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Aortic stenosis TAVR

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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
#1
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/28088437/safety-and-feasibility-of-pci-in-patients-undergoing-tavr-a-systematic-review-and-meta-analysis
#2
REVIEW
Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28077468/integrated-imaging-of-echocardiography-and-computed-tomography-to-grade-mitral-regurgitation-severity-in-patients-undergoing-transcatheter-aortic-valve-implantation
#3
Philippe J van Rosendael, Suzanne E van Wijngaarden, Vasileios Kamperidis, William K F Kong, Melissa Leung, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
AIMS: Quantitative mitral regurgitation (MR) grading remains challenging. This study evaluated the concept of integrating echocardiography and computed tomography for grading MR severity. Specifically, an integrated parameter was developed that combines the true cross-sectional mitral regurgitant orifice area (ROA) assessed with multi-detector row computed tomography (MDCT) with flow data from echocardiography. METHODS AND RESULTS: Systolic MDCT data of 73 patients, referred for transcatheter aortic valve implantation (TAVI) who also had MR, were evaluated...
January 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28075036/double-trouble-a-case-of-periprocedural-detection-of-intracardiac-thrombus-and-aortic-root-dissection-during-emergent-transfemoral-tavr
#4
Carlos Corredor, Eric Horlick, Wendy Tsang, Massimiliano Meineri
We report a case of emergency transcatheter aortic valve replacement (TAVR) in a 65-year-old patient presenting with decompensated severe aortic stenosis. Transesophageal echocardiography (TEE) was used effectively to obtain measurements of the aortic annulus and for intra-procedural guidance. At baseline, we detected a left atrial appendage thrombus and a localized aortic root dissection after balloon valvuloplasty. The case highlights the important role that TEE may play during TAVR procedures.
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28064153/comparison-of-valve-performance-of-the-mechanically-expanding-lotus-and-the-balloon-expanded-sapien3-transcatheter-heart-valves-an-observational-study-with-independent-core-laboratory-analysis
#5
Osama I I Soliman, Nahid El Faquir, Ben Ren, Ernest Spitzer, Lennart van Gils, Hans Jonker, Marcel L Geleijnse, Gerrit-Anne van Es, Jan G Tijssen, Nicolas M van Mieghem, Peter P T de Jaegere
AIMS: The Lotus and SAPIEN3 are second-generation transcatheter heart valves, which are designed to minimize paravalvular aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR). We sought to compare both devices for valve performance and with emphasis on PAR by independent core laboratory analysis. METHODS AND RESULTS: A total of 162 (79 Lotus and 83 SAPIEN3) consecutive patients (51% female, 80 ± 8 years, Logistic EuroSCORE 14.8 ± 9...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28061996/comparative-outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-for-aortic-stenosis-in-nonagenarians
#6
Chad J Zack, Fahad Al-Qahtani, Akram Kawsara, Mohammed Al-Hijji, Ali Hama Amin, Mohamad Alkhouli
Transcatheter aortic valve replacement (TAVR) emerged as a promising alternative to surgical aortic valve replacement (SAVR) in extreme-aged patients with severe aortic stenosis (AS). Data on the outcomes of TAVR or SAVR in nonagenarians are limited. The Nationwide Inpatient Sample was used to identify patients aged 90 years or older who underwent TAVR or SAVR from 2004 to 2013. In-hospital morbidity and mortality were assessed. From 2004 to 2013, 9,066 (national estimate) nonagenarians underwent aortic valve replacement...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28052455/echocardiographic-follow-up-after-transcatheter-aortic-valve-replacement
#7
REVIEW
Vladislavs Sokalskis, Denisa Muraru, Chiara Fraccaro, Massimo Napodano, Augusto D'Onofrio, Giuseppe Tarantini, Luigi Paolo Badano
The use of transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis has rapidly increased during the past years. Accordingly, more and more patients are referred for a follow-up echocardiographic study after TAVR. However, the echocardiographic evaluation of patients who underwent TAVR places specific demands on echocardiographers. Furthermore, TAVR may be associated with new types of complications, which are frequently unrecognized or underestimated due to lack of familiarity with the normal and pathological appearance of TAVR...
January 3, 2017: Echocardiography
https://www.readbyqxmd.com/read/28043443/the-effect-of-initiation-of-a-transcatheter-aortic-valve-replacement-program-in-the-treatment-of-severe-aortic-stenosis
#8
Niv Ad, Sari D Holmes, Deborah J Shuman, Anthony J Rongione, Paul S Massimiano, Alan M Speir, Graciela Pritchard, Shahram Yazdani, Bryan D Raybuck
We assessed the effect of a transcatheter aortic valve replacement (TAVR) program and Heart Team concept on our approach to severe isolated symptomatic aortic stenosis (AS) with regard to surgical practice, patient selection, perioperative outcomes, 1-year survival, and AVR volume. TAVR program began in August 2011. Patients having isolated surgical AVR between January 2008 and August 2011, when the program began (n = 282, 42 months), were compared with those after the program began until February 2015 (n = 344, surgical AVR and n = 126, TAVR, 42 months)...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28041860/transcatheter-aortic-valve-replacement-for-bicuspid-aortic-stenosis-13years-post-heart-transplant
#9
Maureen B Julien, Nimesh Desai, Susan Brozena, Howard C Herrmann
Despite the widespread use of transcatheter aortic valve replacement (TAVR) for moderate and high-risk patients with severe aortic stenosis, it is utilized less frequently in patients with bicuspid aortic valves (BAV). Orthotopic heart transplant (OHT) donors tend to be younger and may have undiagnosed BAV. We present a case of successful TAVR in a patient with BAV thirteen years after OHT.
December 16, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28039604/socioeconomic-and-racial-disparities-a-case-control-study-of-patients-receiving-transcatheter-aortic-valve-replacement-for-severe-aortic-stenosis
#10
Anna Sleder, Shiloh Tackett, Matthew Cerasale, Chetan Mittal, Iyad Isseh, Ryhm Radjef, Andrew Taylor, Rashad Farha, Oleksandra Lupak, Dana Larkin, Lois Lamerato, George Divine, Kimberlydawn Wisdom, Kimberly Baker-Genaw, William O'Neill
BACKGROUND: We sought to quantify socioeconomic disparities in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) at an urban, tertiary referral center. METHODS: This retrospective case-control study identified 67 patients with severe AS (aortic valve [AV] area ≤1 cm(2) or AV area index ≤0.60 cm(2)/m(2) or AV velocity ≥40 mmHg) who underwent TAVR from November 5, 2013 to June 10, 2014. Study subjects were matched to controls with severe AS without TAVR in a 4:1 age-frequency match...
December 30, 2016: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28039339/concomitant-mitral-annular-calcification-and-severe-aortic-stenosis-prevalence-characteristics-and-outcome-following-transcatheter-aortic-valve-replacement
#11
Yigal Abramowitz, Yoshio Kazuno, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, David Anderson, Zev Allison, Geeteshwar Mangat, Wen Cheng, Ambarish Gopal, Hasan Jilaihawi, Michael J Mack, Raj R Makkar
AIMS: Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have certain similar etiology and pathophysiological mechanisms. MAC is frequently encountered in pre-procedural computed tomography (CT) imaging of patients that undergo transcatheter aortic valve replacement (TAVR), but its prognostic implications for these patients have not been thoroughly investigated. This study sought to evaluate the prevalence of MAC among patients with severe AS and to assess the clinical implications of MAC on these patients during and following TAVR...
December 30, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28029207/prospective-comparison-between-three-tavr-devices-acurate-neo-vs-corevalve-vs-sapien-xt-a-single-heart-team-experience-in-patients-with-severe-aortic-stenosis
#12
Tannas Jatene, Antonio Castro-Filho, Rafael A Meneguz-Moreno, Dimytri A Siqueira, Alexandre A C Abizaid, Auristela I O Ramos, Magaly Arrais, David C S Le Bihan, Rodrigo B M Barretto, Adriana C Moreira, Amanda G M R Sousa, J Eduardo Sousa
OBJECTIVE: We sought to compare the new transcatheter aortic valve replacement (TAVR) device ACURATE neo (ACT) with the already established CoreValve (MCV) and SAPIEN XT (SXT) for the treatment of severe aortic stenosis (AS). BACKGROUND: Very few data on TAVR devices are available beyond MCV and SAPIEN and there is no previous study comparing ACT with MCV and SXT. METHODS: We prospectively evaluated consecutive patients who underwent transfemoral TAVR for the treatment of severe AS...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28009955/a-left-to-right-shunt-after-transfemoral-tavr-using-edwards-sapien-3
#13
Julius Steffen, Anton Köhler, Florian Schwarz, Sebastian Sadoni, Christian Hagl, Steffen Massberg, Martin Greif
Transcatheter aortic valve replacement (TAVR) is used for the treatment of aortic stenosis (AS). Besides major bleeding, conduction blocks, stroke or atrial fibrillation, complications include cardiac perforation with possible left-to-right-shunts. Herein is reported the sixth case of a left-to-right shunt in an 87-year-old man who underwent TAVR using a 29 mm Edwards SAPIEN S3 prosthesis to treat AS. Soon after the procedure, a small channel evolving from the right coronary cusp could be detected on echocardiography...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009944/suture-forces-for-closure-of-transapical-transcatheter-aortic-valve-replacement-a-mathematical-model
#14
Liang Ge, Henrik Haraldsson, Michael D Hope, David Saloner, Julius M Guccione, Mark B Ratcliffe, Elaine E Tseng
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized the treatment of severe aortic stenosis in intermediate, high-risk, and inoperable patients. TAVR has multiple access routes, including transfemoral (TF), transapical (TA), direct aortic (DA), axillary, transcarotid, and transcaval. The most commonly applied algorithm is a TF-first approach, where only when patients are unsuitable for TF are alternatives such as TA considered. An infrequent - but dreaded - risk is left ventricular (LV) apical bleeding from tearing or rupture with the TA approach...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27994841/do-all-critical-aortic-stenosis-with-chest-pain-need-aortic-valve-replacement-a-case-report
#15
Munish Sharma, Daniel A N Mascarenhas
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27989062/aortic-regurgitation-after-tavr-from-bad-to-worse
#16
Nick Hiltrop, Tom Adriaenssens, Paul Herijgers, Christophe Dubois
Transcatheter aortic valve replacement (TAVR) is a valuable alternative in surgical high-risk patients with symptomatic aortic valve stenosis. Here, the case is presented of very early transcatheter heart valve degeneration, probably caused by a 'Venturi effect' of a severe paravalvular regurgitant jet. This ultimately led to a leaflet being in the open position, creating severe valvular regurgitation that necessitated classical surgical revision. The occurrence of paravalvular regurgitation, and its known relationship with an adverse prognosis after TAVR, demonstrates the clear need for innovative alterations in valve design to prevent this complication...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989060/acute-invasive-hemodynamic-effects-of-transcatheter-aortic-valve-replacement
#17
Michael Chrissoheris, Antonis Ziakas, Antonis Chalapas, Stavros Chadjimiltiades, Ioannis Styliades, Charalambos Karvounis, Ioulia Nikolaou, Konstantinos Spargias
BACKGROUND: Aortic stenosis imposes a chronic pressure overload on the left ventricle, with attendant adaptations in hemodynamics, muscle mass and performance. The hemodynamic changes that occur during the initial 24 h following abrupt removal of the impediment to left ventricular outflow have not been previously examined. METHODS: A total of 52 patients with right heart catheterization was evaluated before, within 6 h and at 24 h after successful transcatheter aortic valve replacement (TAVR)...
March 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27931592/the-rationale-for-performance-of-coronary%C3%A2-angiography-and-stenting-before-transcatheter-aortic-valve-replacement-from-the-interventional-section-leadership-council-of-the-american-college-of-cardiology
#18
REVIEW
Stephen Ramee, Saif Anwaruddin, Gautam Kumar, Robert N Piana, Vasilis Babaliaros, Tanveer Rab, Lloyd W Klein
Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27922809/impact-of-coronary-artery-disease-on-postoperative-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr-is-preoperative-coronary-revascularization-necessary
#19
Dhaval Chauhan, Mohammad Thawabi, Nicky Haik, Bruce J Haik, Chunguang Chen, Marc Cohen, Mark Russo
BACKGROUND: There remains much controversy on impact of preoperative coronary artery disease (CAD) and necessity of preoperative coronary revascularization on postoperative outcomes in patients undergoing transcatheter aortic valve replacement (TAVR). METHODS: Data were collected retrospectively for 364 consecutive patients undergoing TAVR at Newark Beth Israel Medical Center, New Jersey, from May 15, 2012 to September 17, 2015. Preoperative CAD burden was calculated by three different measures of CAD: SYNTAX score, Duke Myocardial Jeopardy score (DMJS), and number of diseased coronary arteries...
December 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27914503/rationale-and-design-of-the-transcatheter-aortic-valve-replacement-to-unload-the-left-ventricle-in-patients-with-advanced-heart-failure-tavr-unload-trial
#20
Ernest Spitzer, Nicolas M Van Mieghem, Philippe Pibarot, Rebecca T Hahn, Susheel Kodali, Mathew S Maurer, Tamim M Nazif, Josep Rodés-Cabau, Jean-Michel Paradis, Arie-Pieter Kappetein, Ori Ben-Yehuda, Gerrit-Anne van Es, Faouzi Kallel, William N Anderson, Jan Tijssen, Martin B Leon
BACKGROUND: Coexistence of moderate aortic stenosis (AS) in patients with heart failure (HF) with reduced ejection fraction is not uncommon. Moderate AS increases afterload, whereas pharmacologic reduction of afterload is a pillar of contemporary HF management. HYPOTHESIS: Unloading the left ventricle by reducing the transaortic gradient with transfemoral transcatheter aortic valve replacement (TAVR) may improve clinical outcomes in patients with moderate AS and HF with reduced ejection fraction...
December 2016: American Heart Journal
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