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Aortic paravalvular leak

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https://www.readbyqxmd.com/read/29039313/transcatheter-aortic-valve-replacement-in-patients-with-non-calcific-aortic-stenosis
#1
Tian-Yuan Xiong, Yuan Feng, Yan-Biao Liao, Yi-Jian Li, Zhen-Gang Zhao, Xin Wei, Yuan-Ning Xu, Jia-Fu Wei, Yong Peng, Nicolo Piazza, Darren Mylotte, Mao Chen
AIMS: Limited information exists describing the results of transcatheter aortic valve replacement (TAVR) in patients with symptomatic severe non-calcific aortic stenosis (AS). METHODS AND RESULTS: We retrospectively identified patients with non-calcific AS who received TAVR with self-expanding transcatheter heart valves in our center. Clinical and echocardiographic outcomes, and post-procedural multi-detector computed tomography (MDCT) measures were compared to patients undergoing TAVR for calcific AS...
October 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29033504/procedural-characteristics-and-outcomes-of-transcatheter-aortic-valve-implantation-a-single-center-experience-of-the-first-100-inoperable-or-high-surgical-risk-patients-with-severe-aortic-stenosis
#2
Ying-Hwa Chen, Hsiao-Huang Chang, Po-Lin Chen, Zen-Chung Weng, I-Ming Chen, Hsin-Bang Leu, Chun-Yang Huang, Su-Man Lin, Mei-Han Wu
BACKGROUND: This is the first study of a Taiwanese population reporting transcatheter aortic valve implantation (TAVI) outcomes of the first 100 cases from a single center offering two different transcatheter heart valve technologies via six types of approaches. We herein report the 30-day and one-year outcomes in our first 100 TAVI patients at Taipei Veterans General Hospital. METHODS: From May 2010 to April 2016, 100 consecutive patients with severe aortic stenosis (AS) who were considered unsuitable or at high risk for surgical aortic valve replacement underwent TAVI...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29029105/comparative-performance-of-transcatheter-aortic-valve-in-valve-implantation-versus-conventional-surgical-redo-aortic-valve-replacement-in-patients-with-degenerated-aortic-valve-bioprostheses-systematic-review-and-meta-analysis
#3
Miroslaw Gozdek, Giuseppe Maria Raffa, Piotr Suwalski, Michalina Kolodziejczak, Lech Anisimowicz, Jacek Kubica, Eliano Pio Navarese, Mariusz Kowalewski
The objective of this report was to directly compare, by means of a systematic review and meta-analysis, redo surgical aortic valve replacement (re-sAVR) with valve-in-valve transcatheter aortic valve implantation (ViV TAVI) for patients with failed degenerated aortic bioprostheses. Multiple databases were screened for all available reports comparing ViV TAVI with re-sAVR in patients with failing degenerated aortic bioprostheses. The primary outcome was all-cause mortality determined from the longest available survival data...
September 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28963771/transcatheter-aortic-valve-replacement-for-stenotic-bicuspid-aortic-valves-systematic-review-and-meta-analyses-of-observational-studies
#4
Gautam Reddy, Zhen Wang, Rick A Nishimura, Kevin L Greason, Sung-Han Yoon, Raj R Makkar, David R Holmes
OBJECTIVE: The aim of this study was to perform a systematic review and meta-analyses of observational studies of transcatheter aortic valve replacement (TAVR) for bicuspid aortic valve stenosis (BcAV). BACKGROUND: TAVR for BcAV stenosis has been associated with an increased incidence of paravalvular leaks, valve malposition, pacemaker placement and all-cause mortality. The conclusions drawn have been limited by small sample sizes. The use of TAVR for BcAV stenosis remains controversial...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28957996/meta-analysis-of-sutureless-technology-versus-standard-aortic-valve-replacement-and-transcatheter-aortic-valve-replacement
#5
Saqib H Qureshi, Anas Boulemden, Adam Szafranek, Hunaid Vohra
OBJECTIVES: Aortic valve replacement (AVR) using sutureless technology is a feasible alternative in surgical patients. Comparative evidence against established strategies such as conventional AVR and transcatheter AVR is lacking, limiting the assessment of safety and efficacy. METHODS: Medline search for available evidence was undertaken. The outcomes analysed were 30-day mortality, risk for stroke, myocardial infarction, renal failure, paravalvular leak and need for permanent pacemaker...
September 12, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28941127/a-comparison-of-the-fully-repositionable-and-retrievable-boston-lotus-and-direct-flow-medical-valves-for-the-treatment-of-severe-aortic-stenosis-a-single-center-experience
#6
Francesco Giannini, Azeem Latib, Matteo Montorfano, Neil Ruparelia, Vittorio Romano, Matteo Longoni, Luca Ferri, Richard Jabbour, Antonio Mangieri, Damiano Regazzoli, Marco Ancona, Nicola Buzzatti, Lorenzo Azzalini, Akihito Tanaka, Eustachio Agricola, Alaide Chieffo, Ottavio Alfieri, Antonio Colombo
BACKGROUND: Second generation transcatheter aortic valve implantation (TAVI) devices have been designed to reduce the rate of paravalvular leak (PVL) and other complications. An important technological advancement has been the ability to fully reposition devices to facilitate optimal implantation depth and position to reduce the likelihood of PVL. OBJECTIVES: To compare procedural and 30-day outcomes according to the Valve Academic Research Consortium (VARC)-2 criteria following TAVI with the fully repositionable and retrievable Lotus and DFM devices...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28935328/valve-in-valve-transcatheter-aortic-valve-implantation-a-novel-approach-to-treat-paravalvular-leak
#7
Pranav Loyalka, Kelsey B Montgomery, Tom C Nguyen, Richard W Smalling, Melissa Howe, Keshava Rajagopal
Enlarging or "cracking" a surgical stented bioprosthetic valve during valve-in-valve transcatheter aortic valve implantation (TAVI) increases orifice area, reducing transvalvular energy losses. We demonstrate that TAVI with valve cracking can be used to treat paravalvular leak (PVL) while providing optimal aortic valve physiology. A 61-year-old woman with a history of aortic valve replacement with a stented bioprosthesis presented with heart failure. Transthoracic echocardiography revealed severe prosthetic aortic valve stenosis with PVL and severe regurgitation...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28930078/how-should-i-treat-recurrent-severe-paravalvular-leakage-after-successful-interventional-closure-of-a-symptomatic-paravalvular-leak-with-four-plug-devices-following-complicated-bioprosthetic-aortic-valve-replacement-the-importance-of-closely-monitoring-patients
#8
https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#9
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
#10
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
#11
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
#12
COMPARATIVE STUDY
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...
November 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28879526/intracardiac-echocardiography-for-structural-heart-and-electrophysiological-interventions
#13
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/28874169/transfemoral-versus-transapical-approach-for-transcatheter-aortic-valve-implantation-hospital-outcome-and-risk-factor-analysis
#14
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
#15
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
#16
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/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
#17
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
#18
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/28800985/assessment-of-paravalvular-leak-after-transcatheter-aortic-valve-replacement-transesophageal-echocardiography-compared-with-transthoracic-echocardiography
#19
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/28797431/implantation-and-30-day-follow-up-on-all%C3%A2-4-valve-sizes-within-the-portico-transcatheter-aortic-bioprosthetic-family
#20
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
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