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aortic regurgitation guidelines

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https://www.readbyqxmd.com/read/29311349/early-detection-of-subclinical-myocardial-damage-in-chronic-aortic-regurgitation-and-strategies-for-timely-treatment-of-asymptomatic-patients
#1
REVIEW
Joe K T Lee, Anna Franzone, Jonas Lanz, George C M Siontis, Stefan Stortecky, Christoph Gräni, Eva Roost, Stephan Windecker, Thomas Pilgrim
A series of hemodynamic and pathological responses occur in chronic aortic regurgitation, which eventually result in myocardial fibrosis and irreversible left ventricular dysfunction. According to guidelines, valvular surgery is recommended with the development of symptoms, left ventricular systolic dysfunction, or left ventricular dilatation. The optimal timing of surgical intervention has recently been questioned with documentation of irreversible myocardial damage resulting in incomplete left ventricular recovery and adverse clinical outcomes after surgery...
January 9, 2018: Circulation
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#2
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29232249/clinical-trials-in-valvular-surgery-a-2018-update
#3
Bobby Yanagawa, Amine Mazine, Derrick Y Tam, Subodh Verma
PURPOSE OF REVIEW: There is a growing emphasis on the conduct of large-scale, multicenter randomized controlled trials (RCTs) to guide decision-making in cardiac surgery. Here we review recent landmark RCTs in cardiac valvular surgery. RECENT FINDINGS: RCTs are the gold-standard level of data in medicine. However, there are unique challenges of conducting large-scale surgical trials including funding, blinding, generalizability, nonstandardization of the surgical technique, crossover, among others...
December 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29193376/evaluation-of-left-ventricular-reverse-remodeling-in-patients-with-severe-aortic-regurgitation-undergoing-aortic-valve-replacement-comparison-between-diameters-and-volumes
#4
Géraldine Ong, Bjorn Redfors, Aaron Crowley, Husam Abdel-Qadir, Alana Harrington, Yangbo Liu, Myriam Lafrenière-Roula, Howard Leong-Poi, Mark D Peterson, Kim A Connelly
BACKGROUND: In patients with severe aortic regurgitation (AR), the left ventricular ejection fraction (LVEF) and left ventricle (LV) size are crucial for determining clinical prognosis and timing of valve intervention. In clinical practice, LV internal diameters obtained at end-diastole are used to assess the degree of LV dilatation. Whether quantification of LV volumes would provide more robust information as compared to LV linear dimensions is unknown. METHODS: We retrospectively analyzed preoperative and postoperative transthoracic echocardiograms of patients who underwent aortic valve replacement (AVR) for severe AR...
November 28, 2017: Echocardiography
https://www.readbyqxmd.com/read/29174327/a-case-of-cardiac-arrest-associated-with-aortic-valve-regurgitation
#5
Hyun Suk Chai, Suk Woo Lee, Jung Soo Park, Sang Chul Kim, Ji Han Lee, Hoon Kim
Blunt chest trauma can cause not only damage to the thoracic cage, but can also injure intracardiac structures including the papillary muscles, chordae tendineae, and valve leaflets. Aortic valve (AV) injury secondary to blunt chest trauma is a rare occurrence. Clinically, AV injury may be missed during the initial post-trauma assessment due to the lack of suspicion of cardiac involvement. Thus, the diagnosis of AV injury is often delayed or missed for a time interval of days to months. As a consequence, the traumatic AV regurgitation can rapidly or progressively lead to congestive heart failure unless surgically corrected...
November 20, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29106494/impact-of-pulmonary-hypertension-on-long-term-outcome-in-patients-with-severe-aortic-stenosis
#6
Franck Levy, Yohann Bohbot, Khalil Sanhadji, Dan Rusinaru, Anne Ringle, Quentin Delpierre, Sondes Smaali, Mesut Gun, Sylvestre Marechaux, Christophe Tribouilloy
Aims: Pulmonary hypertension (PH) is common in severe symptomatic left-sided valvular disease, particularly in aging populations. Inconsistent results have been reported concerning the association between PH and adverse outcomes after aortic valve replacement for aortic stenosis (AS). We therefore retrospectively investigated the prognostic significance of PH using peak tricuspid regurgitation velocity (TRV), as defined by the current European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines, in a large cohort of patients with severe AS...
June 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#7
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29092919/aortic-valve-replacement-associated-with-survival-in-severe-regurgitation-and-low-ejection-fraction
#8
Amy G Fiedler, Vijeta Bhambhani, Elizabeth Laikhter, Michael H Picard, Meagan M Wasfy, George Tolis, Serguei Melnitchouk, Thoralf M Sundt, Jason H Wasfy
OBJECTIVES: Although guidelines support aortic valve replacement (AVR) in patients with severe aortic regurgitation (AR) and left ventricular ejection fraction (LVEF) <50%, severe left ventricular dysfunction (LVEF <35%) is thought to confer high surgical risk. We sought to determine if a survival benefit exists with AVR compared with medical management in this high-risk, relatively rare population. METHODS: A large institutional echocardiography database was queried to identify patients with severe AR and LVEF <35%...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28872094/-transcatheter-aortic-valve-implantation-present-and-development-trend
#9
Yi He, Haiting Zhou, Shuqiang Zhu, Yongbing Wu
Currently, although surgical aortic valve replacement (SAVR) is still the golden standard in treatment of severe aortic stenosis according to the guideline, transcatheter aortic valve implantation (TAVI) is gradually becoming a common treatment for patients who are prohibitive or in high risk for SAVR. Recently, the valve manufacturers, including medical companies in China, are making their utmost to develop valve device, leading remarkable results achieved by TAVI. With the complications being controlled, TAVI displays promising future...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28857729/a-rapid-echocardiographic-screening-protocol-for-rheumatic-heart-disease-in-samoa-a-high-prevalence-of-advanced-disease
#10
Marvin Allen, John Allen, Take Naseri, Rebecca Gardner, Dennis Tolley, Lori Allen
BACKGROUND: Echocardiography has been proposed as a method to screen children for rheumatic heart disease. The World Heart Federation has established guidelines for echocardiographic screening. In this study, we describe a rapid echocardiogram screening protocol according to the World Heart Federation guidelines in Samoa, endemic for rheumatic heart disease. METHODS: We performed echocardiogram screening in schoolchildren in Samoa between 2013 and 2015. A brief screening echocardiogram was performed on all students...
October 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28856517/bicuspid-aortic-valve-related-aortopathy
#11
REVIEW
Sina Stock, Salah A Mohamed, Hans-Hinrich Sievers
Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. Recent studies have provided new insights into the etiology and clinical impacts of bicuspid aortic valve related aortopathy in different clinical settings, leading to a growing body of opinion towards a more individualized surgical approach than currently provided by the guidelines...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28671804/valvular-heart-disease-in-adults-etiologies-classification-and-diagnosis
#12
REVIEW
Steven M Hollenberg
The prevalence of valvular heart disease (VHD) in the United States was estimated to be approximately 2.5% in the 1990s. The prevalence currently is thought to be increasing because of more accurate diagnostic methods and aging of the population. Mitral regurgitation (MR) is the most common valve defect, followed by aortic stenosis (AS) and aortic regurgitation (AR). Degenerative disease is the most common etiology of MR, AS, and AR, though these forms of VHD also can be caused by congenital valve defects, systemic inflammatory diseases, endocarditis, and many other conditions...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28640443/pathophysiology-of-aortic-stenosis-and-mitral-regurgitation
#13
Gianluca L Perrucci, Marco Zanobini, Paola Gripari, Paola Songia, Bayan Alshaikh, Elena Tremoli, Paolo Poggio
The global impact of the spectrum of valve diseases is a crucial, fast-growing, and underrecognized health problem. The most prevalent valve diseases, requiring surgical intervention, are represented by calcific and degenerative processes occurring in heart valves, in particular, aortic and mitral valve. Due to the increasing elderly population, these pathologies will gain weight in the global health burden. The two most common valve diseases are aortic valve stenosis (AVS) and mitral valve regurgitation (MR)...
June 18, 2017: Comprehensive Physiology
https://www.readbyqxmd.com/read/28560534/exercise-testing-and-stress-imaging-in-aortic-valve-disease
#14
REVIEW
Luc A Pierard, Raluca Dulgheru
Aortic valve disease and especially aortic stenosis (AS) is a growing cardiac pathology. Aortic valve replacement (AVR) is still the only treatment with proven benefit on survival in symptomatic patients and in patients with a left ventricular ejection fraction (LVEF) <50%. The benefit of prophylactic AVR in asymptomatic patients is still unproven. Once symptoms develop, the prognosis worsens. Exercise testing has emerged as a tool to unmask the "pseudo-asymptomatic" patients with AS (those without self-reporting symptoms), to link "exercise induced dyspnea" more confidently and more objectively to aortic valve disease and to allow for a safe "watchful waiting strategy" in "pseudo-symptomatic" patients (those with dyspnea unrelated to aortic valve disease)...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28535761/the-emerging-role-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-hypertensive-heart-disease
#15
REVIEW
Sophie Mavrogeni, Vasiliki Katsi, Vasiliki Vartela, Michel Noutsias, George Markousis-Mavrogenis, Genovefa Kolovou, Athanasios Manolis
BACKGROUND: Arterial hypertension is the commonest cause of cardiovascular death. It may lead to hypertensive heart disease (HHD), including heart failure (HF), ischemic heart disease (IHD) and left ventricular hypertrophy (LVH). MAIN BODY: According to the 2007 ESH/ESC guidelines, the recommended imaging technique is echocardiography (echo), when a more sensitive detection of LVH than that provided by ECG, is needed. Cardiovascular Magnetic Resonance (CMR), a non-invasive, non-radiating technique, offers the following advantages, beyond echo: a) more reliable and reproducible measurements of cardiac parameters such as volumes, ejection fraction and cardiac mass b) more accurate differentiation of LVH etiology by providing information about tissue characterisation c) more accurate evaluation of myocardial ischemia, specifically if small vessels disease is present d) technique of choice for diagnosis of renovascular, aortic tree/branches lesions and quantification of aortic valve regurgitation e) technique of choice for treatment evaluation in clinical trials...
May 23, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28450039/characterization-of-chronic-aortic-and-mitral-regurgitation-undergoing-valve-surgery-using-cardiovascular-magnetic-resonance
#16
Christian L Polte, Sinsia A Gao, Åse A Johnsson, Kerstin M Lagerstrand, Odd Bech-Hanssen
Grading of chronic aortic regurgitation (AR) and mitral regurgitation (MR) by cardiovascular magnetic resonance (CMR) is currently based on thresholds, which are neither modality nor quantification method specific. Accordingly, this study sought to identify CMR-specific and quantification method-specific thresholds for regurgitant volumes (RVols), RVol indexes, and regurgitant fractions (RFs), which denote severe chronic AR or MR with an indication for surgery. The study comprised patients with moderate and severe chronic AR (n = 38) and MR (n = 40)...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28370410/echocardiographic-assessment-of-pediatric-semilunar-valve-disease
#17
REVIEW
Massimiliano Cantinotti, Raffaele Giordano, Michele Emdin, Nadia Assanta, Maura Crocetti, Marco Marotta, Giorgio Iervasi, Leo Lopez, Shelby Kutty
We reviewed echocardiography literature for the assessment and management of semilunar valve disease in children. A search was performed within the National Library of Medicine using the keywords aortic stenosis (AS), aortic regurgitation, pulmonary stenosis (PS), and pulmonary regurgitation in children. The search was further refined adding the keywords-pediatric, neonates, echocardiographic definition, classification, evaluation. Thirty-eight studies were included. For stenotic lesions, there were sufficient consistencies between Doppler and invasive gradients (especially for PS), while other quantitative parameters used in adults showed significant limitations when applied to children...
September 2017: Echocardiography
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#18
EDITORIAL
Samir Kapadia, Amar Krishnaswamy, E Murat Tuzcu
No abstract text is available yet for this article.
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28329360/early-surgery-versus-conventional-treatment-for-asymptomatic-severe-aortic-regurgitation-with-normal-ejection-fraction-and-left-ventricular-dilatation
#19
Yin Wang, Weiwei Jiang, Junwei Liu, Geng Li, Yi Liu, Xingjian Hu, Nianguo Dong
OBJECTIVES: The management of patients with asymptomatic severe aortic regurgitation (AR) remains controversial. The aim of the present study was to assess and compare the clinical results between early surgery and conventional treatment for asymptomatic severe AR in patients with normal left ventricular (LV) systolic function and LV dilatation. METHODS: This retrospective cohort study included 230 consecutive patients with severe AR with left ventricular ejection function (LVEF ≥50%) and left ventricular end-diastolic dimension (LVEDD >70 mm) from 2003 to 2014...
July 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329331/natural-history-of-moderately-dilated-tubular-ascending-aorta-implications-for-determining-the-optimal-imaging-interval
#20
Kay-Hyun Park, Suryeun Chung, Dong Jung Kim, Jun Sung Kim, Cheong Lim
OBJECTIVES: For a moderately dilated ascending aorta (diameter 35-54 mm), current guidelines recommend continuous annual or semi-annual examinations with computed tomography or magnetic resonance imaging. However, few data have shown the yield and benefit of such a protocol. This study aimed to investigate the fate of a moderately dilated ascending aorta and thereby determine the adequate imaging interval. METHODS: In our institutional database, we identified adult patients having an ascending aortic diameter ≥40 mm in contrast-enhanced computed tomography and follow-up imaging(s) after ≥1 year...
May 1, 2017: European Journal of Cardio-thoracic Surgery
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