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Aortic paravalvular leak

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https://www.readbyqxmd.com/read/28219551/concomitant-endografting-of-a%C3%A2-type-b-aortic-dissection-during-transfemoral-aortic-valve-replacement
#1
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
#2
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/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/28150295/impact-of-corevalve-size-selection-based-on-multi-slice-computer-tomography-on-paravalvular-leak-after-transcatheter-aortic-valve-implantation
#7
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/28145874/comparative-matched-outcome-of-evolut-r-vs-corevalve-transcatheter-aortic-valve-implantation
#8
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/28117281/optimal-sizing-for-sapien-3-transcatheter-aortic-valve-replacement-in-patients-with-or-without-left-ventricular-outflow-tract-calcification
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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/28045671/bioprosthetic-aortic-paravalvular-leak-is-valve-in-valve-another-solution
#16
Anwar Tandar, David A Bull, Frederick G P Welt
Paravalvular leak (PVL) following aortic valve implantation is a rare complication but may cause potentially serious consequences. It occurs in 2%-10% of surgical aortic valve replacements and 7%-17% of surgical mitral valve replacements. Transcatheter valve replacement data show that significant PVL occurs in 6%-8% of cases. The management of significant PVL has traditionally involved repeat surgical repair. However, many of these patients are considered too high risk to undergo a repeat surgical procedure; hence, a percutaneous transcatheter approach has often been utilized to treat these patients...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28044267/late-paravalvular-aortic-regurgitation-migration-of-the-valve-or-late-recoil
#17
Ashkan Karimi, Negiin Pourafshar, Ki E Park, Calvin Y Choi, Kiran Mogali, Wade W Stinson, Eddie W Manning, Anthony A Bavry
A 79-year-old man underwent trans-catheter aortic valve replacement for symptomatic severe aortic stenosis with a 26-mm Edwards SAPIEN XT valve. Immediately after valve deployment there was moderate amount of paravalvular leak. Post-dilation was performed with an additional 2 cc of volume, and the paravalvular leak was reduced to trace. Nine months later, trans-thoracic echocardiography revealed moderate to severe paravalvular leak and possible aortic migration of the valve. The patient was brought back for the treatment of the paravalvular leak which was suspected to be due to valve migration...
January 2, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28029363/comparison-of-the-edwards-sapien-s3-versus-medtronic-evolut-r-devices-for-transcatheter-aortic-valve-implantation
#18
Jeremy Ben-Shoshan, Maayan Konigstein, David Zahler, Gilad Margolis, Ehud Chorin, Arie Steinvil, Yaron Arbel, Galit Aviram, Yoav Granot, Michael Barkagan, Gad Keren, Amir Halkin, Shmuel Banai, Ariel Finkelstein
New generation of the most widely used devices for transcatheter aortic valve implantation have been recently introduced into practice. We compare the short-term outcomes of transcatheter aortic valve implantation with the Edwards SAPIEN S3 and the Medtronic Evolut-R. We performed a retrospective analysis from a single high-volume tertiary center. Valve Academic Research Consortium-2 criteria were used to define composite end points of device success and safety at 30 days. Study population included 232 patients implanted with the SAPIEN S3 (n = 124) and Evolut-R (n = 108)...
October 7, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28009941/evaluation-of-aortic-paravalvular-leak-a-special-reference-for-anatomical-localization
#19
Mustafa Ozan Gürsoy, Macit Kalçık, Mehmet Özkan, Mehmet Ali Astarcıoğlu, Süleyman Karakoyun, Sabahattin Gündüz, Tayyar Gökdeniz, Mahmut Yesin, Mehmet Altuğ Tuncer, Cengiz Köksal
BACKGROUND: Paravalvular leakage (PVL) remains an unavoidable complication of heart valve surgery and in its severe forms may lead to heart failure and hemolysis. The study aim was to evaluate the echocardiographic, clinical, surgical and laboratory characteristics of patients with aortic PVL. METHODS: A total of 77 aortic PVL patients underwent transthoracic and transesophageal echocardiography examinations. Clinical, echocardiographical and surgical findings were also recorded...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27989047/results-of-contemporary-valve-surgery-in-patients-with-carcinoid-heart-disease
#20
Thomas Kuntze, Tamer Owais, Maria-Anna Secknus, Daniel Kaemmerer, Richard Baum, Evaldas Girdauskas
BACKGROUND: Carcinoid tumor is a slow-growing type of neuroendocrine tumor, originating from enterochromaffin cells and secreting mainly serotonin. The diagnosis is based on clinical symptoms, hormone blood levels, radiological and nuclear imaging, and histological confirmation. However, most patients have metastases at the time of diagnosis because the clinical signs often remain unnoticed or are attributed to other abdominal conditions. In up to 50% of patients the endocardium is affected due to a hormonally active tumor profile...
May 2016: Journal of Heart Valve Disease
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