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https://www.readbyqxmd.com/read/28219851/understanding-the-requirements-of-self-expandable-stents-for-heart-valve-replacement-radial-force-hoop-force-and-equilibrium
#1
María Sol Cabrera, Cees W J Oomens, Frank P T Baaijens
A proper interpretation of the forces developed during stent crimping and deployment is of paramount importance for a better understanding of the requirements for successful heart valve replacement. The present study combines experimental and computational methods to assess the performance of a nitinol stent for tissue-engineered heart valve implantation. To validate the stent model, the mechanical response to parallel plate compression and radial crimping was evaluated experimentally. Finite element simulations showed good agreement with the experimental findings...
February 7, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28219555/right-ventricular-outflow-tract-obstruction-due-to-immunoglobulin-g4-related-disease
#2
Masaru Ishida, Taichi Sakaguchi, Shigeru Miyagawa, Hiroyuki Nishi, Yasushi Yoshikawa, Satsuki Fukushima, Ai Kawamura, Takayoshi Ueno, Hatsue Ishibashi-Ueda, Yoshiki Sawa
A 64-year-old man with extensive tumorous infiltration of the pulmonary valve underwent partial resection of a tumor of the right ventricular outflow tract and replacement of the affected valve. A diagnosis of immunoglobulin-G4 related disease of the heart was made based on the immunohistologic findings. One year after the surgical resection, growth of the tumorous mass was observed, and steroid therapy was initiated. He had no sign of tumor progression four years after the steroid therapy.
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28216623/development-of-a-novel-individualized-warfarin-dose-algorithm-based-on-a-population-pharmacokinetic-model-with-improved-prediction-accuracy-for-chinese-patients-after-heart-valve-replacement
#3
Yu-Bin Zhu, Xian-Hua Hong, Meng Wei, Jing Hu, Xin Chen, Shu-Kui Wang, Jun-Rong Zhu, Feng Yu, Jian-Guo Sun
The gene-guided dosing strategy of warfarin generally leads to over-dose in patients at doses lower than 2 mg/kg, and only 50% of individual variability in daily stable doses can be explained. In this study, we developed a novel population pharmacokinetic (PK) model based on a warfarin dose algorithm for Han Chinese patients with valve replacement for improving the dose prediction accuracy, especially in patients with low doses. The individual pharmacokinetic (PK) parameter - apparent clearance of S- and R-warfarin (CLs) was obtained after establishing and validating the population PK model from 296 recruited patients with valve replacement...
February 20, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28214000/comparison-of-results-of-tricuspid-valve-repair-versus-replacement-for-severe-functional-tricuspid-regurgitation
#4
Jeong Yoon Jang, Ran Heo, Sahmin Lee, Joon Bum Kim, Dae-Hee Kim, Sung-Cheol Yun, Jong-Min Song, Jae-Kwan Song, Jae-Won Lee, Duk-Hyun Kang
The optimal decision regarding whether to repair or replace the tricuspid valve (TV) remains controversial in patients with very severe functional tricuspid regurgitation (TR). We sought to compare clinical outcomes of TV repair versus replacement for very severe TR associated with severe TV tethering. We included 96 consecutive patients (20 men, 58 ± 11 years of age) who had both severe tethering of TV and very severe functional TR and consequently underwent TV surgery during left-sided valve surgery. TV repair was performed on 79 patients (repair group), whereas 17 patients underwent TV replacement (replacement group)...
January 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28213846/fixation-of-bovine-pericardium-based-tissue-biomaterial-with-irreversible-chemistry-improves-biochemical-and-biomechanical-properties
#5
H Tam, W Zhang, D Infante, N Parchment, M Sacks, N Vyavahare
Bioprosthetic heart valves (BHVs), derived from glutaraldehyde crosslinked (GLUT) porcine aortic valve leaflets or bovine pericardium (BP), are used to replace defective heart valves. However, valve failure can occur within 12-15 years due to calcification and/or progressive structural degeneration. We present a novel fabrication method that utilizes carbodiimide, neomycin trisulfate, and pentagalloyl glucose crosslinking chemistry (TRI) to better stabilize the extracellular matrix of BP. We demonstrate that TRI-treated BP is more compliant than GLUT-treated BP...
February 17, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28208977/comparison-of-levosimendan-milrinone-and-dobutamine-in-treating-low-cardiac-output-syndrome-following-valve-replacement-surgeries-with-cardiopulmonary-bypass
#6
Sunny, Mohd Yunus, Habib Md Reazaul Karim, Manuj Kumar Saikia, Prithwis Bhattacharyya, Samarjit Dey
INTRODUCTION: Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. AIM: To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. MATERIALS AND METHODS: Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208930/precautionary-measures-for-successful-open-heart-surgery-in-g6pd-deficient-patient-a-case-report
#7
Rupesh Kumar
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is among the most common enzymatic disorders of red blood cells. Cardiac surgeries on this group of individuals are associated with an additional risk in terms of impaired oxygenation, prolonged ventilation and increased risk of haemolysis. These patients have a very low threshold for haemolysis due to oxidative stress. Many commonly used drugs also predispose the individual for haemolysis when they are subjected to surgery. Here we present a known case of G6PD deficient patient with symptoms of breathlessness for the last nine years who was taken for surgery with pre-planned precautionary measures to avoid unnecessary haemolysis...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28206727/results-of-tricuspid-valve-surgery-for-functional-tricuspid-regurgitation-acute-and-long-term-outcomes-and-predictors-of-failure
#8
Alberto Pozzoli, Nicola Buzzatti, Luca Vicentini, Michele De Bonis, Ottavio Alfieri
The assessment and management of tricuspid valve disease evolved significantly in the last decade. Tricuspid regurgitation is a frequent heart valve disease and it is most often secondary, due to annular dilatation and leaflet tethering from right ventricular remodelling. The indications for tricuspid valve surgery are several and mainly related to the underlying disease, to the severity of the regurgitation and to the right ventricular function. Moreover, surgical tricuspid repair has been avoided for years, because of the erroneous concept that tricuspid regurgitation should disappear once the primary pathology on the left heart has been resolved...
February 15, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28203419/diagnosis-of-mitral-valve-cleft-using-real-time-3-dimensional-echocardiography
#9
Xinchun Yuan, Aiyun Zhou, Li Chen, Cheng Zhang, Yan Zhang, Pan Xu
BACKGROUND: Mitral valve cleft (MVC) is the most common cause of congenital mitral insufficiency, and MVC may occur alone or in association with other congenital heart lesions. Direct suture and valvuloplasty are the major and effective treatments for mitral regurgitation (MR) caused by MVC. Therefore, it is important to determine the location and magnitude of the pathological damage due to MVC when selecting a surgical procedure for treatment. This study explored the application value of transthoracic real-time 3-dimensional (3D) echocardiography (RT-3DE) in the diagnosis of MVC...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28201842/minimally-invasive-aortic-root-replacement-with-valved-conduits-through-partial-upper-sternotomy
#10
Julia Hillebrand, Mosab Alshakaki, Sven Martens, Mirela Scherer
Background Minimally invasive surgical access through limited sternotomy reduces trauma and morbidity in cardiosurgical patients. However, until now, it is not the standard access for aortic root replacement. This study details our clinic's experience with minimally invasive implantation of valved conduits through partial upper sternotomy and the comparison to conventional full median sternotomy. Methods Between January 2012 and March 2016, a total of 187 patients underwent aortic root replacement with valved conduits in our department...
February 15, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28197280/predictors-of-permanent-pacemaker-implantation-after-coronary-artery-bypass-grafting-and-valve-surgery-in-adult-patients-in-current-surgical-era
#11
Bandar Al-Ghamdi, Yaseen Mallawi, Azam Shafquat, Alexandra Ledesma, Nadiah AlRuwaili, Mohamed Shoukri, Shahid Khan, Aly Al Sanei
BACKGROUND: Permanent pacemaker (PPM) implantation after cardiac surgery is required in 0.4-6% of patients depending on cardiac surgery type. PPM implantation in the early postoperative period may reduce morbidity and postoperative hospital stay. We performed a retrospective review of electronic medical records of adult patients with coronary artery bypass grafting (CABG), valve surgery, or both, over a 3-year period. Our aim was to identify predictors of PPM requirements and PPM dependency on follow-up in the current surgical era...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194496/impact-of-pulmonary-hypertension-on-outcome-in-patients-with-severe-aortic-stenosis-and-preserved-left-ventricular-ejection-fraction
#12
Julien Magne, Dania Mohty, Alessandro Piccardo, Cyrille Boulogne, Mathieu Deltreuil, Vincent Petitalot, Najmeddine Echahidi, Nicole Darodes, Patrice Virot, Thibaud Damy, Victor Aboyans
AIMS: The prognostic impact of elevated pulmonary arterial pressure (PAP) remains controversial in aortic stenosis (AS) and few studies focused on patients with preserved left ventricular ejection fraction (LVEF). We aimed to investigate the impact of pulmonary hypertension (PH), invasively derived, on survival in severe AS with preserved LVEF. METHODS AND RESULTS: Between 2000 and 2010, 749 patients (74 ± 8 years, 57% males) with preserved LVEF and severe AS without other valvular heart disease underwent cardiac catheterization...
February 14, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28185392/thrombotic-valvular-dysfunction-with-transcatheter-mitral-interventions-for-postsurgical-failures
#13
Marvin H Eng, Adam Greenbaum, Dee Dee Wang, Janet Wyman, Dnp, Heider Arjomand, Pradeep Yadav, Hassan Nemeh, Gaetano Paone, Mayra Guerrero, William O'Neill
BACKGROUND: Degenerated surgical mitral valve repairs or surgical prostheses are currently being treated with transcatheter mitral valve replacement (TMVR). We report the procedural and mid-term assessment of thirteen cases. METHODS: From 12/2013 to 12/2015, 13 consecutive patients with degenerated mitral valve repair or valve replacement were treated. Patients were assessed for mitral valve academic valve consortium (MVARC) defined outcomes. RESULTS: Immediate procedural MVARC defined technical success was 92%...
February 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28182589/bicuspid-aortic-valve-aortopathy-mechanistic-and-clinical-insights-from-recent-studies
#14
David G Guzzardi, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy. RECENT FINDINGS: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28179592/five-year-clinical-outcome-of-asymptomatic-vs-symptomatic-severe-aortic-stenosis-after-aortic-valve-replacement
#15
Shinichi Shirai, Tomohiko Taniguchi, Takeshi Morimoto, Kenji Ando, Kengo Korai, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Tsukasa Inada, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Katsuhisa Ishii, Naritatsu Saito, Kazuo Yamanaka, Noboru Nishiwaki, Hiroyuki Nakajima, Toshihiko Saga, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Hitoshi Kitayama, Ryuzo Sakata, Takeshi Kimura
BACKGROUND: There is discordance regarding the effect of symptom status before aortic valve replacement (AVR) on long-term outcome after AVR in severe aortic stenosis (AS).Methods and Results:The CURRENT AS registry is a multicenter retrospective registry enrolling 3,815 consecutive patients with severe AS. Among 1,196 patients managed with the initial AVR strategy, long-term clinical outcomes were compared between the symptomatic patients (n=905), and asymptomatic patients (n=291)...
February 9, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28174055/transcatheter-jenavalve-implantation-in-a-stentless-prosthesis-a-challenging-case-after-4-previous-aortic-procedures
#16
Sandro Sponga, Enzo Mazzaro, Rodrigo Bagur, Ugolino Livi
A 40-year-old man underwent 4 aortic surgeries because of endocarditis and subsequent prosthesis dehiscence. At the last recurrence he presented with acute severe aortic regurgitation of a Pericarbon Freedom (LivaNova plc, London, UK) stentless bioprosthesis and a morphologically disarranged aortic root. He also presented with left ventricular dysfunction and a very low origin of the left coronary artery. Therefore, a fifth redo aortic valve replacement was considered at high surgical risk. Accordingly, before listing the patient for a heart transplantation, a transcatheter valve-in-valve implantation with the JenaValve (JenaValve Technology, GmbH, Munich, Germany) prosthesis was performed...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28171828/leukocytoclastic-vasculitis-associated-with-endocarditis-in-a-patient-with-transposition-of-the-great-arteries-and-mechanical-valve-replacement
#17
Christian Riehle, Gesine M Scharf, Jan-Thorben Sieweke, Florian Zauner, Ulrike Flierl, Jens Treptau, Christos Zormpas, Jana Senf, Nicholas S McCarty, Johann Bauersachs, Daniel G Sedding, Mechthild Westhoff-Bleck
Immunological vascular phenomena can be the initial manifestation of bacterial infection and endocarditis. Here, we report a rare case of leukocytoclastic vasculitis without immune complexes or cryoglobulinemia in a patient with infective endocarditis, congenital heart disease, and a prior mechanical valve replacement. The patient completely recovered following antibiotic therapy, and skin lesions disappeared without immune suppression, which suggested infection-mediated vasculitis. While the treatment of leukocytoclastic vasculitis typically involves immunosuppressive therapy, the treatment for infection-mediated vasculitis is eradication of the infection...
January 24, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28153625/ruptured-mycotic-aneurysm-and-cerebral-vasospasm-in-the-setting-of-endocarditis-and-heart-failure-requiring-cardiothoracic-surgery-case-report-and-review
#18
Chih-Ta Lin, Bruce Tranmer, Susan Durham, David Johnson, Mark Hamlin, R Morton Bolman
BACKGROUND: Ruptured mycotic aneurysm in the setting of cardiac failure and cerebral vasospasm presents unique management challenges. CASE DESCRIPTION: The authors describe a case of a ruptured mycotic aneurysm with subarachnoid hemorrhage (SAH), cerebral vasospasm, and endocarditis with heart failure who successfully underwent craniotomy, neuro-endovascular treatments, and cardiopulmonary bypass for mitral valve replacement while in cerebral vasospasm. This case highlights the clinical management strategies of a patient with a ruptured mycotic aneurysm, SAH, cerebral vasospasm, endocarditis, and heart failure...
January 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28151531/-cognitive-and-quality-of-life-trajectory-after-either-surgical-or-transcatheter-aortic-valve-replacement-in-high-risk-patients
#19
Cristina Ciuca, Daniela Fortuna, Susy Ferrari, Stefano Salizzoni, Enrica Grisoglio, Giuseppe Punta, Stefano Del Ponte, Tiziana Claudia Aranzulla, Davide Gabbieri, Caterina Gandolfo, Flavia Dispensa, Lavinia Vecchio Verderame, Corrado Tamburino, Cinzia Caruso, Claudio Grossi, Elisa Mikus, Vincenzo Guiducci, Roberto Violini, Silvia Rongoni, Claudia Pandolfi, Carolina Moretti, Rossana De Palma, Rabih Chattat, Carlo Savini, Antonio Marzocchi, Francesco Saia
RATIONALE: The impact of transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (AVR) on cognitive status and quality of life in high-risk patients has been incompletely investigated. METHODS: We conducted a prospective, multicenter study including all patients treated with TAVI and high-risk patients undergoing AVR (age ≥80 years or logistic EuroSCORE ≥15%) at participating centers. Multidimensional geriatric evaluation including Mini Mental State Examination (MMSE), EuroQol 5D (EQ5D) and Minnesota Living With Heart Failure Questionnaire (MLHFQ) were performed at baseline and at 3- and 12-month follow-up...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28151005/allograft-heart-valves-current-aspects-and-future-applications
#20
Milan Lisy, Guenay Kalender, Katja Schenke-Layland, Kelvin G M Brockbank, Anna Biermann, Ulrich Alfred Stock
Human heart valve allografts continue to represent almost perfect substitutes for heart valves. They have optimal hemodynamic characteristics and are highly resistant to infections. The first clinical use of allograft heart valves was as homovitals being transplanted after antibiotic incubation without any preservation. Since 1968, relatively standardized frozen cryopreservation (SFC) has been employed, including storage in vapor-phase liquid nitrogen. Disadvantages, particularly in pediatric patients, are limited availability due to organ scarcity, inability to grow, degeneration, immune response, and long-term failure...
February 2, 2017: Biopreservation and Biobanking
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