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https://www.readbyqxmd.com/read/28441151/recent-clinical-trials-in-valvular-heart-disease
#1
Daniel Kiss, Saif Anwaruddin
PURPOSE OF REVIEW: With widespread adoption of transcatheter aortic valve replacement, there has been a change in the approach to management of valvular heart disease. New interest has taken hold in transcatheter therapies for valvular heart disease, as well as research into pathophysiology and progression of disease. Additionally, several key trials have further refined our understanding of surgical management of valvular heart disease. This review will elucidate recent clinical trial data leading to changes in practice...
April 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28427320/the-role-of-inelastic-deformations-in-the-mechanical-response-of-endovascular-shape-memory-alloy-devices
#2
Lorenza Petrini, Alessandro Bertini, Francesca Berti, Giancarlo Pennati, Francesco Migliavacca
Nickel-titanium alloys are commonly adopted for producing cardiovascular minimally invasive devices such as self-expandable stents, aortic valves and stent-grafts. These devices are subjected to cyclic loads (due to blood pulsatility, leg or heart movements), that can induce fatigue fracture, and may also be subjected to very large deformations (due to crimping procedure, a tortuous physiological path or overloads), that can induce material yield. Recently, the authors developed a new constitutive model that considers inelastic strains due to not-completed reverse phase transformation (not all the stress-induced martensite turns back to austenite) or/and plasticity and their accumulation during cyclic loads...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#3
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28408203/surgeon-involvement-in-transcatheter-aortic-valve-replacement-in-the-united-states-a-2016-society-of-thoracic-surgeons-survey
#4
Joseph E Bavaria, Richard L Prager, Keith S Naunheim, Mark S Allen, Robert S D Higgins, Vinod H Thourani, Thomas E MacGillivray, Natalie Boden, Joseph F Sabik
BACKGROUND: The Society of Thoracic Surgeons (STS) surveyed cardiothoracic surgeon participants in its Adult Cardiac Surgery Database (ACSD) to learn the extent of surgeon involvement in transcatheter aortic valve replacement (TAVR) procedures. METHODS: An electronic survey was delivered to 2,594 surgeons in June 2016. When the survey closed 2 weeks later, 487 completed surveys had been submitted for a response rate of 18.8%. RESULTS: Among the 487 participants in the ACSD who responded to the survey, 410 (84...
April 6, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28400461/matched-comparison-of-self-expanding-transcatheter-heart-valves-for-the-treatment-of-failed-aortic-surgical-bioprosthesis-insights-from-the-valve-in-valve-international-data-registry-vivid
#5
Sami Alnasser, Asim N Cheema, Matheus Simonato, Marco Barbanti, Jeremy Edwards, Ran Kornowski, Eric Horlick, Harindra C Wijeysundera, Luca Testa, Francesco Bedogni, Hafid Amrane, Thomas Walther, Marc Pelletier, Azeem Latib, Jean-Claude Laborde, David Hildick-Smith, Won-Keun Kim, Didier Tchetche, Marco Agrifoglio, Jan-Malte Sinning, Ad J van Boven, Joëlle Kefer, Christian Frerker, Nicolas M van Mieghem, Axel Linke, Stephen Worthley, Anita Asgar, Carmelo Sgroi, Mina Aziz, Haim D Danenberg, Marino Labinaz, Ganesh Manoharan, Anson Cheung, John G Webb, Danny Dvir
BACKGROUND: Transcatheter valve-in-valve implantation is an established therapy for high-risk patients with failed surgical aortic bioprosthesis. There are limited data comparing outcomes of valve-in-valve implantation using different transcatheter heart valves (THV). METHODS AND RESULTS: Patients included in the Valve-in-Valve International Data registry (VIVID) and treated with self-expanding THV devices were analyzed using centralized core laboratory blinded to clinical events...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28395281/the-role-of-stress-echocardiography-in-valvular-heart-disease-a-current-appraisal
#6
James L Gentry Iii, Dermot Phelan, Milind Y Desai, Brian P Griffin
Stress echocardiography is a widely available, safe, low-cost, versatile imaging modality which is becoming increasingly recognized as a valuable tool in the assessment of patients with native and prosthetic left-sided valvular heart disease. It provides a quantitative assessment to help guide clinical decision-making when discordance exists between symptoms and severity of valve disease. Exercise (treadmill or bicycle) remains the preferred stress modality, but pharmacological augmentation with dobutamine can be used if needed...
April 11, 2017: Cardiology
https://www.readbyqxmd.com/read/28385406/clinical-bioprosthetic-heart-valve-thrombosis-after-transcatheter-aortic%C3%A2-valve-replacement-incidence-characteristics-and-treatment-outcomes
#7
John Jose, Dmitriy S Sulimov, Mohamed El-Mawardy, Takao Sato, Abdelhakim Allali, Erik W Holy, Björn Becker, Martin Landt, Julia Kebernik, Bettina Schwarz, Gert Richardt, Mohamed Abdel-Wahab
OBJECTIVES: The aim of this study was to determine the incidence, characteristics, and treatment outcomes of patients diagnosed with clinical transcatheter heart valve thrombosis. BACKGROUND: Limited data exists on clinical or manifest transcatheter heart valve thrombosis. Prior studies have focused on subclinical thrombosis. METHODS: A retrospective analysis was conducted of prospectively collected data from a single-center registry that included 642 consecutive patients who underwent transcatheter aortic valve replacement between 2007 and 2015 (305 patients had self-expanding valves; balloon-expandable, n = 281; mechanically expanding, n = 56)...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28379385/five-year-evolution-of-mild-aortic-regurgitation-following-transcatheter-aortic-valve-implantation-early-insights-from-a-single-centre-experience
#8
Nicola Buzzatti, Alessandro Castiglioni, Eustachio Agricola, Marta Barletta, Stefano Stella, Francesco Giannini, Damiano Regazzoli, Antonio Mangieri, Marco Ancona, Pietro Spagnolo, Alaide Chieffo, Matteo Montorfano, Ottavio Alfieri, Antonio Colombo, Azeem Latib
OBJECTIVES: To assess the follow-up evolution and impact of mild aortic regurgitation (1 + AR) following transcatheter aortic valve implantation (TAVI). METHODS: We evaluated the follow-up outcomes and AR evolution of 558 patients affected by native aortic stenosis who underwent TAVI with residual AR ≤ 1+. RESULTS: No residual AR was found in 294 (52.7%) patients, whereas 1 + AR was found in 264 (47.3%) patients. At 5.5 years, freedom from all-cause mortality (56...
March 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28377025/diastolic-mitral-regurgitation-following-transcatheter-aortic-valve-replacement-incidence-predictors-and-association-with-clinical-outcomes
#9
Nir Flint, Zach Rozenbaum, Simon Biner, Gad Keren, Shmuel Banai, Ariel Finkelstein, Yan Topilsky, Amir Halkin
BACKGROUND: Diastolic mitral regurgitation (DMR) results from atrioventricular conduction disturbances, acute aortic regurgitation, and/or marked elevation of left ventricular filling pressure. Generally benign, in some clinical circumstances DMR has presumed to result in hemodynamic decompensation. The aforementioned causes of DMR are frequently encountered in patients treated by transcatheter aortic valve replacement (TAVR) but its clinical significance in this setting has not been studied...
April 1, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28374279/design-analysis-and-testing-of-a-novel-mitral-valve-for-transcatheter-implantation
#10
Selim Bozkurt, Georgia L Preston-Maher, Ryo Torii, Gaetano Burriesci
Mitral regurgitation is a common mitral valve dysfunction which may lead to heart failure. Because of the rapid aging of the population, conventional surgical repair and replacement of the pathological valve are often unsuitable for about half of symptomatic patients, who are judged high-risk. Transcatheter valve implantation could represent an effective solution. However, currently available aortic valve devices are inapt for the mitral position. This paper presents the design, development and hydrodynamic assessment of a novel bi-leaflet mitral valve suitable for transcatheter implantation...
April 3, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28373593/maternal-antihypertensive-medication-use-and-congenital-heart-defects-updated-results-from-the-national-birth-defects-prevention-study
#11
Sarah C Fisher, Alissa R Van Zutphen, Martha M Werler, Angela E Lin, Paul A Romitti, Charlotte M Druschel, Marilyn L Browne
Previous NBDPS (National Birth Defects Prevention Study) findings from 1997 to 2003 suggested that maternal antihypertensive use was associated with congenital heart defects (CHDs). We re-examined associations between specific antihypertensive medication classes and specific CHDs with additional NBDPS data from 2004 to 2011. After excluding mothers missing hypertension information or who reported pregestational diabetes mellitus, a multiple birth, or antihypertensive use but no hypertension, we compared self-reported maternal exposure data on 10 625 CHD cases and 11 137 nonmalformed controls...
April 3, 2017: Hypertension
https://www.readbyqxmd.com/read/28370213/left-ventricular-basal-inferior-pseudoaneurysm-and-left-atrial-dissection-after-myocardial-infarction-case-report
#12
Rui Azevedo Guerreiro, Kisa Congo, João Carvalho, João Pais, Diogo Brás, Bruno Piçarra, Agostinho Caeiro, José Aguiar
Left atrial dissection is a rare entity, mostly occurring after mitral valve surgery, with only a few cases described after myocardial infarction. The authors report a case of a 60-year-old man who presented with an inferior myocardial infarction, complicated with pseudoaneurysm of basal segment of left ventricular inferior wall, which expanded through the mitral ring to left atria, causing left atrial free wall dissection. The left ventriculo-atrial communication through the pseudoaneurysm caused major para-mitral regurgitation and the development of acute heart failure...
March 31, 2017: Echocardiography
https://www.readbyqxmd.com/read/28353137/high-risk-trans-catheter-aortic-valve-replacement-in-a-failed-freestyle-valve-with-low-coronary-height-a-case-report
#13
Ashkan Karimi, Negiin Pourafshar, George Dibu, Thomas M Beaver, Anthony A Bavry
A 55-year-old male with a history of two prior cardiac surgeries presented with decompensated heart failure due to severe bioprosthetic aortic valve insufficiency. A third operation was viewed prohibitively high risk and valve-in-valve trans-catheter aortic valve replacement was considered. There were however several high-risk features and technically challenging aspects including low coronary ostia height, poor visualization of the aortic sinuses, and difficulty in identification of the coplanar view due to severe aortic insufficiency, and a highly mobile aortic valve mass...
March 28, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28347726/expanding-the-cardiac-spectrum-of-noonan-syndrome-with-rit1-variant-left-main-coronary-artery-atresia-causing-sudden-death
#14
Francis Ramond, Sébastien Duband, Pierre Croisille, Hélène Cavé, Georges Teyssier, Véronique Adouard, Renaud Touraine
Noonan syndrome is a well-known genetic condition associating congenital heart defects, short stature, and distinctive facial features. Pulmonary valve stenosis and hypertrophic cardiomyopathy are the most frequent cardiac abnormalities, the latter being associated with a higher mortality. Here we report for the first time, a case of congenital left main coronary artery atresia in a Noonan syndrome associated with RIT1 variant, leading to unrescued sudden death. This case-report supports the already-suspected severity of the RIT1-related Noonan syndrome compared to average Noonan syndrome, and should encourage clinicians to be very cautious with these patients...
March 24, 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28329312/first-experience-with-transfemoral-transcatheter-aortic-valve-implantation-without-prior-balloon-pre-dilatation-using-a-latest-generation-repositionable-and-retrievable-transcatheter-heart-valve%C3%A2
#15
Andreas Schaefer, Eva Harmel, Moritz Seiffert, Daniel Reichart, Florian Deuschl, Niklas Schofer, Yvonne Schneeberger, Stefan Blankenberg, Hermann Reichenspurner, Ulrich Schaefer, Lenard Conradi
OBJECTIVES: : The aim of this study was to prove technical feasibility and document haemodynamic and clinical outcomes of transcatheter aortic valve implantation (TAVI) with the latest generation repositionable and retrievable Lotus™ transcatheter heart valve (THV) without prior balloon-aortic valvuloplasty (BAV). It has been demonstrated for self-expandable and balloon-expandable THV that implantation without prior BAV is not only feasible and safe but also results in lower fluoroscopy times and amounts of contrast agent while yielding non-inferior haemodynamic and clinical outcome...
February 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28329078/apical-closure-device-for-full-percutaneous-transapical-valve-implantation-stress-test-in-an-animal-model%C3%A2
#16
Enrico Ferrari, Stefanos Demertzis, Jennifer Angelella, Denis Berdajs, Piergiorgio Tozzi, Tiziano Moccetti, Francesco Maisano, Ludwig K von Segesser
OBJECTIVES: Transapical valve implantation is traditionally performed through a left antero-lateral mini-thoracotomy. A self-expandable apical closure device has recently been developed for full-percutaneous transapical valve implantation. We performed haemodynamics stress-tests on an animal model to evaluate the sealing properties. METHODS: Under general anaesthesia 5 pigs (mean weight: 67 ± 6 Kg) received full heparinization (100 IU/Kg; activated clotting time >250 s and, through inferior mini-sternotomies, 21-Fr introducer sheaths for transapical aortic valve implantation (outer diameter: 25-Fr) were placed over-the-wire in the apexes...
January 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28321003/midterm-outcomes-with-a-self-expandable-transcatheter-heart-valve-in-japanese-patients-with-symptomatic-severe-aortic-stenosis
#17
Yoshiki Sawa, Kei Torikai, Junjiro Kobayashi, Hiroshi Niinami, Toru Kuratani, Koichi Maeda, Hideaki Kanzaki, Nobuyuki Komiyama, Yutaka Tanaka, Angie Zhang, Shigeru Saito
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a viable alternative to surgical aortic valve replacement in high-risk or inoperable patients with aortic stenosis (AS). Here we report the midterm outcomes of high-risk Japanese patients with severe AS who underwent TAVI with a self-expandable TAV.Methods and Results:The CoreValve Japan Trial was a prospective, multicenter trial of the CoreValve System. A group of 55 patients (mean age 82.5±5.5 years, 30.9% male, 100% NYHA class III/IV, STS 8...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28296065/direct-percutaneous-transaxillary-implantation-of-a-novel-self-expandable-transcatheter-heart-valve-for-aortic-stenosis
#18
Florian Deuschl, Niklas Schofer, Moritz Seiffert, Samer Hakmi, Isamu Mizote, Andreas Schaefer, Johannes Schirmer, Hermann Reichenspurner, Stefan Blankenberg, Lenard Conradi, Ulrich Schäfer
OBJECTIVES: The aim of this study was to evaluate safety, feasibility, and efficacy of transaxillary TAVI using a novel self-expandable transcatheter heart valve (THV) via a direct percutaneous technique. METHODS: The analysis comprises 12 consecutive patients with severe aortic stenosis treated with the ACURATE Neo™ THV (Symetis) by direct percutaneous transaxillary access. RESULTS: Patients presented with a mean age of 79.9 ± 6.2 years and high calculated surgical risk (logEuroSCORE I: 19...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28279501/long-term-follow-up-after-trans-catheter-tricuspid-valve-in-valve-replacement-with-balloon-expandable-aortic-valves
#19
Roberto Scarsini, Mattia Lunardi, Gabriele Pesarini, Fausto Castriota, Mauro Feola, Valeria Ferrero, Giuseppe Faggian, Corrado Vassanelli, Flavio Ribichini
BACKGROUND: Transcatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon-expandable aortic valve stents and the long-term follow-up. METHODS AND RESULTS: From January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28277266/long-term-follow-up-of-patients-with-severe-aortic-stenosis-treated-with-a-self-expanding-prosthesis
#20
Pablo Avanzas, Isaac Pascual, Antonio J Muñoz-García, José Segura, Juan H Alonso-Briales, Javier Suárez de Lezo, Manuel Pan, Manuel F Jiménez-Navarro, José López-Aguilera, José M Hernández-García, César Morís
INTRODUCTION AND OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is a safe and effective alternative to surgical treatment in patients with severe aortic stenosis (AS) and those who are inoperable or at high surgical risk. The primary objective of this study was to evaluate the long-term survival of consecutive patients with severe AS treated with TAVI. METHODS: Observational, multicenter, prospective, follow-up study of consecutive patients with severe symptomatic AS treated by TAVI in 3 high-volume hospitals in Spain...
October 28, 2016: Revista Española de Cardiología
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