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Paravalvular leak

Andre Paixao, Mehmet Cilingiroglu
Paravalvular leak (PVL) remains as uncommon but serious complication after surgical prosthetic valve implantation. PVL when associated which congestive heart failure, hemolytic anemia, or infective endocarditis may require percutaneous treatment. High-surgical risk is common in this population. Dedicated PVL devices are lacking often limiting optimal treatment.
October 2016: Catheterization and Cardiovascular Interventions
Ted Feldman, Fabian Nietlispach
No abstract text is available yet for this article.
October 2016: Catheterization and Cardiovascular Interventions
Philip Y K Pang, Jiasi Zhu, Yoong Kong Sin, Yeow Leng Chua
Most mitral paravalvular leaks (PVLs) occur during the first year after mitral valve replacement (MVR). This report describes the surgical management of 6 patients who developed very late mitral PVLs. The median interval between MVR and initial diagnosis of PVL was 16.5 years. All patients presented with congestive cardiac failure and haemolytic anaemia. The median EuroSCORE II was 9.5%. Two patients (33%) had failed attempts at transcatheter closure. Five patients underwent suture repair of the PVL. One patient underwent MVR after removal of the previous prosthesis...
September 2016: Journal of Thoracic Disease
Claudia Fiorina, Giuseppe Bruschi, Luca Testa, Marco De Carlo, Federico De Marco, Giuseppe Coletti, Stefano Bonardelli, Marianna Adamo, Salvatore Curello, Giovanni Scioti, Paolo Panisi, Francesco Bedogni, Anna S Petronio, Federica Ettori
BACKGROUND: About one-third of candidates for transcatheter aortic valve implantation (TAVI) suffer from severe peripheral artery disease, making the routine femoral approach difficult or impossible. Aim was to compare the trans-axillary (TAx) and the trans-aortic (TAo) route for TAVI with Medtronic CoreValve Revalving System (CRS). METHODS: 242 (23%) out of 1049 consecutive TAVI with 18F CRS were treated in 4 high-volume Italian Centre through TAx (61%) and TAo (39%)...
October 4, 2016: Journal of Cardiovascular Surgery
Pranav Loyalka, Angelo Nascimbene, Michael Schechter, Marija Petrovic, Ajay Sundara Raman, Igor D Gregoric, Biswajit Kar
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) in patients with degenerated bioprosthetic aortic valve has been successfully performed as an alternative to surgery. We describe our initial experience of valve-in-valve TAVI in five patients, using new generation Edwards Sapien 3 transcatheter heart valves implanted into degenerated 19 mm bioprosthetic valves. 20-mm Edwards S3 valves were offered for compassionate use. All patients had significant aortic valve stenosis. METHODS AND RESULTS: The main vascular access was achieved and pre-closed with two Proglide closure devices in one patient and Prostar closure devices in four patients...
October 3, 2016: Catheterization and Cardiovascular Interventions
Rodrigo Bagur, Patrick J Teefy, Bob Kiaii, Pantelis Diamantouros, Michael W A Chu
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become a therapeutic alternative for patients presenting with severe symptomatic aortic stenosis and considered at high-surgical risk. Paravalvular leak (PVL), conduction disorders, and coronary obstruction remain unresolved procedure-related complications. The aim of this manuscript was to report the first North American experience with the ACURATE-neo(TM) aortic bioprosthesis and its ACURATE-TF(TM) delivery system (Symetis S...
September 28, 2016: Catheterization and Cardiovascular Interventions
David W Yaffee, Mathew R Williams, Eugene A Grossi
No abstract text is available yet for this article.
November 2016: Journal of Thoracic and Cardiovascular Surgery
Sebastian Raczkiewicz, Marzena Matejszczak-Woś, Piotr Pysz, Ewa Zaremba-Flis, Grzegorz Smolka, Andrzej Kleinrok
No abstract text is available yet for this article.
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
A A Sakrana, M M Nasr, G A Ashamallah, R A Abuelatta, H A Naeim, M E Tahlawi
AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO)...
November 2016: Clinical Radiology
Sung-Han Yoon, Thierry Lefèvre, Jung-Ming Ahn, Gidon Y Perlman, Danny Dvir, Azeem Latib, Marco Barbanti, Florian Deuschl, Ole De Backer, Philipp Blanke, Thomas Modine, Gregor Pache, Franz-Josef Neumann, Philipp Ruile, Takahide Arai, Yohei Ohno, Hidehiro Kaneko, Edgar Tay, Niklas Schofer, Erik W Holy, Ngai H V Luk, Gerald Yong, Qingsheng Lu, William K F Kong, Jimmy Hon, Hsien-Li Kao, Michael Lee, Wei-Hsian Yin, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Hyo-Soo Kim, Christian Butter, Omar K Khalique, Ulrich Schaefer, Fabian Nietlispach, Susheel K Kodali, Martin B Leon, Jian Ye, Bernard Chevalier, Jonathon Leipsic, Victoria Delgado, Jeroen J Bax, Corrado Tamburino, Antonio Colombo, Lars Søndergaard, John G Webb, Seung-Jung Park
BACKGROUND: Few studies have evaluated the clinical outcomes of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS). Particularly, limited data exist comparing the results of TAVR with new-generation devices versus early-generation devices. OBJECTIVES: This study sought to evaluate the clinical outcomes of TAVR for bicuspid AS with early- and new-generation devices. METHODS: The Bicuspid TAVR Registry is an international multicenter study enrolling consecutive patients with bicuspid AS undergoing TAVR between April 2005 and May 2015...
September 13, 2016: Journal of the American College of Cardiology
Frank Van Praet, Apostolos Roubelakis, José Coddens, Filip Casselman
This report describes an approach for the treatment of high-risk native mitral valve stenosis. It incorporates the deployment of a transcatheter valve in the mitral position under full endoscopic vision, combined with endoscopic mitral repair techniques that secure valve positioning and reduce the risk of paravalvular leak. This approach could be used as a rescue procedure in centres with experience in transcatheter and endoscopic valve techniques.
September 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Houman Khalili, Ben Ebner, George S Hanzel, Ivan D Hanson
No abstract text is available yet for this article.
September 26, 2016: JACC. Cardiovascular Interventions
Aref Rashed, Karoly Gombocz, Janos Fulop, Nasri Alotti
INTRODUCTION: Iatrogenic ventricular septal defect is a rare complication after the surgical replacement of cardiac valves. Small defects may have no hemodynamic significance or remain unremarked at the end of the surgical procedure. Understanding of the valvular anatomy alone is not always enough to avoid such complications, especially in the hands of young surgeons. PRESENTATION OF CASE: We present a case of iatrogenic ventricular septal defect that developed early after the surgical closure of a hemodynamically significant mitral paravalvular leak...
2016: International Journal of Surgery Case Reports
Patrick A Calvert, David B Northridge, Iqbal S Malik, Leonard Shapiro, Peter Ludman, Shakeel A Qureshi, Michael Mullen, Robert Henderson, Mark Turner, Martin Been, Kevin P Walsh, Ivan Casserly, Lindsay Morrison, Nicola L Walker, John Thomson, Mark S Spence, Vaikom S Mahadevan, Angela Hoye, Philip A MacCarthy, Matthew J Daniels, Paul Clift, William R Davies, Philip D Adamson, Gareth Morgan, Suneil K Aggarwal, Yasmin Ismail, Julian O M Ormerod, Habib R Khan, Sujay Subash Chandran, Joseph de Giovanni, Bushra S Rana, Oliver Ormerod, David Hildick-Smith
BACKGROUND: Paravalvular leak (PVL) occurs in 5% to 17% of patients following surgical valve replacement. Percutaneous device closure represents an alternative to repeat surgery. METHODS: All UK and Ireland centers undertaking percutaneous PVL closure submitted data to the UK PVL Registry. Data were analyzed for association with death and major adverse cardiovascular events (MACE) at follow-up. RESULTS: Three hundred eight PVL closure procedures were attempted in 259 patients in 20 centers (2004-2015)...
September 27, 2016: Circulation
Sathish Chikkabyrappa, Doff B McElhinney, Muhamed Saric
We report a rare case of progressive left ventricular outflow tract (LVOT) obstruction after percutaneous device closure of a mechanical prosthetic mitral valve (MV) paravalvular leak (PVL) in the region of aortomitral curtain in a patient who also had small mechanical aortic valve prosthesis with patient-prosthesis mismatch.
August 30, 2016: Echocardiography
Candice Y Lee, Joshua K Wong, Ronald E Ross, David C Liu, Kamal R Khabbaz, Angelo J Martellaro, Heather R Gorea, Jude S Sauer, Peter A Knight
OBJECTIVE: Prostheses attachment is critical in aortic valve replacement surgery, yet reliable prosthetic security remains a challenge. Accurate techniques to analyze prosthetic fixation pressures may enable the use of fewer sutures while reducing the risk of paravalvular leaks (PVL). METHODS: Customized digital thin film pressure transducers were sutured between aortic annulus models and 21-mm bioprosthetic valves with 15 × 4-mm, 12 × 4-mm, or 9 × 6-mm-wide pledgeted mattress sutures...
August 25, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Ganesh Manoharan, Axel Linke, Helge Moellmann, Simon Redwood, Christian Frerker, Jan Kovac, Thomas Walther
AIMS: The aim of this study was to evaluate the safety and performance of the resheathable and repositionable St. Jude Medical Portico self-expanding transfemoral TAVI system. METHODS AND RESULTS: This prospective, single-arm, multicentre study evaluated the 18 Fr Portico system with either a 23 or a 25 mm valve. Patient follow-up was at 30, 90, 180 days and one year. Results up to 30 days are presented. Adverse events were categorised by VARC definitions and adjudicated by an independent events committee...
August 20, 2016: EuroIntervention
Cesare Quarto, Simon Davies, Alison Duncan, Alistair Lindsay, Georg Lutter, Lucian Lozonschi, Neil Moat
OBJECTIVE: A small number of transcatheter mitral valve implants (TMVIs) have been reported using devices designed to treat secondary mitral regurgitation (MR). However, MR has many etiologies, and patients have a broad spectrum of annular size, geometry, and lesions. There are a number of technical challenges for TMVI including left ventricular outflow tract obstruction and paravalvular MR. Thirty days' outcome of first-in-man implants with a novel TMVI device is reported. METHODS: The Tendyne TMVI system consists of a porcine pericardial valve in a tethered nitinol frame...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Julius I Ejiofor, Maroun Yammine, Morgan T Harloff, Siobhan McGurk, Jochen D Muehlschlegel, Prem S Shekar, Lawrence H Cohn, Pinak Shah, Tsuyoshi Kaneko
BACKGROUND: Bioprosthetic aortic valve use has increased steadily according to The Society of Thoracic Surgeons (STS) database analyses. One of the momentums toward this trend is the future utilization of transcatheter valve-in-valve (TViV) techniques when bioprosthetic valves fail. We compared the results of reoperative TViV to surgical aortic valve replacement (SAVR) for degenerated bioprosthetic valves. METHODS: From January 2002 to January 2015, we identified 91 patients with degenerated bioprosthetic valves who underwent isolated AVR (SAVR n = 69, TViV n = 22)...
August 12, 2016: Annals of Thoracic Surgery
H Liu, L Wei, Y Yang, L M Zhu, J Y Zheng, K F Guo, H Luo, W P Zhao, X Yang, Maimaiti Aikebar, C S Wang
OBJECTIVES: To introduce the application of the J-Valve™ system in elderly patients with predominant aortic incompetence without significant valve calcification, and to evaluate its feasibility. METHODS: From April 2014 to July 2015, 33 cases of transapical implantation of J-Valve™ were performed in Department of Cardiac Surgery, Zhongshan Hospital, Fudan University. Sixteen of these patients were diagnosed as predominant aortic incompetence without significant valve calcification...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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