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Expandable heart valves

Timm Schäfer, Christian Doose, Buntaro Fujita, Marc Utzenrath, Sandrine Egron, Christoph Schmitz, Smita Scholtz, Maximilian Kütting, Kavous Hakim-Meibodi, Jochen Börgermann, Jan Gummert, Ulrich Steinseifer, Stephan Ensminger
AIMS: The aim was to determine the best functional position of a transcatheter heart valve (THV) implanted as a valve-in-valve (ViV) procedure in small rapid deployment valves (RDV) in an in vitro model. METHODS AND RESULTS: A 21mm Perceval™, Enable™ or INTUITY™ RDV was mounted into a pulse duplicator and a 23mm balloon-expandable or a self-expanding THV was deployed (valve-in-valve) in two different positions. Under physiological hydrodynamic conditions, performance of the THV was characterized by mean transvalvular pressure gradient (MPG), effective orifice area (EOA) and regurgitation volume (RV)...
October 18, 2016: EuroIntervention
Girish Manjunath, Prakash Rao, Nagendra Prakash, B K Shivaram
Recent data from landmark trials suggest that the indications for cardiac pacing and implantable cardioverter defibrillators (ICDs) are set to expand to include heart failure, sleep-disordered breathing, and possibly routine implantation in patients with myocardial infarction and poor ventricular function.[1] This will inevitably result in more patients with cardiac devices undergoing surgeries. Perioperative electromagnetic interference and their potential effects on ICDs pose considerable challenges to the anesthesiologists...
October 2016: Annals of Cardiac Anaesthesia
Uri Landes, Alexander Sagie, Ran Kornowski
Sutureless aortic bioprostheses (SAB) are increasingly being used to provide shorter cross-clamp time. Valve-in-valve transcatheter aortic valve replacement (VIV-A) is shown to be effective and safe in the vast majority of patients with degenerated bioprosthetics, yet its' use in SAB failure is infrequent. We present a case of balloon-expandable VIV-A in an 80-year-old woman who suffered severe symptomatic aortic regurgitation in a failed Perceval S 21-mm valve. Computed tomography scan demonstrated a deformed valve...
October 3, 2016: Catheterization and Cardiovascular Interventions
Bettina Langhammer, Christoph Huber, Stephan Windecker, Thierry Carrel
Surgical techniques for the treatment of mitral valve disease (MVD) have continuously evolved; however, anatomical details like severe annular calcification remain challenging and require sophisticated surgical strategies. Among patients with symptomatic MVD referred for surgical valve repair or replacement, four presented with circumferential calcification of the mitral annulus precluding conventional surgical techniques. Successful treatment by implanting a balloon-expandable transcatheter aortic heart valve using an antegrade surgical access was performed...
September 27, 2016: European Journal of Cardio-thoracic Surgery
Maurizio Taramasso, Azeem Latib, Paolo Denti, Fabian Nietlispach, Kevin Lynn, Nikola Cesarovic, Alessandro Addis, Maximilian Y Emmert, Andrea Guidotti, Hugo Vanermen, Francesco Maisano
AIMS: The aim of this study was to evaluate the safety, technical feasibility and performance of a new trans-catheter tricuspid repair system. METHODS AND RESULTS: Thirty-one adult swine underwent implantation of a transcatheter tricuspid remodelling system under general anaesthesia. The steerable transcatheter device was introduced through a 24 Fr femoral sheath into the right femoral vein and delivered to the tricuspid annulus on the beating heart. A fixation element was implanted into the tricuspid annulus...
September 18, 2016: EuroIntervention
Benyamin Rahmani, Spyros Tzamtzis, Rose Sheridan, Michael J Mullen, John Yap, Alexander M Seifalian, Gaetano Burriesci
AIMS: The aim of this study was to introduce and demonstrate the feasibility in an acute preclinical model of a new transcatheter heart valve concept with a self-expanding wire frame, polymeric leaflets and a sealing component. METHODS AND RESULTS: The TRISKELE valve was developed based on a previously validated polymeric leaflet design, an adaptive sealing cuff and a novel nitinol wire frame which reduces stress on the leaflets and radial pressure on the surrounding tissue...
September 18, 2016: EuroIntervention
Elena Surkova, Denisa Muraru, Patrizia Aruta, Gabriella Romeo, Jurate Bidviene, Diana Cherata, Luigi P Badano
Advances in ultrasound, computer, and electronics technology have permitted three-dimensional echocardiography (3DE) to become a clinically viable imaging modality, with significant impact on patient diagnosis, management, and outcome. Thanks to the inception of a fully sampled matrix transducer for transthoracic and transesophageal probes, 3DE now offers much faster and easier data acquisition, immediate display of anatomy, and the possibility of online quantitative analysis of cardiac chambers and heart valves...
November 2016: Current Cardiology Reports
Christian E Rex, Johan Heiberg, Kaj-Erik Klaaborg, Vibeke E Hjortdal
PURPOSE: Transcatheter aortic valve implantation (TA-TAVI) is a well-established treatment for aortic valve stenosis in high-risk patients and indications have been continuously expanding to include also intermediate-risk patients. However, in low-risk patients, experiences are still sparse and although clinical outcomes have been shown favorable, HRQoL has remained unexplored. The aim of this report was to describe the long-term health-related quality-of-life (HRQoL) in low-risk patients randomized to TA-TAVI or surgical aortic valve replacement (SAVR)...
September 10, 2016: Scandinavian Cardiovascular Journal: SCJ
A A Sakrana, M M Nasr, G A Ashamallah, R A Abuelatta, H A Naeim, M E Tahlawi
AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO)...
November 2016: Clinical Radiology
Rainer Petzina, Georg Lutter, Christin Wolf, Constantin Kühl, Sandra Freitag-Wolf, Bernd Panholzer, Peter Bramlage, Norbert Frey, Jochen Cremer, Derk Frank
OBJECTIVES: To evaluate the efficacy and safety of Edwards SAPIEN-XT or SAPIEN-3 transcatheter heart valves via transaortic (TAo) access. METHODS: A total of 100 consecutive patients with severe symptomatic aortic stenosis undergoing TAo-transcatheter aortic valve implantation (TAVI) were included in this observational registry (November 2012-December 2014). Periprocedural and post-procedural outcomes were assessed. RESULTS: Of these 100 patients, 1 received a Medtronic CoreValve...
September 5, 2016: Interactive Cardiovascular and Thoracic Surgery
Amir Basir, Paul Gründeman, Frans Moll, Joost van Herwaarden, Gerard Pasterkamp, Reindert Nijland
Various materials that are used for vascular and heart valve prostheses carry drawbacks: some require anticoagulant drugs or have moderate durability; others are not suitable for endovascular treatment. These prostheses are associated with bacterial infections. A material potentially suitable for prostheses is Dyneema Purity®, made of ultra-high-molecular-weight polyethylene. Dyneema Purity® fibers are very thin, flexible, resistant to fatigue and abrasion, and have high strength. S. aureus adherence to Dyneema Purity® was tested and compared with currently used cardiovascular prostheses...
2016: PloS One
Fadi Sawaya, Arie Pieter Kappetein, Wilfried Wisser, Patrick Nataf, Martyn Thomas, Volker Schächinger, Bernard De Bruyne, Hélène Eltchaninoff, Matthias Thielmann, Dominique Himbert, Mauro Romano, Gerhard Wimmer-Greinecker, Patrick Serruys, Thierry Lefèvre
AIMS: Transcatheter aortic valve implantation (TAVI) has gained rapid acceptance for patients with severe aortic stenosis (AS) at high surgical risk for conventional valve replacement. Although TAVI is now a relatively mature technique, limited data about long-term valvular function are available. Our aim was to report the five-year echocardiographic data evaluating valve performance from three early European feasibility studies designed to assess the safety and effectiveness of the first-generation balloon-expandable transcatheter heart valve (SAPIEN THV)...
August 20, 2016: EuroIntervention
Rishi Puri, Jonathan Byrne, Ralf Muller, Hardy Baumbach, Helene Eltchaninoff, Simon Redwood, Asim Cheema, Christophe Dubois, Leo Ihlberg, Harindra C Wijeysundera, Alfredo Cerillo, Matthias Götberg, Kaj Erik Klaaborg, Marc Pelletier, Roberto Blanco-Mata, Richard Edwards, Caterina Gandolfo, Douglas Muir, Francesco Meucci, Jan-Malte Sinning, Pieter Stella, Verena Veulemans, Marko Virtanen, Ander Regueiro, Martin Thoenes, Philippe Pibarot, Emilie Pelletier-Beaumont, Josep Rodés-Cabau
BACKGROUND: While transcatheter aortic valve implantation (TAVI) is established for treating high-operative risk surgical aortic valve replacement candidates, until recently the smallest transcatheter heart valve (THV) measured 23 mm, posing greater risk for annular rupture and THV failure in patients with aortic stenosis (AS) with small aortic annuli (≤20 mm). OBJECTIVES: In the setting of a multicentre registry, we report on the safety, efficacy and early clinical outcomes of the SAPIEN XT 20 mm balloon-expanding THV...
August 17, 2016: Heart: Official Journal of the British Cardiac Society
Fumiaki Yashima, Masanori Yamamoto, Yusuke Watanabe, Kensuke Takagi, Yoshitake Yamada, Taku Inohara, Ryo Yanagisawa, Makoto Tanaka, Takahide Arai, Hideyuki Shimizu, Masahiro Jinzaki, Ken Kozuma, Keiichi Fukuda, Takahiko Suzuki, Kentaro Hayashida
BACKGROUND: Underfilling or overfilling of balloon-expandable transcatheter heart valves (THVs) during transcatheter aortic valve implantation (TAVI) is commonly used to improve conformity to small or calcified annuli in order to avoid serious complications. However, little is known about this technique. This study assessed the effects of underfilling and overfilling of THVs. METHODS AND RESULTS: Data from 213 consecutive TAVI patients treated with balloon-expandable THVs in 4 Japanese centers between October 2013 and December 2014 were prospectively analyzed; 23-mm and 26-mm THVs were implanted in 96 cases (56 underfilling, 22 nominal filling, and 18 overfilling) and 38 cases (23 underfilling and 15 nominal filling), respectively...
November 1, 2016: International Journal of Cardiology
H Lan, Y G Cheng, B C Jia, Y L Chai
OBJECTIVE: To summarize the clinical outcome of totally thoracoscopic cardiac surgery for mitral valve replacement. METHODS: Clinical data of 634 cases undergoing totally thoracoscopic cardiac surgery for mitral valve replacement from May 2004 to February 2016 in Department of Thoracoscopic Cardiacsurgery, Shanghai Yodak Cardiothoracic Hospital was analyzed retrospectively. There were 292 male and 342 female patients, aged from 17 to 68 years with a mean of (45±13) years...
August 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Tirone E David
The development of aortic valve-sparing operations (reimplantation of the aortic valve and remodeling of the aortic root) expanded the surgical armamentarium for treating patients with aortic root dilation caused by a variety of disorders. Young adults with aortic root aneurysms associated with genetic syndromes are ideal candidates for reimplantation of the aortic valve, and the long-term results have been excellent. Incompetent bicuspid aortic valves with dilated aortic annuli are also satisfactorily treated with the same type of operation...
August 9, 2016: Journal of the American College of Cardiology
Prem A Midha, Vrishank Raghav, Jose F Condado, Ikechukwu U Okafor, Stamatios Lerakis, Vinod H Thourani, Vasilis Babaliaros, Ajit P Yoganathan
OBJECTIVES: The purpose of this study was to optimize hemodynamic performance of valve-in-valve (VIV) according to transcatheter heart valve (THV) type (balloon vs. self-expandable), size, and deployment positions in an in vitro model. BACKGROUND: VIV transcatheter aortic valve replacement is increasingly used for the treatment of patients with a failing surgical bioprosthesis. However, there is a paucity in understanding the THV hemodynamic performance in this setting...
August 8, 2016: JACC. Cardiovascular Interventions
Jay D Pal, James M McCabe, Todd Dardas, Gabriel S Aldea, Nahush A Mokadam
The development of new aortic insufficiency after a period of support with a left ventricular assist device can result in progressive heart failure symptoms. Transcatheter aortic valve repair can be an effective treatment in selected patients, but the lack of aortic valve calcification can result in unstable prostheses or paravalvular leak. We describe a technique of deploying a self-expanding CoreValve (Medtronic, Minneapolis, MN, USA) into the aortic annulus, followed by a balloon-expandable SAPIEN-3 (Edwards, Irvine, CA, USA)...
October 2016: Journal of Cardiac Surgery
Saskia Pokorny, Katharina Huenges, Jan Hinerk Hansen, Yannik Schadow, Gunther Fischer, Michael M Morlock, Jochen Cremer, Georg Lutter
OBJECTIVES: A large cohort of patients suffering from severe mitral regurgitation does not meet the indications for conventional surgery and would greatly benefit from a transcatheter approach in the beating heart. Consequently, off-pump transcatheter mitral valve procedures have been the focus of recent research. The aim of this study was the in vivo evaluation and comparison of subannular versus apical fixation of mitral valved stents to show the feasibility of subannular anchorage...
July 29, 2016: European Journal of Cardio-thoracic Surgery
S Yücel, H Ince, S Kische, M A Sherif, H Bushnaq, A Bärisch, A Öner
The demographic changes in society lead to an increasing number of patients with aortic valve stenosis and mitral regurgitation. Simultaneously the higher age of patients is associated with an increase in multimorbidity with a high surgical risk so that they cannot be referred to surgery. Besides the current gold standard of surgery, minimally invasive therapeutic options are increasingly becoming established for these patients. For the differentiated indications and therapeutic success, a multidisciplinary heart team assumes an important role...
August 2016: Herz
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