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https://www.readbyqxmd.com/read/29671282/interventional-cardiology-for-congenital-heart-disease
#1
REVIEW
Damien Kenny
Congenital heart interventions are now replacing surgical palliation and correction in an evolving number of congenital heart defects. Right ventricular outflow tract and ductus arteriosus stenting have demonstrated favorable outcomes compared to surgical systemic to pulmonary artery shunting, and it is likely surgical pulmonary valve replacement will become an uncommon procedure within the next decade, mirroring current practices in the treatment of atrial septal defects. Challenges remain, including the lack of device design focused on smaller infants and the inevitable consequences of somatic growth...
March 29, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29660359/transcatheter-mitral-valve-in-valve-dislocation-a-rescue-strategy
#2
Alessandro Leone, Jacopo Alfonsi, Emanuele Pilato, Luigi Lovato, Luca Di Marco, Giacomo Murana, Francesco Saia, Davide Pacini, Roberto Di Bartolomeo
In the TAVR (transcatheter aortic valve replacement) era, trans-apical valve-in-valve mitral valve implantation (TA-MVI) is considered an alternative treatment for high risk patients with degenerated mitral bioprosthesis. We report an unusual strategy to remedy to a potentially fatal complication as the mitral prosthesis migration into the aortic arch. The dislocated prosthesis was successfully stabilized in the aortic arch with a bare aortic stent, ensuring an adequate perfusion of epiaortic vessels.
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29659801/long-term-performance-of-homografts-versus-stented-bioprosthetic-valves-in-the-pulmonary-position-in-patients-aged-10-20-years
#3
Douglas Bell, Sudesh Prabhu, Kim S Betts, Yilin Chen, Dorothy Radford, Chris Whight, Cameron Ward, Homayoun Jalali, Prem Venugopal, Nelson Alphonso
OBJECTIVES: We aimed to compare the long-term performance of pulmonary homografts and stented bioprosthetic valves in the pulmonary position in patients aged 10-20 years. METHODS: Between January 1995 and December 2015, 188 patients aged 10-20 years undergoing pulmonary valve replacement were identified retrospectively from hospital databases in both congenital cardiac centres in Brisbane. Valve performance was evaluated using previously described standard criteria...
April 11, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29659023/a-dynamic-model-based-approach-to-motion-and-deformation-tracking-of-prosthetic-valves-from-biplane-x-ray-images
#4
Martin G Wagner, Charles R Hatt, David A P Dunkerley, Lindsay E Bodart, Amish N Raval, Michael A Speidel
PURPOSE: Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure in which a prosthetic heart valve is placed and expanded within a defective aortic valve. The device placement is commonly performed using two-dimensional fluoroscopic imaging. Within this work, we propose a novel technique to track the motion and deformation of the prosthetic valve in three dimensions based on biplane fluoroscopic image sequences. METHODS: The tracking approach uses a parameterized point cloud model of the valve stent which can undergo rigid 3D transformation and different modes of expansion...
April 16, 2018: Medical Physics
https://www.readbyqxmd.com/read/29656120/systemic-inflammatory-response-syndromes-in-the-era-of-interventional-cardiology
#5
REVIEW
Riccardo Gorla, Raimund Erbel, Kim A Eagle, Eduardo Bossone
Systemic inflammatory response syndrome (SIRS), initially reported after cardiovascular surgery, has been described after various interventional cardiology procedures, including endovascular/thoracic aortic repair (EVAR/TEVAR), implantation of heart rhythm devices, percutaneous coronary intervention (PCI), electrophysiology procedures (EP), and transcatheter aortic valve implantation (TAVI). In these settings, a comprehensive understanding of the triggers, pathogenesis as well as a common diagnostic/therapeutic algorithm is lacking and will be discussed in this review...
April 12, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29649955/repair-of-tevar-associated-type-a-dissection-in-the-elderly-is-possible-with-reasonable-morbidity-and-mortality
#6
Angela Kornberger, Risteski Petar, Hazem El Beyrouti, Mahmud Khalil, Iris Burck, Nancy Halloum, Andres Beiras-Fernandez, Christian-Friedrich Vahl
BACKGROUND: Type A aortic dissection (AAD) is a devastating complication of thoracic endovascular repair (TEVAR). In elderly patients, surgery for AAD carries considerable morbidity and mortality. Repair of AAD after previous TEVAR is an even greater challenge as it usually requires the arch to be addressed and a preexisting stent graft to be included into the aortic repair. METHODS: A case series of 5 elderly patients who presented with acute AAD after previous TEVAR was reviewed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29643916/antireflux-metal-stent-for-initial-treatment-of-malignant-distal-biliary-obstruction
#7
Shinichi Morita, Yasuaki Arai, Shunsuke Sugawara, Miyuki Sone, Yasunari Sakamoto, Takuji Okusaka, Shigetaka Yoshinaga, Yutaka Saito, Shuji Terai
Objectives: To compare the use of an antireflux metal stent (ARMS) with that of a conventional covered self-expandable metal stent (c-CSEMS) for initial stenting of malignant distal biliary obstruction (MDBO). Materials and Methods: We retrospectively investigated 59 consecutive patients with unresectable MDBO undergoing initial endoscopic biliary drainage. ARMS was used in 32 patients and c-CSEMS in 27. Technical success, functional success, complications, causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), and reintervention were compared between the groups...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29642797/recurrent-aortic-dissection-in-a-patient-with-an-actin-mutation-treated-with-a-laser-fenestrated-aortic-arch-stent-graft
#8
J Michael Cullen, Gorav Ailawadi, John F Angle, Matthew Thomas, Gilbert R Upchurch
A 58-year-old African American female, who had previously undergone a valve-sparing aortic root replacement for a type A dissection, represented 2 months later with a new focal dissection and aneurysm with intramural hematoma just distal to the origin of the left subclavian artery. Since no landing zone distal to the subclavian artery existed, the patient underwent thoracic endovascular aortic repair with laser fenestration-aided stent-graft placement in the left subclavian artery. The patient recovered without complication, and 52 months later, she is doing well with normal renal function and ambulatory status...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29623280/neo-left-main-channel-creation-using-double-stenting-alongside-a-sapien-3-aortic-valve-bioprosthesis-for-left-main-coronary-obstruction-following-valve-in-valve-transcatheter-aortic-valve-replacement-a-case-report-with-review-of-literature
#9
Apurva D Patel, Thomas Haldis, Kais Al Balbissi, Timir Paul
Transcatheter aortic valve replacement in the setting of failed surgical bioprosthesis (valve-in-valve) is a valuable option for patients with bioprosthetic aortic stenosis or regurgitation who are deemed high risk for repeat open heart surgery. Although the procedure is successful with proper preprocedural assessment, instances of left main (LM) coronary artery ostium obstruction have been documented. We present a case of LM coronary obstruction in the immediate postoperative period following implantation of a 20-mm Edwards Sapien 3 valve inside the degenerated 21-mm Mitroflow bioprosthesis stenosis, which was treated with double stenting alongside the Edwards Sapien 3 valve creating a channel ("neo left main") that extended from mid-LM to the upper margin of the Edwards Sapien 3 valve...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29622157/delayed-coronary-obstruction-after-transcatheter-aortic-valve-replacement
#10
Richard J Jabbour, Akihito Tanaka, Ariel Finkelstein, Michael Mack, Corrado Tamburino, Nicolas Van Mieghem, Ole de Backer, Luca Testa, Pamela Gatto, Paola Purita, Zouhair Rahhab, Verena Veulemans, Anja Stundl, Marco Barbanti, Roberto Nerla, Jan Malte Sinning, Danny Dvir, Giuseppe Tarantini, Molly Szerlip, Werner Scholtz, Smita Scholtz, Didier Tchetche, Fausto Castriota, Christian Butter, Lars Søndergaard, Mohamed Abdel-Wahab, Horst Sievert, Ottavio Alfieri, John Webb, Josep Rodés-Cabau, Antonio Colombo, Azeem Latib
BACKGROUND: Delayed coronary obstruction (DCO) is an uncommon and barely reported complication following transcatheter aortic valve replacement (TAVR). OBJECTIVES: The aim of this study was to describe the incidence and pathophysiological features of DCO after TAVR, obtained from a large international multicenter registry. METHODS: Data were retrospectively collected from an international multicenter registry consisting of 18 centers between November 2005 and December 2016...
April 10, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29622147/transcatheter-laceration-of-aortic-leaflets-to-prevent-coronary-obstruction-during-transcatheter-aortic-valve-replacement-concept-to-first-in-human
#11
Jaffar M Khan, Danny Dvir, Adam B Greenbaum, Vasilis C Babaliaros, Toby Rogers, Gabriel Aldea, Mark Reisman, G Burkhard Mackensen, Marvin H K Eng, Gaetano Paone, Dee Dee Wang, Robert A Guyton, Chandan M Devireddy, William H Schenke, Robert J Lederman
OBJECTIVES: This study sought to develop a novel technique called bioprosthetic or native aortic scallop intentional laceration to prevent coronary artery obstruction (BASILICA). BACKGROUND: Coronary artery obstruction is a rare but fatal complication of transcatheter aortic valve replacement (TAVR). METHODS: We lacerated pericardial leaflets in vitro using catheter electrosurgery, and tested leaflet splaying after benchtop TAVR. The procedure was tested in swine...
April 9, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29608576/a-novel-catheter-with-retractable-stent-that-can-prevent-aortic-insufficiency-during-left-ventricular-assist
#12
Jing Lin, Zhen Qin, Hong Qian, Yajiao Li, Nanfu Luo, Lei Du
Left ventricle (LV) assist, which refers to the use of a mini-pump or catheter implanted across the aortic valve connected to the pump, can promote myocardial recovery after left ventricle failure. However, conventional LV assist catheters compress the aortic valve, which can induce aortic insufficiency. Here we describe a novel LV assist catheter containing a retractable stent at its distal end that may prevent such insufficiency. The device was tested in six goats in which the coronary artery was ligated to induce acute LV failure, and then an LV assist was installed with a novel catheter in the left ventricle via the left subclavian artery...
2018: PloS One
https://www.readbyqxmd.com/read/29590744/the-clinical-efficacy-of-silicone-stents-for-endoscopic-dacryocystorhinostomy-a-meta-analysis
#13
Do Hyun Kim, Seon Ik Kim, Ho Jun Jin, Subin Kim, Se Hwan Hwang
Objectives: We evaluated the effect of silicone stent use during endoscopic dacryocystorhinostomy on postoperative morbidities in comparison with versus without a silicone stent. Methods: Two authors independently searched six databases (PubMed, Embase, Scopus, the Web of Science, the Cochrane library, and Google Scholar) from inception of article collection to July 2017. The analysis included prospective randomized studies that compared intraoperative silicone stent insertion (silicone group) with no application of a silicone stent (control group), in which the outcomes of interest were success rate (lacrimal passage patent check with syringing, symptom relief, or endoscopic confirmation of fluorescein dye from the opening of Hasner's valve) and morbidities (e...
March 30, 2018: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/29571348/first-surgical-melody-valve-in-valve-implantation-for-early-degeneration-in-mitral-position
#14
Maria Grandinetti, Alessandro Varrica, Alessandro Giamberti, Mario Carminati, Alessandro Frigiola
Congenital mitral valve disease is a real challenge in infants and small children. The implantation of expandable stented valves in mitral position has become one of the options of choice in consideration of their acceptable short-term expandable durability and subsequent feasibility of balloon expansion of these devices. We report the first case of a surgical Melody valve-in-valve procedure for early Melody valve degeneration in the mitral position. The result was good, and the procedure safe, rapid, and without an increased risk when a mechanical valve implantation will be necessary...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29566416/beyond-stroke-prevention-in-atrial-fibrillation-exploring-further-unmet-needs-with-rivaroxaban
#15
C M Gibson, G J Hankey, T Nafee, R C Welsh
With improved life expectancy and the aging population, the global burden of atrial fibrillation (AF) continues to increase, and with AF comes an estimated fivefold increased risk of ischaemic stroke. Prophylactic anticoagulant therapy is more effective in reducing the risk of ischaemic stroke in AF patients than acetylsalicylic acid or dual-antiplatelet therapy combining ASA with clopidogrel. Non-vitamin K antagonist oral anticoagulants are the standard of care for stroke prevention in patients with non-valvular AF...
March 22, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29544953/quantitative-assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-replacement-using-a-patient-specific-pulsatile-flow-model
#16
Yutaka Tanaka, Shigeru Saito, Saeko Sasuga, Azuma Takahashi, Yusuke Aoyama, Kazuto Obama, Mitsuo Umezu, Kiyotaka Iwasaki
BACKGROUND: Quantitative assessment of post-transcatheter aortic valve replacement (TAVR) aortic regurgitation (AR) remains challenging. We developed patient-specific anatomical models with pulsatile flow circuit and investigated factors associated with AR after TAVR. METHODS: Based on pre-procedural computed tomography (CT) data of the six patients who underwent transfemoral TAVR using a 23-mm SAPIEN XT, anatomically and mechanically equivalent aortic valve models were developed...
May 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29522111/evaluation-of-transventricular-placement-of-porcine-small-intestinal-submucosa-stent-valves-in-the-pulmonary-position-in-juvenile-sheep-model
#17
Qingling Zhou, Fei Teng, Yongshan Zhang, Qiang Sun, Guowei Meng
OBJECTIVES: We assessed the transventricular placement of porcine small intestinal submucosa (SIS) stent valves in a juvenile sheep model at the 3-month follow-up evaluation. METHODS: We constructed a pulmonary stent valve by suturing a porcine SIS bicuspid valve into a bell-shaped 'Z' nitinol stent and implanted 7 SIS stent valves transventricularly in the pulmonary position in 7 sheep. The function of the stent valves was assessed using a pulsatile flow simulation system in vitro...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29521437/first-human-implant-of-the-alterra-adaptive-prestent-tm-a-new-self-expanding-device-designed-to-remodel-the-right-ventricular-outflow-tract
#18
Evan M Zahn, Jennifer C Chang, Dustin Armer, Ruchira Garg
Current balloon expandable transcatheter valves have limited applicability to patients with "native" right ventricular outflow tracts (RVOT), meaning those who have had previous surgery and are left with large, compliant, irregular RVOT. The Alterra Adaptive PrestentTM is a self-expanding, partially covered stent that was designed to internally reconfigure these types of RVOT, making them suitable for implantation of a commercially available balloon expandable heart valve, the SAPIEN 3. Herein, we describe the first human implant of this device...
March 9, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29518515/malignancy-does-not-affect-outcomes-of-pharmacomechanical-thrombolysis-in-acute-symptomatic-iliofemoral-deep-vein-thrombosis
#19
William J Yoon, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
INTRODUCTION & OBJECTIVES: Cancer patients demonstrate increased risk for venous thromboembolism (VTE), VTE recurrence, and anticoagulation-associated bleeding. Pharmacomechanical thrombolysis and thrombectomy (PMT) improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral deep venous thrombosis (DVT). It remains unknown whether pharmacomechanical thrombolysis can be used safely in patients with active cancer. We hypothesized that perioperative and short-term outcomes of pharmacomechanical iliofemoral DVT thrombolysis would not differ between patients with cancer and those without cancer...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29517511/implanted-in-body-tissue-engineered-heart-valve-can-adapt-the-histological-structure-to-the-environment
#20
Yoshiaki Takewa, Hirohito Sumikura, Satoru Kishimoto, Noritsugu Naito, Kei Iizuka, Daichi Akiyama, Ryosuke Iwai, Eisuke Tatsumi, Yasuhide Nakayama
Tissue-engineered heart valves (TEHVs) are expected to be viable grafts. However, it is unknown whether they transit their histological structure after implantation. We developed a novel autologous TEHV (named stent biovalve) for transcatheter implantation, using in-body tissue engineering based on a tissue encapsulation phenomenon. In this study, a time-course histological transition of implanted biovalves was investigated in goats. Three types of stent biovalves were prepared by 2 month embedding of plastic molds mounted with metallic stents, in the subcutaneous spaces...
March 5, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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