosis, but little is known about the use of transcatheter valves in patients with severe pure aortic regurgitation. We describe the implantation of Medtronic CoreValve Evolut R (Medtronic, Minneapolis, MN) to treat an 82-year-old patient affected by severe pure aortic regurgitation who underwent prior mitral valve replacement with a biological valve protruding into the left ventricular outflow tract...
December 2016: Annals of Thoracic Surgery
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