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Paravalvular leak

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https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#1
Guglielmo Saitto, Paolo Nardi, Gian P Ussia, Domenico Sergi, Paolo Prati, Marco Russo, Francesco Romeo, Giovanni Ruvolo
: Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device...
September 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28895294/pathology-of-self-expanding-transcatheter-aortic-valves-findings-from-the-corevalve-us-pivotal-trials
#2
Kazuyuki Yahagi, Sho Torii, Elena Ladich, Robert Kutys, Maria E Romero, Hiroyoshi Mori, Frank D Kolodgie, Jeffrey J Popma, Renu Virmani, Aloke V Finn
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has recently become an alternative to surgical aortic valve replacement for patients with severe aortic stenosis. However, paravalvular leaks, possible leaflet thrombosis, and device durability following TAVR remain unresolved issues. METHODS AND RESULTS: We conducted the first systematic microscopic and macroscopic pathologic analysis of self-expanding CoreValve transcatheter aortic valves removed at autopsy or surgically from the U...
September 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#3
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28886853/comparison-of-efficacy-and-safety-of-transcatheter-aortic-valve-implantation-in-patients-with-bicuspid-versus-tricuspid-aortic-valves
#4
Anna Sannino, Ari Cedars, Robert C Stoler, Molly Szerlip, Michael J Mack, Paul A Grayburn
Bicuspid aortic valve (BAV) stenosis has been considered a contraindication to transcatheter aortic valve implantation (TAVI). The aim of this study is to compare the efficacy and safety of TAVI in patients with BAV with those with tricuspid aortic valve (TAV) using balloon-expandable and self-expanding transcatheter heart valves. This retrospective study included 823 consecutive patients with severe, symptomatic aortic valve stenosis undergoing TAVI in 2 institutions, Baylor Heart and Vascular Hospital (Dallas, TX) and The Heart Hospital Baylor Plano (Plano, TX), from January 2012 to February 2016...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28879526/intracardiac-echocardiography-for-structural-heart-and-electrophysiological-interventions
#5
REVIEW
Craig Basman, Yuvrajsinh J Parmar, Itzhak Kronzon
PURPOSE OF REVIEW: With an increasing number of interventional procedures performed for structural heart disease and cardiac arrhythmias each year, echocardiographic guidance is necessary for safe and efficient results. The purpose of this review article is to overview the principles of intracardiac echocardiography (ICE) and describes the peri-interventional role of ICE in a variety of structural heart disease and electrophysiological interventions. RECENT FINDINGS: Both transthoracic (TTE) and transesophageal echocardiography have limitations...
September 6, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28874307/prosthetic-mitral-valve-paravalvular-leak-a-problem-that-requires-dexterity
#6
James W Hansen, Gautam Gadey, Thomas C Piemonte
Prosthetic valve paravalvular leak (PVL) is a known and relatively common complication of surgical valve replacement, which may lead to significant morbidity. Patients with significant mitral valve replacement (MVR) PVL typically present with symptoms of heart failure and elevated filling pressures or with hemolytic anemia. Percutaneous closure of these leaks has become the preferred therapy. Percutaneous closure of MVR PVL can be technically challenging, given the anatomy of the approach (trans-septal, trans-apical), the level of associated comorbidities and the geographic location of the paravalvular defect...
July 24, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28874169/transfemoral-versus-transapical-approach-for-transcatheter-aortic-valve-implantation-hospital-outcome-and-risk-factor-analysis
#7
Enrico Ferrari, Eric Eeckhout, Sanjiv Keller, Olivier Muller, Piergiorgio Tozzi, Denis Berdajs, Ludwig Karl von Segesser
BACKGROUND: Transcatheter aortic valve implantation is indicated in high-risk patients with aortic stenosis. We compared the clinical outcome of 180 consecutive patients who underwent transapical (TA) and transfemoral (TF) procedures in a single centre. METHODS: Ninety consecutive TA (TA-group) and 90 consecutive TF (TF-group) were performed from 2009 to 2014. Clinical variables were prospectively collected and retrospectively analysed for hospital outcomes and to identify risk factors for hospital mortality, vascular complications and stroke...
September 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28843322/latest-generation-transcatheter-aortic-valve-replacement-devices-and-procedures
#8
REVIEW
Chekrallah Chamandi, Rishi Puri, Tania Rodriguez-Gabella, Josep Rodés-Cabau
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk. More recently, TAVR has emerged as a valid alternative to surgical aortic valve replacement for treating intermediate-risk patients, and several studies are currently evaluating the role of TAVR in low-risk patients. Transcatheter heart valve (THV) technologies have evolved considerably over time, and important iterations have been implemented in many of the latest-generation devices to (1) reduce the size and improve delivery system properties; (2) improve valve deployment, repositioning, and retrievability; and (3) reduce paravalvular leaks...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28838487/cardioscopically-guided-beating-heart-surgery-paravalvular-leak-repair
#9
Benoit Rosa, Zurab Machaidze, Margherita Mencattelli, Sunil Manjila, Borami Shin, Karl Price, Michael A Borger, Vinod Thourani, Pedro Del Nido, David W Brown, Christopher W Baird, John E Mayer, Pierre E Dupont
PURPOSE: There remains a paucity of direct visualization techniques for beating-heart intracardiac procedures. To address this need, we evaluated a novel cardioscope in the context of aortic paravalvular leaks (PVLs) localization and closure. DESCRIPTION: A porcine aortic PVL model was created using a custom-made bioprosthetic valve, and PVL presence was verified by epicardial echocardiography. Transapical delivery of occlusion devices guided solely by cardioscopy was attempted 13 times in a total of three pigs...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28838477/transcatheter-mitral-valve-implantation-using-the-highlife-system
#10
Marco Barbanti, Nicolò Piazza, Sarah Mangiafico, Jean Buithieu, Sabine Bleiziffer, Giuseppe Ronsivalle, Salvatore Scandura, Angelo Giuffrida, Antonio Popolo Rubbio, Massimo Mazzamuto, Carmelo Sgroi, Rüdiger Lange, Corrado Tamburino
OBJECTIVES: This study is the first report of 2 cases of HighLife (HighLife, Paris, France) implantation in humans. BACKGROUND: Transcatheter mitral valve implantation represents a promising approach to treating mitral regurgitation in patients at increased risk of perioperative mortality. The HighLife transcatheter mitral valve is a 2-component system. The valve is implanted in the mitral position and is anchored by interacting and then reaching an equilibrium position with a previously positioned subannular implant...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28836337/overexpansion-of-the-29-mm-sapien-3-transcatheter-heart-valve-in-patients-with-large-aortic-annuli-area-%C3%A2-683-mm-2-a-case-series
#11
Moses Mathur, James M McCabe, Gabriel Aldea, Jay Pal, Creighton W Don
OBJECTIVES: To evaluate overexpanded 29 mm SAPIEN (S3) transcatheter heart valves in patients with aortic annuli area >683 mm(2) . BACKGROUND: The largest valve area the 29 mm S3 is specified for is 683 mm(2) . Valve overexpansion has been performed in patients with larger aortic annuli, but data are limited. Moreover, feasibility in areas >740 mm(2) is unknown. METHODS: All 29 mm S3 transcatheter aortic valve replacements (TAVR) at a single center over 23-months were retrospectively reviewed...
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28819953/impact-of-post-dilatation-on-the-reduction-of-paravalvular-leak-and-mortality-after-transcatheter-aortic-valve-implantation
#12
Paweł Kleczyński, Artur Dziewierz, Marzena Daniec, Maciej Bagieński, Łukasz Rzeszutko, Danuta Sorysz, Jarosław Trębacz, Robert Sobczyński, Marek Tomala, Dariusz Dudek
BACKGROUND: Post-implantation paravalvular leak (PVL) remains a significant complication of transcatheter aortic valve implantation (TAVI). More importantly, its occurrence may impact long-term mortality. AIM: We sought to evaluate the effects of balloon post-dilatation (PD) on the reduction of PVL and mortality in patients undergoing TAVI. METHODS: A total of 101 consecutive patients undergoing TAVI were enrolled. Angiography, echocardiography, and the aortic regurgitation index (ARI) were used to assess the severity of PVL before and after balloon PD...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28800986/are-transthoracic-and-transesophageal-echocardiography-equal-partners-in-the-assessment-of-paravalvular-leak-after-tavr
#13
EDITORIAL
Michelle Capdeville, Andrej Alfirevic
No abstract text is available yet for this article.
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800985/assessment-of-paravalvular-leak-after-transcatheter-aortic-valve-replacement-transesophageal-echocardiography-compared-with-transthoracic-echocardiography
#14
Emily G Teeter, Claire Dakik, Mary Cooter, Zainab Samad, Kamrouz Ghadimi, J Kevin Harrison, Jeffery Gaca, Mark Stafford-Smith, Brandi A Bottiger
OBJECTIVES: Determine whether moderate or greater paravalvular leak (PVL) after transcatheter aortic valve replacement quantified using intraoperative transesophageal echocardiography (TEE) is associated with mortality and investigate the correlation between PVL grading using intraoperative TEE and postoperative transthoracic echocardiography (TTE). DESIGN: Retrospective, observational study. SETTING: Single academic institution. PARTICIPANTS: The study comprised adult patients undergoing elective transcatheter aortic valve replacement between April 2011 and February 2014...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28799521/transcatheter-mitral-valve-replacement-long-term-outcomes-of-first-in-man-experience-with-an-apically-tethered-device-a-case-series-from-a-single-centre
#15
Alison Duncan, Anan Daqa, James Yeh, Simon Davies, Anselm Uebing, Cesare Quarto, Neil Moat
AIMS: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/2-year outcomes of the 5 first-in-man patients undergoing chronic TMVR with the Tendyne device. METHODS AND RESULTS: Five patients (STS score 14%-23%) underwent TMVR using a Tendyne system under compassionate use at a single centre. 1 patient (who was noncompliant with anti-coagulation) died 9 months after TMVR following a cerebrovascular accident...
August 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28797431/implantation-and-30-day-follow-up-on-all%C3%A2-4-valve-sizes-within-the-portico-transcatheter-aortic-bioprosthetic-family
#16
Helge Möllmann, Axel Linke, David M Holzhey, Thomas Walther, Ganesh Manoharan, Ulrich Schäfer, Karl Heinz-Kuck, Ad J Van Boven, Simon R Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Stephen G Worthley
OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS: Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28782492/impact-of-pre-existing-kidney-dysfuntion-on-outcomes-following-transcatheter-aortic-valve-replacement
#17
Ikechukwu A Ifedili, Oluwaseyi Bolorunduro, Tamunoinemi Bob-Manuel, Mark R Heckle, Ellis Christian, Saibal Kar, Uzoma N Ibebuogu
BACKGROUND: Pre-existing chronic kidney disease (CKD) portends adverse outcomes following heart valve surgery. However, only limited and conflicting evidence is available on the impact of CKD on outcomes following transcatheter aortic valve replacement (TAVR). The objective of this review was to evaluate the effect of pre-existing CKD on TAVR outcomes. METHODS: We performed a systematic electronic search using the PRISMA statement to identify all randomized controlled trials and observational studies investigating the effect of pre-existing CKD on outcomes following TAVR...
August 4, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28766839/techniques-and-outcomes-of-paravalvular-leak-repair-after-transcatheter-aortic-valve-replacement
#18
Thomas M Waterbury, Guy S Reeder, Sorin V Pislaru, Allison K Cabalka, Charanjit S Rihal, Mackram F Eleid
OBJECTIVES: To investigate the feasibility, procedural success, and outcomes of paravalvular leak (PVL) closure in patients with prior transcatheter aortic valve replacement (TAVR). BACKGROUND: PVL after TAVR is associated with adverse patient outcomes and increased mortality. Percutaneous PVL closure has emerged as a therapeutic strategy for addressing this issue, but data for transcatheter PVL repair after TAVR remains limited. METHODS: This is a single center retrospective review of PVL closure after TAVR...
August 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28738447/comparison-of-local-versus-general-anesthesia-in-patients-undergoing-transcatheter-aortic-valve-replacement-a-meta-analysis
#19
Pedro A Villablanca, Divyanshu Mohananey, Katarina Nikolic, Sripal Bangalore, David P Slovut, Verghese Mathew, Vinod H Thourani, Josep Rode's-Cabau, Iván J Núñez-Gil, Tina Shah, Tanush Gupta, David F Briceno, Mario J Garcia, Jacob T Gutsche, John G Augoustides, Harish Ramakrishna
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is typically performed under general anesthesia (GA). However, there is increasing data supporting the safety of performing TAVR under local anesthesia/conscious sedation (LA). We performed a meta-analysis to gain better understanding of the safety and efficacy of LA versus GA in patients with severe aortic stenosis undergoing TAVR. METHODS AND RESULTS: We comprehensively searched EMBASE, PubMed, and Web of Science...
July 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707442/paravalvular-leak-versus-need-for-permanent-pacemaker-after-tavr-sailing-between-scylla-and-charybdis
#20
EDITORIAL
Mehmet Cilingiroglu, Konstantinos Marmagkiolis
Absence or minimization of PVL after TAVR and its potential association with higher rates of PPM placement has been the Achilles' heel of TAVR procedures. Pre-existing RBBB and depth of implantation are independent predictors of PPM need after Lotus valve implantation. Optimization of device design, increased operator experience, and focus on accurate device placement seem to result in decreased need for PPM after Lotus valve implantation.
July 2017: Catheterization and Cardiovascular Interventions
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