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Aortic paravalvular leak

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https://www.readbyqxmd.com/read/27931593/techniques-and-outcomes-of%C3%A2-percutaneous-aortic-paravalvular%C3%A2-leak%C3%A2-closure
#1
Mohamad Alkhouli, Mohammad Sarraf, Elad Maor, Saurabh Sanon, Allison Cabalka, Mackram F Eleid, Donald J Hagler, Peter Pollak, Guy Reeder, Charanjit S Rihal
OBJECTIVES: The aim of this study is to provide a summary of the currently applied aortic paravalvular leak (PVL) closure techniques and describe the procedural and long-term outcomes in a large consecutive cohort of patients. BACKGROUND: Percutaneous repair has emerged as an effective therapy for patients with PVL. To date, clinical outcome data on percutaneous closure of aortic PVL are limited. METHODS: All patients who underwent catheter-based treatment of aortic PVL between 2006 and 2015 were identified...
December 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27899293/valvular-regurgitation-after-implantation-of-prostheses-secured-with-cor-knot-automated-fasteners
#2
Alexander A Brescia, Steven F Bolling, Himanshu J Patel
Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular less common. The Cor-knot automated fastener (LSI SOLUTIONS, Victor, NY, USA) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two cases in which Cor-Knot fastener orientation appeared to result in transvalvular regurgitation necessitating redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results...
November 26, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27899128/european-real-world-trans-catheter-aortic-valve-implantation-systematic-review-and-meta-analysis-of-european-national-registries
#3
REVIEW
G Krasopoulos, F Falconieri, U Benedetto, J Newton, R Sayeed, R Kharbanda, A Banning
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has been adopted rapidly in Europe. TAVI national registries can augment understanding of technologies and represent real-world experience, providing further clinical insights. We undertook a meta-analysis of published European national TAVI registries to assess current results following TAVI in Europe. METHODS: Electronic databases were searched. The review focused on the comparison of the following TAVI strategies: transfemoral (TF) and transapical (TA) SAPIEN and CoreValve implantation...
November 29, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27898502/-full-metal-jacket-treatment-of-multiple-paravalvular-leaks
#4
Giuseppe Santoro, Giancarlo Scognamiglio, Maria T Palladino, Carola Iacono, Giampiero Gaio, Maria G Russo
A 40-year-old man with osteogenesis imperfecta type I submitted to multiple procedures of surgical mitral and aortic valve replacement was referred for refractory congestive heart failure due to significant paravalvular leaks (PVLs) of both mitral and aortic prostheses. Due to perceived very high risk of a further mitroaortic surgery, transcatheter closure of PVLs under three-dimensional echocardiographic guide was performed. Thus, four Amplatzer Vascular Plug type II (St. Jude Medical Corp, St. Paul, Minnesota, USA) devices were implanted into the aortic PVLs, and three Amplatzer Vascular Plug type II devices were used to occlude a huge mitral PVL...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27878547/transcatheter-closure-of-paravalvular-leaks-state-of-the-art
#5
I Cruz-Gonzalez, J C Rama-Merchan, J Rodríguez-Collado, J Martín-Moreiras, A Diego-Nieto, M Barreiro-Pérez, P L Sánchez
Paravalvular leak (PVL) is a serious complication after surgical valve replacement or after transcatheter aortic valve replacement. Approximately 1-5% of PVLs can lead to serious clinical consequences, including congestive heart failure and/or haemolytic anaemia. For years, surgical re-intervention has been considered the treatment of choice for symptomatic patients with PVLs. However, surgical re-intervention is associated with a high risk of morbidity and mortality. Transcatheter PVL (TPVL) closure is a less invasive alternative to surgical re-intervention...
November 22, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27873034/on-the-mechanics-of-transcatheter-aortic-valve-replacement
#6
Lakshmi P Dasi, Hoda Hatoum, Arash Kheradvar, Ramin Zareian, S Hamed Alavi, Wei Sun, Caitlin Martin, Thuy Pham, Qian Wang, Prem A Midha, Vrishank Raghav, Ajit P Yoganathan
Transcatheter aortic valves (TAVs) represent the latest advances in prosthetic heart valve technology. TAVs are truly transformational as they bring the benefit of heart valve replacement to patients that would otherwise not be operated on. Nevertheless, like any new device technology, the high expectations are dampened with growing concerns arising from frequent complications that develop in patients, indicating that the technology is far from being mature. Some of the most common complications that plague current TAV devices include malpositioning, crimp-induced leaflet damage, paravalvular leak, thrombosis, conduction abnormalities and prosthesis-patient mismatch...
November 21, 2016: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27864470/percutaneous-pulmonary-valve-implantation-in-the-native-right-ventricular-outflow-tract-using-a-29-mm-edwards-sapien-3-valve
#7
Patcharapong Suntharos, Lourdes R Prieto
Percutaneous pulmonary valve implantation is now an acceptable treatment option. The Edwards SAPIEN valve, intended for transcatheter aortic valve implantation, has been used in patients whose landing zone diameter is >22 to 24 mm which is not suitable for Melody valve. We report a patient in whom we successfully placed the latest generation, Edwards SAPIEN 3 (ES3) in the pulmonary position. However, because of the short covered portion of this valve, there was a significant paravalvular leak through the stent struts requiring implantation of a second ES3 valve...
November 18, 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27862901/does-minimalist-transfemoral-transcatheter-aortic-valve-replacement-produce-better-survival-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#8
Jose F Condado, Moosa N Haider, Stamatios Lerakis, Patricia Keegan, Hope Caughron, Vinod H Thourani, Chandan Devireddy, Bradley Leshnower, Kreton Mavromatis, Eric L Sarin, James Stewart, Robert Guyton, Jessica Forcillo, Ateet Patel, Amy Simone, Peter C Block, Vasilis Babaliaros
OBJECTIVES: To compare outcomes after minimalist and standard transfemoral transcatheter aortic valve replacement (TF-TAVR) in patients with severe chronic obstructive pulmonary disease (COPD). BACKGROUND: TF-TAVR is increasingly performed with conscious sedation and transthoracic echocardiography guidance (minimalist). The safety/efficacy of this technique in patients with severe COPD is unknown. METHODS: We compared demographics, 30-day outcomes and 1-year survival of patients with severe COPD (FEV1% ≤50) who underwent minimalist vs...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27849308/sutureless-aortic-prosthesis-implantation-the-first-brazilian-experience-with-perceval-device
#9
Ana Paula Tagliari, Leandro de Moura, Luiz Henrique Dussin, Eduardo Keller Saadi
This is a report of the first Brazilian experience with the Perceval sutureless aortic prosthesis in two patients with severe aortic stenosis. Transesophageal echocardiography was used during the procedure. The aortotomy was performed 1 cm above the sinotubular junction, followed by leaflets removal and decalcification. Correct valve size was selected, device released and an accommodation balloon used. The cardiopulmonary bypass times were 47 and 38 min and the cross-clamp times were 38 and 30 min. There was a significant decrease in mean gradients (41 and 75 mmHg preoperatively; 7 and 8 mmHg postoperatively)...
July 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27817951/transform-multicenter-experience-with-rapid-deployment-edwards-intuity-valve-system-for-aortic-valve-replacement-us-clinical-trial-performance-of-a-rapid-deployment-aortic-valve
#10
Glenn R Barnhart, Kevin D Accola, Eugene A Grossi, Y Joseph Woo, Mubashir A Mumtaz, Joseph F Sabik, Frank N Slachman, Himanshu J Patel, Michael A Borger, H Edward Garrett, Evelio Rodriguez, Patrick M McCarthy, William H Ryan, Francis G Duhay, Michael J Mack, W Randolph Chitwood
BACKGROUND: The TRANSFORM (Multicenter Experience With Rapid Deployment Edwards INTUITY Valve System for Aortic Valve Replacement) trial (NCT01700439) evaluated the performance of the INTUITY rapid deployment aortic valve replacement (RDAVR) system in patients with severe aortic stenosis. METHODS: TRANSFORM was a prospective, nonrandomized, multicenter (n = 29), single-arm trial. INTUITY is comprised of a cloth-covered balloon-expandable frame attached to a Carpentier-Edwards PERIMOUNT Magna Ease aortic valve...
October 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27817206/subacute-radiation-dermatitis-following-an-interventional-cardiology-procedure
#11
Nélia Cunha, Pedro Cardoso, Joana Cabete
Although radiation dermatitis is a widely known complication of radiotherapy, its association with fluoroscopy-guided interventional procedures is yet underrecognized. We present a case of a 66-year-old man with a left scapular cutaneous lesion, initially diagnosed as a fixed drug eruption. The subsequent knowledge of a previous percutaneous aortic paravalvular leak closure procedure allowed a correct clinicopathological correlation and the final diagnosis of subacute radiodermatitis associated with fluoroscopy...
November 6, 2016: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/27793402/one-year-outcomes-of-transcatheter-aortic%C3%A2-valve-implantation-using-the-direct%C3%A2-aortic%C3%A2-approach
#12
Giuseppe Bruschi, Marian Branny, Molly Schiltgen, Federica Ettori, Bertrand Marcheix, Hafid Amrane, Hasan Bushnaq, M Erwin S H Tan, Uday Trivedi, Piotr Branny, Silvio Klugmann, Giuseppe Coletti, Nicolas Dumonteil, Fabiano Porta, Anna Nordell, Neil Moat
BACKGROUND: The direct aortic (DA) approach allows for transcatheter aortic valve implantation (TAVI) in patients with difficult peripheral vascular anatomy. The CoreValve ADVANCE Direct Aortic (ADVANCE DA) study was performed to assess the outcomes of DA TAVI with the CoreValve System (Medtronic, Minneapolis, MN) in routine practice. METHODS: Patients were selected for the DA approach by local cardiac surgical teams, and TAVI was performed with patients under general anesthesia...
October 25, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27779335/left-ventricular-stiffness-predicts-outcome-in-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-implantation
#13
Lorenzo Conte, Iacopo Fabiani, Nicola R Pugliese, Cristina Giannini, Salvatore La Carruba, Marco Angelillis, Paolo Spontoni, Marco De Carlo, Anna Sonia Petronio, Vitantonio Di Bello
OBJECTIVES: Assessment of the prognostic role of left ventricular stiffness (LVS) in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS: We performed a complete two-dimensional transthoracic echocardiographic study before and after TAVI in patients with severe AS at high surgical risk. In order to assess LVS, we measured LV end-diastolic pressure (EDP) invasively during TAVI and LV end-diastolic volume (EDV) by means of echocardiography...
October 25, 2016: Echocardiography
https://www.readbyqxmd.com/read/27776799/relation-between-clinical-best-practices-and-6-month-outcomes-after-transcatheter-aortic-valve-implantation-with-corevalve-from-the-advance-ii-study
#14
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27701369/trans-axillary-versus-trans-aortic-approach-for-transcatheter-aortic-valve-implantation-with-corevalve-revalving-system-insights-from-multicentre-experience
#15
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
https://www.readbyqxmd.com/read/27696659/transcatheter-aortic-valve-implantation-with-a-sapien-3-commander-20-mm-valves-in-patients-with-degenerated-19-mm-bioprosthetic-aortic-valve
#16
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
https://www.readbyqxmd.com/read/27677241/first-north-american-experience-with-the-transfemoral-acurate-neo-tm-self-expanding-transcatheter-aortic-bioprosthesis
#17
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
https://www.readbyqxmd.com/read/27612848/paravalvular-leak-after-transcatheter-aortic-valve-implantation-is-it-anatomically-predictable-or-procedurally-determined-mdct-study
#18
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
https://www.readbyqxmd.com/read/27609682/transcatheter-aortic-valve-replacement-with-early-and-new-generation-devices-in-bicuspid-aortic-valve-stenosis
#19
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
https://www.readbyqxmd.com/read/27587432/percutaneous-device-closure-of-paravalvular-leak-combined-experience-from-the-united-kingdom-and-ireland
#20
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
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