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Paravalvular leak

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https://www.readbyqxmd.com/read/28345243/dehiscence-of-a-pulmonary-bioprosthesis-with-a-focal-dissection-of-the-pulmonary-artery-in-a-patient-with-congenital-pulmonic-stenosis
#1
Evin Yucel, Ami Bhatt, Christos G Mihos, Brian B Ghoshhajra, Doreen DeFaria Yeh
Pulmonary valve replacement (PVR) is the most common adult congenital cardiac operation performed. Valve degeneration leading to prosthetic stenosis and/or regurgitation is a long-term risk in this population and may be associated with paravalvular leak (PVL). Complications involving the proximal pulmonary artery, including dissection, are less clearly defined. Herein, we report the case of a 30-year-old patient with a history of multiple pulmonary valve interventions secondary to congenital pulmonic stenosis, who developed dehiscence of a bioprosthetic PVR associated with significant paravalvular leak (PVL) and further complicated by a focal dissection of the proximal pulmonary artery...
March 27, 2017: Echocardiography
https://www.readbyqxmd.com/read/28330793/procedural-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-for-bicuspid-versus-tricuspid-aortic-valve-stenosis
#2
Sung-Han Yoon, Sabine Bleiziffer, Ole De Backer, Victoria Delgado, Takahide Arai, Johannes Ziegelmueller, Marco Barbanti, Rahul Sharma, Gidon Y Perlman, Omar K Khalique, Erik W Holy, Smriti Saraf, Florian Deuschl, Buntaro Fujita, Philipp Ruile, Franz-Josef Neumann, Gregor Pache, Masao Takahashi, Hidehiro Kaneko, Tobias Schmidt, Yohei Ohno, Niklas Schofer, William K F Kong, Edgar Tay, Daisuke Sugiyama, Hiroyuki Kawamori, Yoshio Maeno, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Shingo Kuwata, Gerald Yong, Hsien-Li Kao, Michael Lee, Hyo-Soo Kim, Thomas Modine, S Chiu Wong, Francesco Bedgoni, Luca Testa, Emmanuel Teiger, Christian Butter, Stephan M Ensminger, Ulrich Schaefer, Danny Dvir, Philipp Blanke, Jonathon Leipsic, Fabian Nietlispach, Mohamed Abdel-Wahab, Bernard Chevalier, Corrado Tamburino, David Hildick-Smith, Brian K Whisenant, Seung-Jung Park, Antonio Colombo, Azeem Latib, Susheel K Kodali, Jeroen J Bax, Lars Søndergaard, John G Webb, Thierry Lefèvre, Martin B Leon, Raj Makkar
BACKGROUND: Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is being increasingly performed. OBJECTIVES: From the Bicuspid AS TAVR multicenter registry, the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS were compared. METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity-score matching assembling 546 pairs of patients with similar baseline characteristics...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329271/short-and-long-term-results-after-prosthetic-mitral-valve-implantation-in-patients-with-severe-mitral-annulus-calcification%C3%A2
#3
Ronny Ben-Avi, Boris Orlov, Leonid Sternik, Alexander Kogan, Rafael Kuperstien, Amjad Shalabi, Eilon Ram, Alexander Lipey, Ehud Raanani
OBJECTIVES: To investigate short- and long-term outcomes of a conservative decalcification approach in mitral valve replacement (MVR) surgery in the presence of mitral annulus calcification (MAC). METHODS: Of the 1038 patients who underwent MVR, 133 (13%) had significant MAC with at least 30% of the annular circumference heavily calcified. In most patients, the surgical approach to MAC included conservative decalcification, supra-annular prosthesis implantation and insertion of a pericardial patch between the MV annulus and the prosthesis...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28296026/bioprosthetic-mitral-valve-paravalvular-leak-closure-using-intracardiac-echocardiography-guided-three-dimensional-electroanatomic-mapping
#4
Subhi J Al'Aref, Richard B Devereux, Jim W Cheung, Geoffrey Bergman
The development of paravalvular leak (PVL) following surgical replacement of an aortic or mitral valve is an uncommon complication with significant morbidity and mortality. Surgical or percutaneous repair of PVL can be technically challenging. We describe the application of intracardiac echocardiography guided 3-dimensional electroanatomic mapping to facilitate PVL closure in a symptomatic patient with a previously placed bioprosthetic mitral valve. © 2017 Wiley Periodicals, Inc.
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28279318/surgical-paravalvular-leak-closure-no-more-second-chances
#5
EDITORIAL
Adam B Greenbaum, Tiberio M Frisoli
No abstract text is available yet for this article.
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28279317/outcomes-after-paravalvular-leak-closure-transcatheter-versus-surgical-approaches
#6
John A Wells, Jose F Condado, Norihiko Kamioka, Andy Dong, Andrew Ritter, Stamatios Lerakis, Stephen Clements, James Stewart, Bradley Leshnower, Robert Guyton, Jessica Forcillo, Ateet Patel, Vinod H Thourani, Peter C Block, Vasilis Babaliaros
OBJECTIVES: The aim of this study was to compare outcomes of transcatheter intervention (TI) versus surgical intervention (SI) for paravalvular leak (PVL). BACKGROUND: Data comparing the treatment of PVL with TI and SI are limited. METHODS: A retrospective cohort study was conducted comparing baseline characteristics, procedural details, and 1-year survival in consecutive patients who underwent TI or SI for moderate or greater PVL from 2007 to 2016...
March 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28275491/percutaneous-paravalvular-leak-closure-after-corevalve-transcatheter-aortic-valve-implantation-using-an-arterio-arterial-loop
#7
Rodrigo Estévez-Loureiro, Tomás Benito-González, Javier Gualis, Armando Pérez de Prado, Carlos Cuellas, Felipe Fernandez-Vazquez
Significant periprosthetic aortic regurgitation after transcatheter aortic valve implantation has become a major concern of this technique given its association with impaired survival. We report the successful closure of such defect using a vascular occlusion device with the creation of an arterio-arterial loop to gain enough support to advance the delivery sheath into de the left ventricle.
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28272209/dissection-of-the-interventricular-septum-echocardiographic-features
#8
Xiaoyan Gu, Yihua He, Shurong Luan, Ying Zhao, Lin Sun, Hongjia Zhang, J V Ian Nixon
Dissection of the interventricular septum (IVS) is an extremely rare entity. An institutional echocardiographic database was retrospectively reviewed; 13 patients with a diagnosis of IVS dissection were found and confirmed by cardiac surgery. The purposes of the study were: to determine the value of transthoracic echocardiography (TTE) in establishing the diagnosis of IVS dissection, and to detail the TTE features of IVS dissection.Thirteen patients with IVS dissection diagnosed by TTE, 8 males and 5 females were taken from 789,114 TTE studies performed between 1985 and 2014...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28248407/hemodynamic-changes-after-transcatheter-aortic-valve-implantation-during-sequential-follow-ups-in-patients-with-bicuspid-aortic-valve-compared-with-tricuspid-aortic-valve
#9
Tian-Yuan Xiong, Ming-Xia Zheng, Xin Wei, Yi-Jian Li, Yan-Biao Liao, Zhen-Gang Zhao, Yuan-Ning Xu, Hong Tang, Yuan Feng, Mao Chen
BACKGROUND: To investigate the individual sequential hemodynamic changes after transcatheter aortic valve implantation (TAVI), especially for patients with bicuspid aortic valve (BAV), in comparison with tricuspid aortic valve (TAV). METHODS: The study population comprised 85 patients with severe aortic stenosis who underwent TAVI for BAV (n = 49) or TAV (n = 36) with at least two serial echocardiographic follow-ups. Doppler echocardiography was scheduled to be performed at discharge and 1, 3, 6 months and 1 year after the procedure...
March 1, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#10
Arman Kilic, Mary A Siki, Wilson Y Szeto, Joseph E Bavaria, Saif Anwaruddin, Nimesh D Desai
An 87-year-old woman with severe aortic stenosis underwent a transfemoral transcatheter aortic valve replacement (TAVR). Intraoperative transesophageal echocardiography demonstrated a well-seated valve with no paravalvular leak; however, a new acute type B aortic dissection was identified. Endografts were delivered through the TAVR sheath and deployed, effectively treating the dissection. The patient did well postoperatively, with imaging at 2 years demonstrating a well-functioning aortic valve and no migration or endoleak of the thoracic endografts...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28188002/does-pre-existing-aortic-regurgitation-protect-from-death-in-patients-who-develop-paravalvular-leak-after-tavi
#11
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...
April 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28185394/characteristics-and-outcomes-of-re-do-percutaneous-paravalvular-leak-closure
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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