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Paravalvular leak

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https://www.readbyqxmd.com/read/28188002/does-pre-existing-aortic-regurgitation-protect-from-death-in-patients-who-develop-paravalvular-leak-after-tavi
#1
Andrea Colli, Laura Besola, Stefano Salizzoni, Dario Gregori, Giuseppe Tarantini, Marco Agrifoglio, Alaide Chieffo, Tommaso Regesta, Davide Gabbieri, Francesco Saia, Corrado Tamburino, Flavio Ribichini, Orazio Valsecchi, Bruno Loi, Alessandro Iadanza, Miroslava Stolcova, Alessandro Minati, Gianluca Martinelli, Francesco Bedogni, Anna Petronio, Michele Dallago, Antioco Cappai, Augusto D'Onofrio, Gino Gerosa, Mauro Rinaldi
OBJECTIVE: The aim of this study was to investigate interactions among pre-procedural aortic regurgitation (AR), post-procedural paravalvular leak (PVL) and long-term clinical outcomes. METHODS AND RESULTS: We analyzed data prospectively collected in the Italian Transcatheter balloon-Expandable Registry (ITER) on aortic stenosis (AS) patients. The degree of pre-procedural AR and post-procedural PVL was stratified as: absent/trivial, mild, and moderate/severe. VARC definitions were applied to outcomes...
February 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185394/characteristics-and-outcomes-of-re-do-percutaneous-paravalvular-leak-closure-re-do-percutaneous-paravalvular-leak-closure
#2
Mohammed A Al-Hijji, Mohamad Alkhouli, Mohammad Sarraf, Chad J Zack, Joseph F Malouf, Vuyisile T Nkomo, Allison K Cabalka, Guy S Reeder, Charanjit S Rihal, Mackram F Eleid
BACKGROUND: Percutaneous paravalvular leak (PVL) closure is an alternative treatment option for severely symptomatic, high-surgical risk patients with PVL. Some patients require multiple percutaneous PVL closure procedures. However, the procedural characteristics and success rate of re-do PVL closure have not been well studied. AIMS: The aim of this study is to investigate the indications, procedural characteristics, technical success rate, and 30-day major adverse cardiovascular events (MACE) in patients who underwent re-do PVL closure...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183467/initial-experience-of-a-second-generation-self-expanding-transcatheter-aortic-valve-the-uk%C3%A2-ireland-evolut-r-implanters-registry
#3
Sundeep S Kalra, Sami Firoozi, James Yeh, Daniel J Blackman, Shabnam Rashid, Simon Davies, Neil Moat, Miles Dalby, Tito Kabir, Saib S Khogali, Richard A Anderson, Peter H Groves, Darren Mylotte, David Hildick-Smith, Rajiv Rampat, Jan Kovac, Ashan Gunarathne, Jean-Claude Laborde, Stephen J Brecker
OBJECTIVES: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve. BACKGROUND: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications. METHODS: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183466/early-clinical-outcomes-after-transcatheter%C3%A2-aortic-valve-replacement-using-a-novel-self-expanding-bioprosthesis%C3%A2-in%C3%A2-patients-with-severe%C3%A2-aortic%C3%A2-stenosis-who-are-suboptimal%C3%A2-for%C3%A2-surgery-results-of-the-evolut-r-u-s-study
#4
Jeffrey J Popma, Michael J Reardon, Kamal Khabbaz, J Kevin Harrison, G Chad Hughes, Susheel Kodali, Isaac George, G Michael Deeb, Stan Chetcuti, Robert Kipperman, John Brown, Hongyan Qiao, James Slater, Mathew R Williams
OBJECTIVES: This study sought to evaluate this transcatheter aortic valve (TAV) bioprosthesis in patients who are poorly suitable for surgical aortic valve (AV) replacement. BACKGROUND: A novel self-expandable TAV bioprosthesis was designed to provide a low-profile delivery system, conformable annular sealing, and the ability to resheath and reposition during deployment. METHODS: The Evolut R U.S. study included 241 patients with severe aortic stenosis who were deemed to be at least high risk for surgery treated at 23 clinical sites in the United States...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28169084/transcatheter-versus-surgical-aortic-valve-replacement-in-patients-with-lower-surgical-risk-scores-a-systematic-review-and-meta-analysis-of-early-outcomes
#5
Sameer Arora, Paula D Strassle, Cassandra J Ramm, Jeremy A Rhodes, Satyanarayana R Vaidya, Thomas G Caranasos, John P Vavalle
BACKGROUND: The results from the PARTNER 2 trial showed the feasibility of transcatheter aortic valve replacement (TAVR) in intermediate surgical risk patients. Although low risk clinical trials will take time to conclude, some data has emerged comparing TAVR with surgical aortic valve replacement (SAVR) in lower risk patients. METHODS: A Medline search was conducted using standard methodology to search for studies reporting results comparing TAVR and SAVR. Studies were included if the overall mean Society of Thoracic Surgeons Score was less than 4% (or equivalent Euroscore)...
January 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28168809/hopscotch-technique-a-novel-method-for-percutaneous-closure-of-paravalvular-leaks
#6
Carlos E Ruiz, Li Chi-Hion, Jelnin Vladimir, Perk Gila, Weiss Dillon, Kronzon Itzhak, Kliger Chad
OBJECTIVES: To describe the feasibility and safety of the Hopscotch Technique, a novel method to close paravalvular leaks. BACKGROUND: Successful closure of paravalvular leaks requires the complete seal of irregular defects, frequently interrupted by remaining sutures or tissue that converts a large defect into a complex series of contiguous smaller defects. Successful treatment with devices placed in a single space is impossible with constrained appearance and significant residual leak; therefore, new techniques to deploy smaller devices in the correct location are needed...
February 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28163423/mechanism-of-valve-failure-and-efficacy-of-reintervention-through-catheterization-in-patients-with-bioprosthetic-valves-in-the-pulmonary-position
#7
Ryan Callahan, Lisa Bergersen, Christopher W Baird, Diego Porras, Jesse J Esch, James E Lock, Audrey C Marshall
BACKGROUND: Surgical and transcatheter bioprosthetic valves (BPVs) in the pulmonary position in patients with congenital heart disease may ultimately fail and undergo transcatheter reintervention. Angiographic assessment of the mechanism of BPV failure has not been previously described. AIMS: The aim of this study was to determine the mode of BPV failure (stenosis/regurgitation) requiring transcatheter reintervention and to describe the angiographic characteristics of the failed BPVs and report the types and efficacy of reinterventions...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28150295/impact-of-corevalve-size-selection-based-on-multi-slice-computer-tomography-on-paravalvular-leak-after-transcatheter-aortic-valve-implantation
#8
Piotr Chodór, Krzysztof Wilczek, Roman Przybylski, Jan Głowacki, Tomasz Kukulski, Witold Streb, Tomasz Niklewski, Grzegorz Honisz, Przemysław Trzeciak, Tomasz Podolecki, Łukasz Włoch, Marian Zembala, Zbigniew Kalarus
BACKGROUND: Paravalvular leak (PVL) has significant impact on long-term outcomes in patients after transcatheter aortic valve implantation (TAVI). This study sought to determine whether multi-slice computed tomography (MSCT)-guided valve selection reduces PVL after CoreValve implantation. METHODS: The analysis encompassed 69 patients implanted with CoreValve and were divided into two groups. In Group I (30 patients), valve selection was based on standard procedures, in Group II (39 pts), on MSCT measurements...
February 2, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28145877/transcatheter-mitral-paravalvular-leak-closure-facilitated-by-preprocedural-cardiac-ct-for-simulation-of-fluoroscopic-anatomy-and-paravalvular-defect-localization
#9
Kasper Korsholm, Ulrik Mortensen, Jesper Møller Jensen, Nicolo Piazza, Pascal Thériault-Lauzier, Jens Erik Nielsen-Kudsk
Paravalvular leakage (PVL) occurs in 6%-15% of cases after surgical heart valve replacement. A percutaneous approach is increasingly used to close PVLs as an alternative to repeat surgery. Computed tomography (CT) can be used for simulation of fluoroscopic cardiac anatomy. This technique allows preprocedural definition of optimal C-arm angulations and PVL localization in reference to fluoroscopic views. It is very helpful for guidewire crossing of the PVL and positioning of the closure device. We report a case with the first use of dedicated software for fluoroscopic simulation (FluoroCT) in transcatheter mitral PVL closure...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145874/comparative-matched-outcome-of-evolut-r-vs-corevalve-transcatheter-aortic-valve-implantation
#10
Uri Landes, Tamir Bental, Alon Barsheshet, Abid Assali, Hana Vaknin Assa, Amos Levi, Katia Orvin, Ran Kornowski
OBJECTIVES: The Evolut-R (Medtronic, Inc) is a transcatheter aortic valve implantation (TAVI) system that was built on the well-established foundation of Medtronic's CoreValve device platform. Although already in extensive clinical utilization, it is unknown if the Evolut-R improves TAVI outcomes. Herein, we compared TAVI outcomes of the Evolut-R and CoreValve devices. METHODS: A propensity score 1:1 matching was conducted on 358 Evolut-R patients (n = 75) and CoreValve patients (n = 283)...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28126445/a-complex-transcatheter-mitral-valve-replacement-and-repair-for-the-treatmemt-of-refractory-severe-mitral-regurgitation
#11
Jose F Condado, Vasilis C Babaliaros, Vinod H Thourani, Hanna K Jensen, Dennis W Kim, Brian W Kaebnick, Peter C Block, Stamatios Lerakis
Hybrid transcatheter Mitral Valve-in-Ring and Mitral Valve-in-Valve procedures can be an alternative to traditional surgical valve replacement in patients with high surgical risk. We present a case of a 65-year-old male with recurrent severe mitral regurgitation (MR) that failed two traditional surgical attempts due to severe chest fibrosis. We performed a mitral valve-in ring replacement with a Sapien valve followed by a mitral valve-in-valve replacement with a Melody valve. Patient had a residual paravalvular leak that was closed with a vascular plug...
January 23, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28118180/transcatheter-treatment-of-complex-malfunction-of-tricuspid-valve-prosthesis
#12
Giuseppe Santoro, Giancarlo Scognamiglio, Maria T Palladino, Heba T Mahmoud, Maria G Russo
A 45-year-old man with Ebstein anomaly of the tricuspid valve, previously submitted for tricuspid valve replacement and plication of the atrialized part of the right ventricle, was referred because of signs of increased systemic venous pressure and low output symptoms. Clinical picture was due to severe prosthetic valve stenosis and significant paravalvular regurgitation across an aneurismal dilatation of the atrialized right ventricle. A combined transcatheter approach by Melody valve implantation and Amplatzer Vascular Plug occlusion of the paravalvular leak completely relieved the hemodynamic and clinical findings...
January 23, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28117281/optimal-sizing-for-sapien-3-transcatheter-aortic-valve-replacement-in-patients-with-or-without-left-ventricular-outflow-tract-calcification
#13
Yoshio Maeno, Yigal Abramowitz, Hasan Jilaihawi, Sharjeel Israr, Sunghan Yoon, Rahul P Sharma, Yoshio Kazuno, Hiroyuki Kawamori, Masaki Miyasaka, Tanya Rami, Geeteshwar Mangat, Nobuyuki Takahashi, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Raj R Makkar
AIMS: The impact of left ventricular outflow tract calcification (LVOT-CA) on Sapien 3 transcatheter aortic valve replacement (S3-TAVR) is not well understood. The aims of the present study were to determine optimal device sizing for S3-TAVR in patients with or without LVOT-CA and to evaluate the influence of residual paravalvular leak (PVL) on survival after S3-TAVR in these patients. METHODS AND RESULTS: This study analyzed 280 patients (LVOT-CA=144, no LVOT-CA=136) undergoing S3-TAVR...
January 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#14
EDITORIAL
James M McCabe, Larry S Dean
Increasing annular calcification portends more adverse outcomes and worse hemodynamic results following percutaneous structural heart interventions. Though the Direct Flow prosthesis did not appear to have significantly different post-procedural gradients based on aortic valve calcium burden in a selected group of patients, the average residual gradients were relatively high in all cases and the presence of a paravalvular leak was more common with increasing valvular calcification. It is unclear how the Direct Flow prosthesis fits into the armamentarium of TAVR prostheses...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28109558/choice-of-balloon-expandable-versus-self-expanding-transcatheter-aortic-valve-impacts-hemodynamics-differently-according-to-aortic-annular-size
#15
Toby Rogers, Arie Steinvil, Jiaxiang Gai, Rebecca Torguson, Edward Koifman, Sarkis Kiramijyan, Smita Negi, Sang Yeub Lee, Petros Okubagzi, Lowell F Satler, Itsik Ben-Dor, Augusto D Pichard, Ron Waksman
We sought to determine whether balloon-expandable valve (BEV) and self-expanding valve (SEV) affect valve hemodynamics differently according to native aortic annulus size. Transcatheter aortic valve replacement can achieve superior prosthetic valve hemodynamics compared with surgical aortic valve replacement, particularly in patients with small aortic annulus. One hundred ninety-three consecutive transcatheter aortic valve replacement patients were grouped into tertiles defined by computed tomography derived aortic annulus systolic perimeter...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#16
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28100877/transcatheter-aortic-valve-implantation-with-different-valve-designs-for-severe-device-landing-zone-calcification
#17
Yoshio Maeno, Yigal Abramowitz, Yoshio Kazuno, Hiroyuki Kawamori, Geeteshwar Mangat, Nobuyuki Takahashi, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, Hasan Jilaihawi, Raj R Makkar
Severe device landing zone calcification (DLZ-CA) predicted paravalvular leak (PVL) and post-dilatation (PD) after transcatheter aortic valve implantation (TAVI). The aim of this study was to determine the influence of DLZ-CA on PVL or PD rates after SAPIEN XT (XT) versus CoreValve (CV).We analyzed patients undergoing TAVI who had severe DLZ-CA. Severe DLZ-CA defined the upper left ventricular outflow tract calcification; the cross-sectional region 2 mm inferior to the annular plane. PVL was evaluated at 30days using transthoracic echocardiography...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28092288/sutureless-aortic-valves-who-is-the-right-patient
#18
Amine Mazine, Christopher Bonneau, Dimos Karangelis, Bobby Yanagawa, Subodh Verma, Daniel Bonneau
PURPOSE OF REVIEW: Sutureless aortic valve replacement (AVR) has emerged as an alternative to traditional AVR for patients with aortic stenosis who present a higher surgical risk, such as the elderly, or those with small or highly calcified aortic roots. With transcatheter aortic valve implantation - the other major AVR alternative - being used in increasingly lower-risk patients, the place of sutureless valves in the AVR landscape needs to be defined. In this review, we discuss recent data and expert opinion as it pertains to the subject of sutureless AVR...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28066608/transcatheter-aortic-valve-implantation-tavi-versus-sutureless-aortic-valve-replacement-suavr-for-aortic-stenosis-a-systematic-review-and-meta-analysis-of-matched-studies
#19
Nelson Wang, Yi-Chin Tsai, Natasha Niles, Vakhtang Tchantchaleishvili, Marco Di Eusanio, Tristan D Yan, Kevin Phan
BACKGROUND: With improving technologies and an increasingly elderly populations, there have been an increasing number of therapeutic options available for patients requiring aortic valve replacement. Recent evidence suggests that transcatheter aortic valve implantation (TAVI) is one suitable option for high risk inoperable patients, as well as high risk operable patients. Sutureless valve technology has also been developed concurrently, with facilitates surgical aortic valve replacement (SUAVR) by allow resection and replacement of the native aortic valve with minimal sutures and prosthesis anchoring required...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28057286/transcatheter-valve-in-ring-implantation%C3%A2-for-the-treatment-of-residual%C3%A2-or-recurrent-tricuspid-valve-dysfunction-after-prior-surgical-repair
#20
Jamil Aboulhosn, Allison K Cabalka, Daniel S Levi, Dominique Himbert, Luca Testa, Azeem Latib, Raj R Makkar, Younes Boudjemline, Dennis W Kim, Joelle Kefer, Sabine Bleiziffer, Gunter Kerst, Danny Dvir, Doff B McElhinney
OBJECTIVES: This study sought to describe the results of transcatheter tricuspid valve-in-ring (TVIR) implantation for treatment of tricuspid regurgitation (TR). BACKGROUND: Off-label use of transcatheter valves within surgically placed tricuspid annuloplasty prostheses has only been described in small reports. An international multicenter registry was developed to collect data on TVIR implantation. METHODS: Data were collected from 13 sites on 22 patients (5 to 69 years of age) with TR who underwent catheterization with the intent to perform TVIR implantation...
January 9, 2017: JACC. Cardiovascular Interventions
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