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Aortic paravalvular leak

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https://www.readbyqxmd.com/read/29627180/transatrial-implantation-of-a-transcatheter-heart-valve-for-severe-mitral-annular-calcification
#1
Fabien Praz, Omar K Khalique, Raymond Lee, Ramesh Veeragandham, Hyde Russell, Mayra Guerrero, Ashequl M Islam, David W Deaton, Tsuyoshi Kaneko, Susheel K Kodali, Martin B Leon, Vinayak Bapat, Hiroo Takayama, Michael A Borger, Isaac George
OBJECTIVE: To assess the outcomes of transatrial implantation of a transcatheter heart valve (THV) for the treatment of mitral valve disease with severe mitral annular calcification (MAC). METHODS: Implantation of a balloon-expandable THV was performed on cardiopulmonary bypass via left atrial exposure in patients considered at risk for left ventricular outflow tract obstruction. The anterior mitral valve leaflet was systematically resected and pledgeted sutures were placed to enhance stability and reduce paravalvular leak...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29622987/outcome-of-transcatheter-aortic-valve-implantation-in-high-risk-patients-with-severe-aortic-stenosis
#2
Hamdy Soliman, Khlid Alrabaat, Tarek Aboalaazm, Shaimaa Mostafa, Asaad Samy
Aim: To assess outcome of TAVI in high risk patients with severe symptomatic aortic stenosis. Patients and methods: 40 patients with symptomatic severe aortic stenosis and high risk underwent TAVI with implantation of either Sapien XT valve or Core Valve and followed for 6 months. Device success, cardiovascular mortality, myocardial infarction, stroke, life-threatening bleeding and vascular complications were defined according to Valve Academic Research Consortium definitions...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29617510/symptomatic-aortic-paravalvular-leak-percutaneous-treatment-with-amplatzer-vascular-plug-iii-device-as-an-alternative-to-surgery
#3
Gabriel E Pérez Baztarrica, Gastón Heredia, Juan Arellano, Juan Fernández, Rafael Porcile
A significant prosthetic paravalvular leak is an uncommon and severe postsurgical complication correlated to the occurrence of congestive heart failure and hemolytic anemia. Percutaneous treatment has become an attractive and effective proposal to relieve symptoms and reduce complications in patients whose high rate of morbidity/mortality precludes a new surgery. This is the case of an 81-year-old patient with a history of biological aortic valve replacement seeking medical help due to heart failure and hemolytic anemia, with a prosthetic paravalvular regurgitation jet and high surgical mortality according to EuroSCORE II...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29617495/early-clinical-results-of-perceval-sutureless-aortic-valve-in-139-patients-freeman-experience
#4
Syed Saleem Mujtaba, Simon Ledingham, Asif Raza Shah, Stephen Clark, Thasee Pillay, Stephan Schueler
OBJECTIVE: The aim of this retrospective study is to evaluate the safety and performance of the Perceval sutureless valve in patients undergoing aortic valve replacement. We report the 30-day clinical outcomes of 139 patients. METHODS: From January 2014 to December 2016, 139 patients underwent sutureless aortic valve replacement. Their operation notes, National Adult Cardiac Surgery Database and perioperative transoesophageal echocardiography findings were studied retrospectively...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29610444/hemodynamic-effects-of-valve-asymmetry-in-sapien-3-transcatheter-aortic-valves
#5
Daniel R Mangels, Mary Siki, Rohan Menon, Joseph Bavaria, Saif Anwaruddin, Jay Giri, Nimesh Desai, Wilson Y Szeto, Prashanth Vallabhajosyula, Howard C Herrmann
BACKGROUND: Eccentric valve deployment after transcatheter aortic valve replacement (TAVR) has been associated with abnormal leaflet shear stresses that may accelerate structural valve deterioration (SVD). This phenomenon has not been studied in patients receiving Sapien 3 prostheses (Edwards Lifesciences). METHODS: A retrospective cohort analysis of 100 patients who received Sapien 3 valves between 2013 and 2015 at a single institution was performed. Axial fluoroscopic images from the co-planar view were used to assess TAVR asymmetry, which was defined as a ratio of left-to-right valve heights ≤0...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29588730/a-glimpse-into-the-future-in-2020-which-patients-will-undergo-tavi-or-savr
#6
Crochan J O'Sullivan, Peter Wenaweser
Transcatheter aortic valve implantation (TAVI) has evolved into a safe and effective procedure to treat symptomatic patients with severe aortic stenosis (AS), with predictable and reproducible results. Rates of important complications such as vascular complications, strokes and paravalvular leaks are lower than ever, because of improved patient selection, systematic use of multidector computer tomography, increasing operator experience and device iteration. Accumulating data suggest that transfemoral TAVI with newer generation transcatheter heart valves and delivery systems is superior to conventional surgical aortic valve replacement among intermediate- and high-risk patients with severe symptomatic AS with regard to all-cause mortality and stroke...
May 2017: Interventional Cardiology
https://www.readbyqxmd.com/read/29582947/-long-term-follow-up-of-transcatheter-self-expandable-aortic-valve-implantation
#7
Shmuel Chen, Vicky Zenios, Dan Gilon, David Planer, Ronen Beeri, Chaim Lotan, Haim D Danenberg
INTRODUCTION: Aortic stenosis is the most common significant valvular disease in the western world. These patients are treated operatively unless they are at high operative risk or inoperable. During the last decade an alternative approach has evolved - transcatheter aortic valve implantation (TAVI). This method was shown to be at least as effective and safe as the operative one. However, very little data exists on long term follow-up (5 years and above), especially regarding valve durability and patient survival...
March 2018: Harefuah
https://www.readbyqxmd.com/read/29566812/transcatheter-aortic-valve-replacement-in-patients-with-low-flow-low-gradient-aortic-stenosis-the-topas-tavi-registry
#8
Henrique Barbosa Ribeiro, Stamatios Lerakis, Martine Gilard, João L Cavalcante, Raj Makkar, Howard C Herrmann, Stephan Windecker, Maurice Enriquez-Sarano, Asim N Cheema, Luis Nombela-Franco, Ignacio Amat-Santos, Antonio J Muñoz-García, Bruno Garcia Del Blanco, Alan Zajarias, John C Lisko, Salim Hayek, Vasilis Babaliaros, Florent Le Ven, Thomas G Gleason, Tarun Chakravarty, Wilson Y Szeto, Marie-Annick Clavel, Alberto de Agustin, Vicenç Serra, John T Schindler, Abdellaziz Dahou, Rishi Puri, Emilie Pelletier-Beaumont, Melanie Côté, Philippe Pibarot, Josep Rodés-Cabau
BACKGROUND: Few data exist on patients with low-flow, low-gradient aortic stenosis (LFLG-AS) undergoing transcatheter aortic valve replacement (TAVR). Also, very scarce data exist on the usefulness of dobutamine stress echocardiography (DSE) before TAVR in these patients. OBJECTIVES: The authors sought to evaluate clinical outcomes and changes in left ventricular ejection fraction (LVEF) following TAVR in patients with classical LFLG-AS. METHODS: This multicenter registry included 287 patients with LFLG-AS undergoing TAVR...
March 27, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29548584/rapid-deployment-or-sutureless-versus-conventional-bioprosthetic-aortic-valve-replacement-a-meta-analysis
#9
Suk Ho Sohn, Myoung-Jin Jang, Ho Young Hwang, Kyung Hwan Kim
OBJECTIVES: This meta-analysis was conducted to compare the early and follow-up outcomes of aortic valve replacement using rapid deployment or sutureless (RD) valves (RDAVR group) with aortic valve replacement using conventional bioprostheses (CAVR group). METHODS: A literature search of 5 online databases was conducted. The primary outcomes were postoperative complications and the secondary outcomes included the aortic cross-clamp (ACC) and cardiopulmonary bypass (CPB) times and early mortality and all-cause mortality during follow-up...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29530883/hemodynamic-and-echocardiographic-comparison-of-the-lotus-and-corevalve-transcatheter-aortic-valves-in-patients-with-high-and-extreme-surgical-risk-an-analysis-from-the-reprise-iii-randomized-controlled-trial-repositionable-percutaneous-replacement-of-stenotic
#10
Federico M Asch, Mani A Vannan, Siddharth Singh, Bijoy Khandheria, Stephen H Little, Dominic J Allocco, Ian T Meredith, Ted E Feldman, Michael J Reardon, Neil J Weissman
BACKGROUND : Comparative echocardiographic data on transcatheter aortic valve replacement systems from randomized trials are limited. The REPRISE III trial (Repositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Randomized Clinical Evaluation) is a multicenter, randomized comparison of a mechanically expanded (Lotus) versus self-expanding (CoreValve) transcatheter aortic valve replacement device. This analysis rigorously assesses Doppler-derived valve hemodynamics and the impact on outcomes at 1 year in patients with extreme/high surgical risk treated with Lotus and CoreValve from REPRISE III...
March 12, 2018: Circulation
https://www.readbyqxmd.com/read/29511981/paravalvular-leak-in-structural-heart-disease
#11
REVIEW
Kashish Goel, Mackram F Eleid
PURPOSE OF REVIEW: This review will summarize the growing importance of diagnosing and managing paravalvular leak associated with surgical and transcatheter valves. RECENT FINDINGS: The burden of paravalvular leak is increasing; however, advanced imaging techniques and high degree of clinical suspicion are required for diagnosis and management. The latest data from pivotal clinical trials in the field of transcatheter aortic valve replacement suggest that any paravalvular leak greater than mild was associated with worse clinical outcomes...
March 6, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29488887/novel-predictors-of-mild-paravalvular-aortic-regurgitation-in-sapien-3-transcatheter-aortic-valve-implantation
#12
Gilbert H L Tang, Syed Zaid, Samuel R Schnittman, Hasan Ahmad, Ryan Kaple, Cenap Undemir, Tanya Dutta, Angelica Poniros, Joanne Bennett, Cheng Feng, Martin Cohen, Steven L Lansman
AIMS: Paravalvular leak(PVL) remains an important issue in TAVI. The Edwards Sapien3(S3) valve has reduced PVL but up to one-third of patients remain with mild leak. Our study aims to identify predictors of mild PVL after TAVI with S3 valve. METHODS AND RESULTS: From 10/2015 to 5/2017, 122 consecutive patients underwent S3 TAVI for symptomatic severe aortic stenosis. 33 patients with mild PVL on transthoracic echocardiography at 30-day follow-up were compared to 89 with none/trace PVL...
February 27, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29469031/ad-hoc-percutaneous-paravalvular-leak-closure-after-transcatheter-aortic-valve-replacement-facilitated-by-integrated-multimodality-imaging
#13
Tian-Yuan Xiong, Giuseppe Martucci, Hind Alosaimi, Nicolo Piazza
No abstract text is available yet for this article.
February 20, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29455818/mitral-regurgitation-exacerbation-due-to-sutureless-aortic-valve-replacement
#14
Timothy Lee, Alexander J C Mittnacht, Shinobu Itagaki, Allan Stewart
Sutureless aortic valves are increasingly used for aortic valve replacement (AVR) with excellent outcomes. Implantation requires device expansion in a subannular position within the native aortic root. We report a patient with severe aortic stenosis who received a Perceval sutureless AVR (LivaNova, London, United Kingdom), resulting in a competent prosthesis with an absence of paravalvular leak and aortic regurgitation. However, this implantation resulted in the exacerbation of mitral regurgitation. The sutureless valve required explantation, and a traditional sutured valve was subsequently implanted, which returned the mitral regurgitation to baseline...
March 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29453309/sutureless-perceval-aortic-valve-versus-conventional-stented-bioprostheses-meta-analysis-of-postoperative-and-midterm-results-in-isolated-aortic-valve-replacement
#15
REVIEW
Massimo Meco, Andrea Montisci, Antonio Miceli, Paolo Panisi, Francesco Donatelli, Silvia Cirri, Matteo Ferrarini, Antonio Lio, Mattia Glauber
BACKGROUND: Aortic stenosis is the most common valvular disease and has a dismal prognosis without surgical treatment. The aim of this meta-analysis was to quantitatively assess the comparative effectiveness of the Perceval (LivaNova) valve versus conventional aortic bioprostheses. METHODS AND RESULTS: A total of 6 comparative studies were identified, including 639 and 760 patients who underwent, respectively, aortic valve replacement with the Perceval sutureless valve (P group) and with a conventional bioprosthesis (C group)...
February 16, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29444998/treatment-of-aortic-stenosis-with-a-self-expanding-resheathable-transcatheter-valve-one-year-results-of-the-international-multicenter-portico-transcatheter-aortic-valve-implantation-system-study
#16
Axel Linke, David Holzhey, Helge Möllmann, Ganesh Manoharan, Ulrich Schäfer, Christian Frerker, Stephen G Worthley, A J van Boven, Simon Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Thomas Walther
BACKGROUND: The aim of the Portico TAVI (transcatheter aortic valve implantation) system study was to evaluate outcomes ≤1 year after implantation of a novel resheathable, self-expanding TAVI system in a multicenter patient population with severe aortic stenosis (AS). METHODS AND RESULTS: High-risk patients (n=222) with symptomatic severe AS (mean age, 83.0±4.6 years; 74.3% women) were enrolled across 12 centers in Europe and Australia. The study's primary end point was all-cause mortality at 30 days...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29401266/randomized-trial-of-the-carpentier-edwards-supra-annular-prosthesis-versus-the-medtronic-mosaic-aortic-prosthesis-10-year-results
#17
Omar Zibdeh, Ian Bugg, Shriyam Patel, Gina Twine, Jonathan Unsworth-White
OBJECTIVES: We performed a prospective randomized study comparing the clinical performance of the Carpentier-Edwards supra-annular valve (CE-SAV) (Edwards Lifesciences, Irvine, CA, USA) and the newer Mosaic (Medtronic Corporation, Minneapolis, MN, USA) porcine bioprostheses in the aortic position over a 10-year period. METHODS: Between January 2001 and March 2005, 398 patients undergoing bioprosthetic aortic valve replacement were randomized to receive either the CE-SAV (n = 193) or the Mosaic (n = 205) prosthesis...
February 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29397472/gastrointestinal-bleeding-in-native-and-prosthetic-valve-disease
#18
REVIEW
Joseph L Blackshear
Gastrointestinal bleeding with severe aortic stenosis was originally described in the 1950s by Heyde, although for years, the association was debated. Further discovery of mechanisms and the ubiquity and severity of acquired von Willebrand syndrome in the left ventricular assist device therapy have removed any doubts. At this time, gastrointestinal bleeding from intestinal angiodysplasia in patients with turbulence-related proteolysis of the highest molecular weight multimers of von Willebrand factor is now known to occur in patients with aortic stenosis, and also subaortic obstruction and associated mitral insufficiency in hypertrophic cardiomyopathy, isolated mitral and aortic insufficiency, endocarditis, and in patients with prosthetic valve dysfunction, either from stenosis or insufficiency...
February 3, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29372398/transapical-approach-in-transcatheter-cardiovascular-interventions
#19
REVIEW
Minoru Tabata
The left ventricular apex has excellent accessibility to the aortic valve, mitral valve, left ventricular outflow tract and thoracic aorta. Although the number of transapical approach in transcatheter aortic valve replacement has been decreasing in recent years, it is still a useful option for patients with very poor peripheral vascular access. The apex has been chosen as a primary access site for many devices of transcatheter mitral valve repair/replacement and mitral valve-in-valve procedures. Additionally, the transapical approach has been used for other transcatheter cardiovascular interventions such as paravalvular leak repair after mitral or aortic valve replacement, pseudoaneurysm repair of the left ventricular outflow tract, and thoracic endovascular aortic repair...
January 25, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29348010/early-outcomes-with-the-evolut-pro-repositionable-self-expanding-transcatheter-aortic-valve-with-pericardial-wrap
#20
John K Forrest, Abeel A Mangi, Jeffrey J Popma, Kamal Khabbaz, Michael J Reardon, Neal S Kleiman, Steven J Yakubov, Daniel Watson, Susheel Kodali, Isaac George, Peter Tadros, George L Zorn, John Brown, Robert Kipperman, Sara Saul, Hongyan Qiao, Jae K Oh, Mathew R Williams
OBJECTIVES: This study sought to evaluate the Medtronic Evolut PRO Transcatheter Aortic Valve System in patients with severe symptomatic aortic stenosis. BACKGROUND: A next-generation self-expanding transcatheter aortic valve was designed with an external pericardial wrap with the intent to reduce paravalvular leak while maintaining the benefits of a low-profile, self-expanding, and repositionable supra-annular valve. METHODS: The Medtronic Evolut PRO Clinical Study included 60 patients undergoing transcatheter aortic valve replacement with the Evolut PRO valve at 8 investigational sites in the United States...
January 22, 2018: JACC. Cardiovascular Interventions
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