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stenosis aortic valve

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https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#1
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29147686/lipoprotein-a-associated-molecules-are-prominent-components-in-plasma-and-valve-leaflets-in-calcific-aortic-valve-stenosis
#2
Michael Torzewski, Amir Ravandi, Calvin Yeang, Andrea Edel, Rahul Bhindi, Stefan Kath, Laura Twardowski, Jens Schmid, Xiaohong Yang, Ulrich F W Franke, Joseph L Witztum, Sotirios Tsimikas
The LPA gene is the only monogenetic risk factor for calcific aortic valve stenosis (CAVS). Oxidized phospholipids (OxPL) and lysophosphatidic acid generated by autotaxin (ATX) from OxPL are pro-inflammatory. Aortic valve leaflets were categorized pathologically from Both ATX-apoB and ATX-apo(a) were measureable in plasma. Lp(a), autotaxin, OxPL and MDA epitopes progressively increased in immunostaining (p<0.001 for all). Six species of OxPL and LysoPA were identified following extraction from valve leaflets...
June 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/29146482/impaired-left-atrial-strain-as-a-predictor-of-new-onset-atrial-fibrillation-after-aortic-valve-replacement-independently-of-left-atrial-size
#3
Guilherme Pessoa-Amorim, Jennifer Mancio, Luís Vouga, José Ribeiro, Vasco Gama, Nuno Bettencourt, Ricardo Fontes-Carvalho
INTRODUCTION AND OBJECTIVES: Left atrial dysfunction in aortic stenosis may precede atrial enlargement and predict the occurrence of atrial fibrillation (AF). To test this hypothesis, we assessed left atrial function and determined its impact on the incidence of AF after aortic valve replacement. METHODS: A total of 149 severe aortic stenosis patients (74±8.6 years, 51% men) with no prior AF were assessed using speckle-tracking echocardiography. Left atrial function was evaluated using peak atrial longitudinal strain (PALS), peak atrial contraction strain (PACS), and phasic left atrial volumes...
November 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29141531/statins-in-aortic-disease
#4
Vicky Tsigkou, Gerasimos Siasos, Eva Mpletsa, Maria-Paraskevi Panoilia, Aggeliki Papastavrou, Giorgos Kokosias, Evangelos Oikonomou, Marina Zaromitidou, Manolis Vavuranakis, Christodoulos Stefanadis, Dimitris Tousoulis
BACKGROUND: Numerous studies indicate that statins have also multiple beneficial actions (known as 'pleiotropic actions') on cardiovascular system through the improvement of endothelial dysfunction, inflammation, oxidative stress, increased arterial thrombosis, and the stabilization of the atherosclerotic plaque. Aortic disease primarily consists of aortic valve stenosis, aortic valve regurgitation, aneurysm disease, and genetic disorders such as Marfan syndrome, bicuspid aortic valve and aortic coarctation...
November 14, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29137967/procedural-and-thirty-day-outcomes-following-transfemoral-implantation-of-the-fully-repositionable-and-retrievable-lotus-valve-without-routine-pre-dilatation-in-a-consecutive-patient-cohort-a-single-centre-experience
#5
Neil Ruparelia, Katharine Thomas, James D Newton, Kate Grebenik, Amar Keiralla, George Krasopoulos, Rana Sayeed, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND / PURPOSE: The Lotus valve (Boston Scientific, Natick, MA, USA) is a contemporary transcatheter aortic valve implantation (TAVI) device that is fully repositionable and retrievable to aid implantation and optimise procedural results. The ability to implant the device without routine pre-dilatation is another possible advantage reducing associated risks and procedure times. The aim of this study is to report procedural and 30-day outcomes following TAVI in a consecutive patient group presenting with severe symptomatic aortic stenosis with the Lotus valve system without routine pre-dilatation...
November 4, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29136138/calcific-aortic-valve-stenosis-hard-disease-in-the-heart-a-biomolecular-approach-towards-diagnosis-and-treatment
#6
Frederique E C M Peeters, Steven J R Meex, Marc R Dweck, Elena Aikawa, Harry J G M Crijns, Leon J Schurgers, Bas L J H Kietselaer
Calcific aortic valve stenosis (CAVS) is common in the ageing population and set to become an increasing economic and health burden. Once present, it inevitably progresses and has a poor prognosis in symptomatic patients. No medical therapies are proven to be effective in holding or reducing disease progression. Therefore, aortic valve replacement remains the only available treatment option. Improved knowledge of the mechanisms underlying disease progression has provided us with insights that CAVS is not a passive disease...
November 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29131801/real-world-experience-using-the-acurate-neo%C3%A2-prosthesis-30-day-outcomes-of-1000-patients-enrolled-in-the-savi-tf-registry
#7
Helge Möllmann, Christian Hengstenberg, Michael Hilker, Sebastian Kerber, Ulrich Schäfer, Tanja Rudolph, Axel Linke, Norbert Franz, Thomas Kuntze, Holger Nef, Utz Kappert, Thomas Walther, Michael O Zembala, Stefan Toggweiler, Won-Keun Kim
AIMS: The aim of the SAVI-TF registry was to assess the safety and performance of the self-expanding ACURATE neoTM transfemoral transcatheter heart valve in a large patient population with severe aortic stenosis and to investigate if the outcomes obtained in the CE-mark cohort can be replicated in an unselected all-comers population. METHODS AND RESULTS: From October 2014 until April 2016, 1000 patients were enrolled in this prospective, European multicenter registry...
November 14, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29131296/complete-percutaneous-approach-versus-surgical-access-in-transfemoral-transcatheter-aortic-valve-implantation-results-from-a-multicenter-registry
#8
Janusz Kochman, Łukasz Kołtowski, Zenon Huczek, Bartosz Rymuza, Radosław Wilimski, Maciej Dąbrowski, Adam Witkowski, Marek Grygier, Anna Olasińska-Wiśniewska, Piotr Kubler, Krzysztof Reczuch, Radosław Parma, Andrzej Ochała, Dariusz Jagielak, Wacław Kochman, Eberhard Grube
BACKGROUND: Although the femoral approach is the most common route utilized in transcatheter aortic valve implantation (TAVI) it still carries a substantial risk of severe bleeding and vascular complications. The aim of our study was to compare the safety and efficacy of the complete percutaneous (CPC) approach with surgical cutdown and closure (SCC) in TAVI patients. METHODS: The study population comprised 683 patients with severe aortic stenosis who underwent transfemoral TAVI...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29130619/a-feasibility-study-of-transaxillary-tavi-with-the-lotus-valve
#9
Sagar N Doshi, Sudhakar George, Chun Shing Kwok, Anthony Mechery, Mamas Mamas, Peter F Ludman, Jonathan N Townend, Moninder Bhabra
OBJECTIVES: To assess the feasibility of axillary transcatheter aortic valve implantation (TAVI) using the Lotus valve. BACKGROUND: TAVI is used to treat patients with severe aortic stenosis, with transfemoral (TF) access being the safest and most widely used route. In patients unsuitable for this, there are reports that the axillary artery may be safest alternative access route. The Lotus device is a fully retrievable 2nd generation transcatheter heart valve which is licensed for femoral and transaortic access...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#10
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29129879/transcatheter-aortic-valve-implantation-for-degenerated-19-mm-aortic-bioprosthetic-valve
#11
Kizuku Yamashita, Tomoyuki Fujita, Satsuki Fukushima, Yusuke Shimahara, Yuta Kume, Yorihiko Matsumoto, Naonori Kawamoto, Tatsuro Hitsumoto, Nobuyasu Ito, Yasuhiro Hamatani, Atsushi Okada, Hiroyuki Takahama, Makoto Amaki, Takuya Hasegawa, Yasuo Sugano, Hideaki Kanzaki, Toshihisa Anzai, Satoshi Yasuda, Junjiro Kobayashi
BACKGROUND: The valve-in-valve procedure, in which a transcatheter heart valve (THV) is implanted over a prosthetic valve, has been shown to be safe and therapeutically effective, depending on the size of the replacement valve.Methods and Results:We report 3 cases of successful valve-in-valve procedure to replace a degenerated 19-mm stented prosthetic aortic valve. Balloon-expanding THVs were implanted: 20-mm in the 1st case and 23-mm in the next 2. Aortic stenosis was almost completely resolved in all patients, who recovered promptly and without cardiac adverse events...
November 11, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29128868/association-of-lpa-variants-with-aortic-stenosis-a-large-scale-study-using-diagnostic-and-procedural-codes-from-electronic-health-records
#12
Hao Yu Chen, Line Dufresne, Hannah Burr, Athithan Ambikkumar, Niko Yasui, Kevin Luk, Dilrini K Ranatunga, Rachel A Whitmer, Mark Lathrop, James C Engert, George Thanassoulis
Importance: Elevated lipoprotein(a) levels are a risk factor for aortic stenosis (AS). However, a large-scale replication of associations between LPA variants and AS, their interactions with risk factors, and the effect of multiple risk alleles is not well established. Objective: To replicate the association between LPA variants with AS and identify subgroups who are at higher risk of developing AS. Design, Setting, and Participants: This case-control study of AS included 44 703 individuals (3469 cases) 55 years or older who were enrolled in the Genetic Epidemiology Research on Aging cohort and who were members of the Kaiser Permanente Northern California health care delivery system...
November 12, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29128473/transfemoral-aortic-valve-implantation-is-more-successful-with-the-edwards-sapien-3-compared-with-the-edwards-xt-for-the-treatment-of-symptomatic-severe-aortic-stenosis
#13
Birgid Gonska, Julia Seeger, Alexander Junker, Christoph Rodewald, Ulrike Trepte, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual aortic regurgitation (AR) after transfemoral aortic valve implantation (TAVI) is associated with increased mortality. The new Edwards Sapien 3 valve (ES3) is designed to reduce paravalvular AR. AIM: To compare a new-generation and a late-generation balloon-expandable transcatheter heart valve. METHODS: In this study, 100 consecutive patients treated with the ES3 for symptomatic native severe aortic stenosis were compared with 100 consecutive patients treated with the Edwards Sapien XT valve (EXT); all valves were implanted via transfemoral access...
November 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#14
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29124471/clinical-outcome-and-functional-characteristics-of-patients-with-asymptomatic-low-flow-low-gradient-severe-aortic-stenosis-with-preserved-ejection-fraction-are-closer-to-high-gradient-severe-than-to-moderate-aortic-stenosis
#15
Mohammad Kavianipour, Amir Farkhooy, Frank A Flachskampf
Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27)...
November 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29122274/frequency-and-significance-of-intravascular-hemolysis-before-and-after-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis
#16
Tsung-Yu Ko, Mao-Shin Lin, Lung-Chun Lin, Ying-Ju Liu, Chih-Fan Yeh, Ching-Chang Huang, Ying-Hsien Chen, Yih-Sharng Chen, Hsien-Li Kao
Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121921/transcatheter-aortic-valve-implantation-and-surgical-aortic-valve-replacement-among-hospitalized-patients-with-and-without-type-2-diabetes-mellitus-in-spain-2014-2015
#17
Manuel Mendez-Bailon, Noel Lorenzo-Villalba, Nuria Muñoz-Rivas, Jose Maria de Miguel-Yanes, Javier De Miguel-Diez, Josep Comín-Colet, Valentin Hernandez-Barrera, Rodrigo Jimenez-Garcia, Ana Lopez-de-Andres
BACKGROUND: Type 2 diabetes mellitus (T2DM) is strongly related to the in-hospital and short-term prognosis in patients with cardiovascular diseases needing surgical or invasive interventions. How T2DM might influence the treatment of aortic stenosis (AS) has not been completely elucidated for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). The aims of this study were: (1) to describe the use of aortic valve replacement procedures (TAVI and SAVR) among hospitalized patients with and without T2DM; and (2) to identify factors associated with in hospital mortality (IHM) among patients undergoing these procedures...
November 9, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29121837/triple-outlet-right-ventricle-with-duplication-of-the-aortic-root-and-intrapericardial-ascending-aorta
#18
Ashish Katewa, Balswaroop Sahu, Vishal Jain, Robert H Anderson
We present a case of a highly unusual congenital cardiac malformation, namely, triple outlet right ventricle with duplication of the aortic root and the intrapericardial component of the ascending aorta. A girl, aged five, presented with complaints of cyanosis and effort intolerance and was diagnosed with double-outlet right ventricle and subpulmonary infundibular stenosis. Intraoperatively, we noted that the aortic root was guarded by two separate aortic valves, oriented anteroposteriorly relative to each other, and separated within the right ventricle by a muscle bar...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29121522/effects-of-vitamin-k-antagonist-on-aortic-valve-degeneration-in-non-valvular-atrial-fibrillation-patients-prospective-4-year-observational-study
#19
Kazuhiro Yamamoto, Yukihiro Koretsune, Takashi Akasaka, Akira Kisanuki, Nobuyuki Ohte, Takashi Takenaka, Masaaki Takeuchi, Kiyoshi Yoshida, Kazunori Iwade, Yuji Okuyama, Yutaka Hirano, Yasuharu Takeda, Yasumasa Tsukamoto, Yoshiharu Kinugasa, Satoshi Nakatani, Takashi Sakamoto, Katsuomi Iwakura, Takashi Sozu, Tohru Masuyama
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. METHODS: Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group)...
November 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29121410/medication-management-of-patients-undergoing-transcatheter-aortic-valve-replacement
#20
Bethany A Kalich, J Erin Ledford, Ian B Hollis
Aortic stenosis (AS) is the most common form of valvular heart disease. A detailed diagnostic workup is necessary to promptly stage and classify disease severity to determine the optimal management. Medical therapy and valvuloplasty are options that fail to delay or reverse disease progression. Surgical aortic valve replacement (SAVR) is curative but has significant limitations for some patient populations. A newer option, transcatheter aortic valve replacement (TAVR), has become more widely available to patients with intermediate- or high-operative risk...
November 9, 2017: Pharmacotherapy
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