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Aortic paravalvular leak

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https://www.readbyqxmd.com/read/29469031/ad-hoc-percutaneous-paravalvular-leak-closure-after-transcatheter-aortic-valve-replacement-facilitated-by-integrated-multimodality-imaging
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/29348006/importance-of-contrast-aortography-with%C3%A2-lotus-transcatheter-aortic-valve-replacement-a-post-hoc-analysis-from-the-respond-post-market-study
#9
Lennart van Gils, Jochen Wöhrle, David Hildick-Smith, Sabine Bleiziffer, Daniel J Blackman, Mohamed Abdel-Wahab, Ulrich Gerckens, Stephen Brecker, Vinayak Bapat, Thomas Modine, Osama I Soliman, Andrey Nersesov, Dominic Allocco, Volkmar Falk, Nicolas M Van Mieghem
OBJECTIVES: The aim of this post hoc analysis from the RESPOND (Repositionable Lotus Valve System-Post-Market Evaluation of Real World Clinical Outcomes) post-market study was to assess the final implantation depth on the contrast aortogram after Lotus valve (Boston Scientific, Marlborough, Massachusetts) transcatheter aortic valve replacement (TAVR) and to correlate with permanent pacemaker implantation (PPI) and paravalvular leak (PVL). BACKGROUND: Contrast aortography allows for the assessment of implantation depth and PVL during and after TAVR...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29315371/computed-tomography-characteristics-of-the-aortic-valve-and-the-geometry-of-sapien-3-transcatheter-heart-valve-in-patients-with-bicuspid-aortic-valve-disease
#10
Hiroyuki Kawamori, Sung-Han Yoon, Tarun Chakravarty, Yoshio Maeno, Mohammad Kashif, Sharjeel Israr, Yigal Abramowitz, Geeteshwar Mangat, Masaki Miyasaka, Tanya Rami, Yoshio Kazuno, Nobuyuki Takahashi, Hasan Jilaihawi, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Rahul Sharma, Raj R Makkar
Aims: We assessed the geometry of transcatheter heart valve (THV) and valve function associated with SAPIEN 3 implantation in patients with bicuspid aortic valve (BAV) stenosis. Methods and results: We included 280 consecutive patients who had a contrast computed tomography (CT) before and after transcatheter aortic valve implantation (TAVI) in our institution. Each THV was assessed by CT at five cross-sectional levels: inflow, annulus, mid, sinus, and outflow. The geometry of THV was assessed for eccentricity (1 - minimum diameter/maximum diameter) and expansion (CT derived external valve area/nominal external valve area)...
January 5, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29311499/transcatheter-aortic-valve-implantation-tavi-for-native-aortic-valve-regurgitation%C3%A3-a-systematic-review
#11
Altayyeb Yousef, Zachary MacDonald, Trevor Simard, Juan J Russo, Joshua Feder, Michael V Froeschl, Alexander Dick, Christopher Glover, Ian G Burwash, Azeem Latib, Josep Rodés-Cabau, Marino Labinaz, Benjamin Hibbert
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the standard of care for management of high-risk patients with aortic stenosis. Limited data is available regarding the performance of TAVI in patients with native aortic valve regurgitation (NAVR).Methods and Results:We performed a systematic review from 2002 to 2016. The primary outcome was device success as per VARC-2 criteria. Secondary endpoints included procedural complications, and 30-day and 1-year mortality rates...
December 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29297188/primary-safety-and-effectiveness-feasibility-study-after-surgical-aortic-valve-replacement-with-a-new-generation-bioprosthesis-one-year-outcomes
#12
Krzysztof Bartus, Radosław Litwinowicz, Mariusz Kusmierczyk, Agata Bilewska, Maciej Bochenek, Maciej Stapor, Sebastian Wozniak, Jacek Rozanski, Jerzy Sadowski, Boguslaw Kapelak
BACKGROUND: Structural valve deterioration (SVD) is a major obstacle to lifetime durability for bioprosthetic heart valves. Bioprosthetic valve created with RESILIA™ tissue was designed to produce long-term resistance to SVD. AIM: The objective of this study was to evaluate the safety and performance of this new class of RESILIA™ tissue aortic bioprosthesis. METHODS: A nonrandomized, prospective, multi-center, single-arm, observational study was performed in 133 patients who underwent surgical aortic valve replacement between July 2011 and February 2013...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29281606/expanding-indications-for-tavr-the-preferred-procedure-in-intermediate-risk-patients
#14
REVIEW
David L Brown
Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29276437/continuous-suture-technique-for-aortic-valve-replacement-shortens-cross-clamp-and-bypass-times
#15
Tadashi Kitamura, James Edwards, Kagami Miyaji
The interrupted noneverting mattress suture technique is typically used in conventional surgical aortic valve replacement. The continuous suture technique, although faster, has been associated with a higher incidence of paravalvular leak. Using a slightly modified technique to minimize this risk, we investigated whether continuous suturing would shorten aortic cross-clamp time in aortic valve replacement in comparison with interrupted suturing. We reviewed the cases and compared the perioperative data of 60 consecutive patients in Japan and Australia (35 men and 25 women; median age, 70 yr) who had undergone aortic valve replacement with or without septal myectomy...
December 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/29234617/transcatheter-mitral-valve-implantation-in-open-heart-surgery-an-off-label-technique
#16
Jacopo Alfonsi, Giacomo Murana, Anna Corsini, Carlo Savini, Roberto Di Bartolomeo, Davide Pacini
Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova SOLO; LivaNova PLC, London, UK)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29207365/thirty-day-outcomes-in-100-consecutive-patients-undergoing-transfemoral-aortic-valve-replacement-with-the-portico-valve-on-an-all-comer-basis
#17
Silvia Mas-Peiro, Mariuca Vasa-Nicotera, Helge Weiler, Nestoras Papadopoulos, Roberta De Rosa, Andreas M Zeiher, Stephan Fichtlscherer
OBJECTIVES: Transcatheter heart valves such as the self-expandable Portico valve (St. Jude Medical) are being developed to overcome limitations of first-generation devices. Since clinical experience with this valve is still limited in a real-world setting, we investigated its use on an all-comer basis. METHODS: Between October 2015 and October 2016, a total of 100 consecutive patients assessed for transcatheter aortic valve replacement (TAVR) and found suitable for the Portico valve were included...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29185181/efficacy-and-safety-of-transcatheter-aortic-valve-implantation-with-edwards-sapien-3-and-xt-in-smaller-asian-anatomy
#18
Makoto Nakashima, Yusuke Watanabe, Hirofumi Hioki, Yugo Nara, Fukuko Nagura, Naoyoshi Hosogoe, Hideyuki Kawashima, Akihisa Kataoka, Shuji Otsuki, Kumiko Konno, Hiroyuki Kyono, Naoyuki Yokoyama, Ken Kozuma
We aimed to compare the efficacy and safety of transcatheter aortic valve implantation (TAVI) using Edwards SAPIEN 3 (S3) valve and SAPIEN XT) in smaller anatomy. The new generation S3 TAVI device has been used worldwide; however, its efficacy and safety in smaller Asian anatomy remain unknown. Between February 2014 and March 2017, 166 consecutive patients (S3, 54; XT, 112) were treated with balloon-expandable TAVI in a single center and their outcomes were analyzed. Median patient age was 85 (range: 81-88) years and mean body surface area was 1...
November 28, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29174775/novel-automated-suturing-technology-for-minimally-invasive-aortic-valve-replacements
#19
Joshua K Wong, Amber L Melvin, Juan A Siordia, Devang J Joshi, Jude S Sauer, Peter A Knight
PURPOSE: Annular suture placement during minimally invasive right anterior thoracotomy aortic valve replacements (MI-AVR) can be challenging. We present the early clinical experience with novel automated suturing technology that may reduce the technical difficulty of this operation. DESCRIPTION: The technology presented involves an automated articulating suturing device that simultaneously drives dual-curved needles through the aortic annulus to place a pledgeted horizontal mattress suture remotely; a second device with 2 straight needles places suture through the sewing cuff of a prosthetic heart valve...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29168984/transcatheter-vs-surgical-aortic-valve-replacement-in-low-to-intermediate-surgical-risk-candidates-a-meta-analysis-and-systematic-review
#20
REVIEW
Safi U Khan, Ahmad N Lone, Muhammad A Saleem, Edo Kaluski
The American and European expert documents recommend transcatheter aortic valve replacement (TAVR) for inoperable or high-surgical-risk patients with severe aortic stenosis. In comparison, efficacy of TAVR is relatively less studied in low- to intermediate-surgical-risk patients. We sought to discover whether TAVR can be as effective as surgical aortic valve replacement (SAVR) in low- to intermediate-surgical-risk candidates. Four randomized clinical trials (RCTs) and 8 prospective matched studies were selected using PubMed/MEDLINE, Embase, and Cochrane Library (inception: March 2017)...
November 23, 2017: Clinical Cardiology
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