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Heart valve implantation

Ashleigh Long, Paul Mahoney
BACKGROUND: Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement has shown early promise in patients deemed poor surgical candidates as a less invasive alternative to conventional reoperative mitral valve (MV) replacement. OBJECTIVE: This retrospective, single-center study reviewed the procedural outcomes of all TMVIV and TMVIR procedures between 2013-2018 at a large tertiary referral center serving the southeastern United States. An analysis of patient safety measures was also performed, with a retrospective assessment of relative procedural safety that included preoperative risk stratification and postoperative mortality predictors, operative time, average blood loss, length of hospital stay, and readmission rates...
June 15, 2018: Journal of Invasive Cardiology
Kevin M Veen, Rahatullah Muslem, Osama I Soliman, Kadir Caliskan, Marit E A Kolff, Dagmar Dousma, Olivier C Manintveld, Ozcan Birim, Ad J J C Bogers, Johanna J M Takkenberg
OBJECTIVES: Moderate-to-severe tricuspid regurgitation is common in end-stage heart disease and is associated with an impaired survival after left ventricular assist device (LVAD) surgery. Controversy remains whether concomitant tricuspid valve surgery (TVS) during LVAD implantation is beneficial. We aimed to provide a contemporary overview of outcomes in patients who underwent LVAD surgery with or without concomitant TVS. METHODS: A systematic literature search was performed for articles published between January 2005 and March 2017...
April 20, 2018: European Journal of Cardio-thoracic Surgery
Carlijn V C Bouten, Anthal I P M Smits, Frank P T Baaijens
In situ heart valve tissue engineering using cell-free synthetic, biodegradable scaffolds is under development as a clinically attractive approach to create living valves right inside the heart of a patient. In this approach, a valve-shaped porous scaffold "implant" is rapidly populated by endogenous cells that initiate neo-tissue formation in pace with scaffold degradation. While this may constitute a cost-effective procedure, compatible with regulatory and clinical standards worldwide, the new technology heavily relies on the development of advanced biomaterials, the processing thereof into (minimally invasive deliverable) scaffolds, and the interaction of such materials with endogenous cells and neo-tissue under hemodynamic conditions...
2018: Frontiers in Cardiovascular Medicine
L A Nikolenko, E S Shopova, E S Golovneva, E S Nikolenko
Due to current options of cardiac surgery, operations on the heart of elderly patients have become routine in specialized cardiosurgical centers. The issue of pre- and postoperative anemia of different nature is essential in surgical correction of heart valves and coronary bypass. AIM: To study indexes of red blood in elderly patients with ischemic heart disease (IHD) and pathology of heart valves before and after surgical correction, including the relationship with position and type of the prosthesis...
2018: Kardiologiia
Shouzheng Wang, Xu Meng, Zhiling Luo, Xiangbin Pan
We reported a successful beating-heart transapical mitral valve repair in a 78-year-old patient suffering severe mitral regurgitation with prohibitive surgical risk using MitralstitchTM system, a novel device distinguished by its' implanted neochord mimicking the surgical pledgeted suture and the retrievable positioner facilitating leaflet capture. This technology would be a competitive option for high-risk patients with severe mitral regurgitation due to leaflet prolapse.
June 8, 2018: Annals of Thoracic Surgery
Adolfo Ferrero Guadagnoli, Carlotta De Carlo, Francesco Maisano, Edwin Ho, Matteo Saccocci, Oscar Cuevas, Marco Luciani, Shingo Kuwata, Fabian Nietlispach, Maurizio Taramasso
Are the current data on the Cardioband in the clinical area enough to consider it a tool for mitral regurgitation treatment? Severe secondary mitral valve insufficiency frequently affects high-risk surgical patients. The Cardioband system is a novel percutaneous surgical-like device for direct annuloplasty. It is implanted into the beating heart by transvenous femoral access, with minimal impact on hemodynamic and cardiac function during implantation. So far, it has demonstrated safety and feasibility in high-risk patients with functional mitral regurgitation; it has imparted significant annular reduction and regurgitation improvements...
June 7, 2018: Expert Review of Medical Devices
Elise Lupon, Anais Lemaire, Christophe Cron, Bertrand Marcheix
It is well known that a heavily calcified mitral valve significantly increases the perioperative and postoperative risks of mitral valve surgery. A 71-year-old woman was referred to our department with severe mitral valve disease. Cardiac imaging revealed extremely severe calcification of the entire left heart. Surgery was performed through a median sternotomy with standard cardiopulmonary bypass. After dilating the mitral orifice with a balloon, we replaced the valve with a transcatheter Edwards Sapiens 3 aortic valve under direct vision...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
Y-N Xu, T-Y Xiong, Y-J Li, Y-B Liao, Z-G Zhao, X Wei, Y Feng, M Chen
BACKGROUND: Although balloon sizing has been found to be useful during transcatheter aortic valve implantation (TAVI), its effectiveness in patients with bicuspid aortic valve (BiAV) remains unknown. METHODS: Patients who underwent balloon sizing were retrospectively identified. The study comprised 67 patients (61.2% with BiAV). Preprocedural hypothetical transcatheter heart valve (THV) sizing was based on multislice computed tomography (MSCT) measurements at the annulus...
June 5, 2018: Herz
Luke J Rogers, Ian Cox, Malcolm Dalrymple-Hay, Clinton Lloyd
Transcatheter mitral valve implantation is a relatively novel intervention that replaces the mitral valve of individuals deemed too high-risk or unsuitable for surgery. It is associated with a number of specific risks, including left ventricular outflow tract obstruction. In this report, we present the case of a 75-year-old man who was unable to undergo redo surgical repair and had a number of risk factors for left ventricular outflow tract obstruction. To minimize this risk, we deployed transcatheter mitral valve implantation within the anterior mitral valve leaflet resulting in mild mitral valve regurgitation postoperatively and no left ventricular outflow tract obstruction...
June 2, 2018: European Journal of Cardio-thoracic Surgery
David Attias, Mohammed Nejjari, Francesco Nappi, Julien Dreyfus, Mackram F Eleid, Charanjit S Rihal
The optimal management of aortic surgical bioprosthesis presenting with severe symptomatic structural valve deterioration is currently a matter of debate. Over the past 20 years, the number of implanted bioprostheses worldwide has been rapidly increasing at the expense of mechanical prostheses. A large proportion of patients, however, will require intervention for bioprosthesis structural valve deterioration. Current options for older patients who often have severe comorbidities include either transcatheter valve-in-valve (TVIV) implantation or redo valve surgery...
June 2, 2018: European Journal of Cardio-thoracic Surgery
Lucia Musumeci, Nicolas Jacques, Alexandre Hego, Alain Nchimi, Patrizio Lancellotti, Cécile Oury
Aortic Valve Disease (AVD) is the most common Valvular Heart Disease (VHD), affecting millions of people worldwide. Severe AVD is treated in most cases with prosthetic aortic valve replacement, which involves the substitution of the native aortic valve with a prosthetic one. In this review we will discuss the different types of prosthetic aortic valves available for implantation and the challenges faced by patients, medical doctors, researchers and manufacturers, as well as the approaches that are taken to overcome them...
2018: Frontiers in Cardiovascular Medicine
Lucia Manuri, Rita Emanuela Calaciura, Andrea De Zorzi, Lilia Oreto, Massimiliano Raponi, Anja Lehner, Nikolaus Haas, Salvatore Agati
Transcatheter creation or enlargement of an atrial septal defect has been used to promote adequate blood flow and mixing in some forms of congenital heart defects or as a relief valve in right or left atrial hypertension, resulting in better cardiac output and/or systemic saturation. We report a case of a 4-year-old male affected by complex congenital heart disease who was admitted for management of severe cyanosis following a staged pericardial fenestrated Fontan procedure. Transoesophageal echocardiogram showed a wide fenestration of 9 mm in size with a severely dilated pericardial Fontan system...
May 30, 2018: Interactive Cardiovascular and Thoracic Surgery
Fernando de Torres-Alba, Gerrit Kaleschke, Helmut Baumgartner
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Early surgical repair has dramatically improved the outcome of this condition. However, despite the success of contemporary approaches with early complete repair, these are far from being curative and late complications are frequent. The most common complication is right ventricle outflow tract (RVOT) dysfunction, affecting most patients in the form of pulmonary regurgitation, pulmonary stenosis, or both, and can lead to development of symptoms of exercise intolerance, arrhythmias, and sudden cardiac death...
May 30, 2018: Revista Española de Cardiología
Faisal Owdah Alatawi, Reda A Abuelatta, Ahmed B AlAhmedi, Ibraheem H Alharbi, Saleh S Alghamdi, Amal A Sakrana, Osama A Alamodi, Hesham A Naeim
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been recognized as a valid alternative to surgery for severe aortic valve stenosis (AS) in high-risk surgical patients. OBJECTIVE: Determine first-year clinical outcomes for TAVI at Madinah Cardiac Center (MMC) in Saudi Arabia. DESIGN: Retrospective, analytical cross-sectional. SETTING: Tertiary cardiac care center. PATIENTS AND METHODS: All patients who underwent TAVI for severe AS between February 2013 and December 2016 were included...
May 2018: Annals of Saudi Medicine
Cesar Gonzalez de Alba, Fernando Molina Berganza, John Brownlee, Muhammad Khan, Dilachew Adebo
Experience with cardiac magnetic resonance to evaluate coronary arteries in children and young adult patients is limited. Because noninvasive imaging has advantages over coronary angiography, we compared the effectiveness of these techniques in patients who were being considered for percutaneous pulmonary valve implantation. We retrospectively reviewed the cases of 26 patients (mean age, 12.53 ± 4.85 yr; range, 5-25 yr), all of whom had previous right ventricular-to-pulmonary artery homografts. We studied T2-prepared whole-heart images for coronary anatomy, velocity-encoded cine images for ventricular morphology, and function- and time-resolved magnetic resonance angiographic findings...
April 2018: Texas Heart Institute Journal
Anwarul Hasan, Sherif Soliman, Fatima El Hajj, Yuan-Tsan Tseng, Huseyin C Yalcin, Hany Elsayed Marei
Heart valve diseases are among the leading causes of cardiac failure around the globe. Nearly 90,000 heart valve replacements occur in the USA annually. Currently, available options for heart valve replacement include bioprosthetic and mechanical valves, both of which have severe limitations. Bioprosthetic valves can last for only 10-20 years while patients with mechanical valves always require blood-thinning medications throughout the remainder of the patient's life. Tissue engineering has emerged as a promising solution for the development of a viable, biocompatible and durable heart valve; however, a human implantable tissue engineered heart valve is yet to be achieved...
May 29, 2018: Scientific Reports
Lauge Østergaard, Kasper Adelborg, Jens Sundbøll, Lars Pedersen, Emil Loldrup Fosbøl, Morten Schmidt
The positive predictive value of an infective endocarditis diagnosis is approximately 80% in the Danish National Patient Registry. However, since infective endocarditis is a heterogeneous disease implying long-term intravenous treatment, we hypothesiszed that the positive predictive value varies by length of hospital stay. A total of 100 patients with first-time infective endocarditis in the Danish National Patient Registry were identified from January 2010 - December 2012 at the University hospital of Aarhus and regional hospitals of Herning and Randers...
May 30, 2018: Epidemiology and Infection
Christian Kuhn, Christian Frerker, Anne-Kathrin Meyer, Thomas Kurz, Ulrich Schäfer, Florian Deuschl, Mohammed Abdel-Wahab, Dimitry Schewel, Ahmed Elghalban, Karl-Heinz Kuck, Norbert Frey, Derk Frank
AIMS: The recently released Medtronic CoreValve Evolut R 34 mm is the largest self-expanding transcatheter heart valve ever developed. Clinical data for this device size are scarce. We therefore aimed to evaluate the clinical performance and safety of the new device. METHODS AND RESULTS: We report on the first 101 consecutive patients treated with transfemoral transcatheter aortic valve implantation (TAVI) using the 34 mm Evolut R device in a multicentre registry...
June 8, 2018: EuroIntervention
Junji Morita, Masato Fukunaga, Kenichi Hiroshima, Michio Nagashima, Mizuki Miura, Kenji Ando
We report the case of a 74-year-old man with a previously implanted pacemaker lead. He had undergone Medtronic™ Micra Transcatheter Pacing System (TPS, Medtronic plc, MN, USA) implantation because of lead fracture. We implanted a new TPS and retrieved the dislodged one. We used a multiple-loop snare (EN snare® ) and an 8.5F steerable sheath (Agilis NXT; St. Jude Medical, St Paul, MN, USA). The TPS was obstructed by the chordae tendineae of the tricuspid valve and the pacemaker lead. We pushed the TPS to the apex site; this enabled us to move the TPS away from the chordae tendineae and pacemaker lead...
May 25, 2018: Indian Pacing and Electrophysiology Journal
Tomasz Jazwiec, Marcin Malinowski, Alastair G Proudfoot, Lenora Eberhart, David Langholz, Hans Schubert, Jeremy Wodarek, Tomasz A Timek
OBJECTIVES: Clinical and experimental tricuspid valve physiology data are derived predominantly from anesthetized subjects, but normal tricuspid valve geometry and dynamics may be altered by general anesthesia and mechanical ventilation. We set out to investigate 3-dimensional geometry and dynamics of the tricuspid valve complex in awake and anesthetized sheep. METHODS: While on cardiopulmonary bypass and with the heart beating, 6 adult sheep (50 ± 8 kg) underwent implantation of 6 sonomicrometry crystals around the tricuspid annulus...
April 21, 2018: Journal of Thoracic and Cardiovascular Surgery
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