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Self-expanding valve

Costanza Pellegrini, Oliver Husser, Won-Keun Kim, Andreas Holzamer, Thomas Walther, Tobias Rheude, Nicola Patrick Mayr, Teresa Trenkwalder, Michael Joner, Jonathan Michel, Fabian Chaustre, Adnan Kastrati, Heribert Schunkert, Christof Burgdorf, Michael Hilker, Helge Möllmann, Christian Hengstenberg
INTRODUCTION AND OBJECTIVES: The incidence of permanent pacemaker implantation (PPI) and new conduction abnormalities (CA) with the ACURATE neo (Symetis S.A., Eclubens, Switzerland) has not been studied in detail. We aimed to analyze their predictors, evaluating patient- and device-related factors, including implantation depth and device-to-annulus ratio (DAR). METHODS: Two analyses of a multicenter population were performed: new PPI in pacemaker-naive patients (n = 283), and PPI/new-CA in patients without prior CA or pacemaker (n = 232)...
March 15, 2018: Revista Española de Cardiología
Anne-Sophie Zenses, Morgane A Evin, Viktória Stanová, Marie-Annick Clavel, Paul Barragan, Josep Rodés-Cabau, Jean-François Obadia, Philippe Pibarot, Régis Rieu
AIMS: Valve-in-Valve (ViV) procedure has become a valuable alternative for the treatment of failed surgical bioprostheses (BP) in high risk patients. However, in small BPs, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed at examining the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the hemodynamics of ViV within small BPs. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of 3 BP models: Trifecta, Mitroflow and Epic Supra...
March 13, 2018: EuroIntervention
Thomas Walther, Ganesh Manoharan, Axel Linke, Helge Möllmann, David Holzhey, Stephen G Worthley, Won-Keun Kim, Ulrich Schäfer
OBJECTIVES: To examine the incidence and timing of new-onset left bundle branch block (LBBB) and new permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve implantation (TAVI) using the repositionable, self-expanding Portico™ TAVI system (St. Jude Medical, St Paul, MN, USA). Clinical impact and periprocedural factors associated with new PPI were also assessed. METHODS: A total of 198 high-risk patients without pre-existing pacemaker [83...
March 9, 2018: European Journal of Cardio-thoracic Surgery
Federico M Asch, Mani A Vannan, Siddharth Singh, Bijoy Khandheria, Stephen H Little, Dominic J Allocco, Ian T Meredith, Ted E Feldman, Michael J Reardon, Neil J Weissman
BACKGROUND : Comparative echocardiographic data on transcatheter aortic valve replacement systems from randomized trials are limited. The REPRISE III trial (Repositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Randomized Clinical Evaluation) is a multicenter, randomized comparison of a mechanically expanded (Lotus) versus self-expanding (CoreValve) transcatheter aortic valve replacement device. This analysis rigorously assesses Doppler-derived valve hemodynamics and the impact on outcomes at 1 year in patients with extreme/high surgical risk treated with Lotus and CoreValve from REPRISE III...
March 12, 2018: Circulation
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
Mohammad Abdelghani, Robbert J de Winter, Yosuke Miyazaki, Rodrigo Modolo, Hiroki Tateishi, Rafael Cavalcante, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Osama I I Soliman, Yoshinobu Onuma, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
OBJECTIVES: To explore the rate, the determinants of success, and the hemodynamic impact of balloon postdilatation (BPD) of self-expanding transcatheter heart valves (SE-THVs) BACKGROUND: BPD is commonly used to optimize valve expansion and reduce paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) without clearly knowing its hemodynamic benefits. METHODS: Patients (n = 307) who received a SE-THV were stratified according to whether a BPD was performed or not...
March 9, 2018: Catheterization and Cardiovascular Interventions
Patrizia Presbitero, Loredana Iannetta, Paolo Pagnotta, Bernhard Reimers, Marco L Rossi, Dennis Zavalloni Parenti, Giovanni Bianchi, Francesco Bedogni
BACKGROUND: It is well known that bicuspid valve stenosis can be treated with transcatheter aortic valve implantation (TAVI) even if specific issues can cause problems: dilatation of ascending aorta, possible aorthopathy, eccentricity of the valve and calcium distribution in leaflets and in commissures. We classified Bicuspid aortic valve (BAV) in type 0 (2 cusps and no raphe), and type 1 (2 cusps and one or more raphes). The aim of the present study was to report the results of two types of valve (CoreValve from 2009 to 2016 and Lotus valve from 2014 to 2017) in a consecutive series of BAV patients treated in 2 Italian centers...
April 2018: Minerva Cardioangiologica
Mani Arsalan, Won-Keun Kim, Arnaud Van Linden, Christoph Liebetrau, Benjamin D Pollock, Giovanni Filardo, Mathias Renker, Helge Möllmann, Mirko Doss, Ulrich Fischer-Rasokat, Adalbert Skwara, Christian W Hamm, Thomas Walther
OBJECTIVES: Due to increasing clinical experience with transcatheter aortic valve implantation (TAVI) procedures, sophisticated imaging and advanced device technology, TAVI complication rates are low; however, patients requiring conversion to surgery are confronted with an increased mortality risk. In this retrospective study, we evaluated the predictors for conversion and the outcomes of these patients. METHODS: We analysed the records of all patients undergoing TAVI in our centre from 2011 to 2016 and focused on cases that required conversion to sternotomy...
March 1, 2018: European Journal of Cardio-thoracic Surgery
Yifei Jin, Yangyang Shen, Jun Yin, Jin Qian, Yong Huang
Stimuli-responsive hydrogels and/or composite hydrogels have been of great interest for various printing applications including four-dimensional (4D) printing. While various responsive hydrogels and/or composite hydrogels have been found to respond to given stimuli and change shapes as designed, the fabrication of three-dimensional (3D) structures from such responsive hydrogels is still a challenge due to their poor 3D printability, and most of responsive material-based patterns are two-dimensional (2D) in nature...
March 1, 2018: ACS Applied Materials & Interfaces
François Huchet, Jean Christian Roussel, Vincent Letocart, Thibaut Manigold
AIMS: TAVR implantation in unicuspid aortic valve has rarely been reported previously, due to the rareness of this morphology. This case tries to bring answers to some challenges we may have to face in TAVR current practice. METHODS AND RESULTS: We describe the case of a cardiogenic shock complicating a pure native regurgitating and non-calcified unicuspid aortic valve, in a 40 years old woman without medical follow up. Conventional treatment options such as valve surgery or heart transplantation were denied due to extreme operative risk and multiple allo-immunizations...
February 27, 2018: EuroIntervention
Guy Achkouty, Nicolas Amabile, Konstantinos Zannis, Aurélie Veugeois, Christophe Caussin
From January 2013 to January 2017, 686 consecutive patients were referred to our centre for transcatheter aortic valve replacement, including 5 subjects with severe aortic regurgitation and acute refractory cardiogenic shock. These patients were contraindicated for surgical treatment by the heart team because of high surgical risk (median logistic EuroSCORE: 74.6/Society of Thoracic Surgeons score: 37.9). The success rate of valve implantation was 100% through transfemoral access with self-expandable devices...
March 2018: Canadian Journal of Cardiology
Jun-Bean Park, In-Chang Hwang, Whal Lee, Jung-Kyu Han, Chi-Hoon Kim, Seung-Pyo Lee, Han-Mo Yang, Eun-Ah Park, Hyung-Kwan Kim, Paul T L Chiam, Yong-Jin Kim, Bon-Kwon Koo, Dae-Won Sohn, Hyuk Ahn, Joon-Won Kang, Seung-Jung Park, Hyo-Soo Kim
BACKGROUND: Limited data exist regarding the impact of aortic valve calcification (AVC) eccentricity on the risk of paravalvular regurgitation (PVR) and response to balloon post-dilation (BPD) after transcatheter aortic valve replacement (TAVR). We investigated the prognostic value of AVC eccentricity in predicting the risk of PVR and response to BPD in patients undergoing TAVR. METHODS: We analyzed 85 patients with severe aortic stenosis who underwent self-expandable TAVR (43 women; 77...
December 27, 2017: International Journal of Cardiology
Fernand Missohou
PURPOSE: Bowel is often the dose-limiting organ in curative pelvic irradiation because of radiation enteritis when dose exceeds 40 to 45 Gy. To limit radiation enteritis, a silicone tissue-expander prothesis (STEP) connected to a subcutaneous self-sealing valve was prospectively used in children undergoing pelvic or abdominal radiation therapy. This study reports the 15-year long-term outcomes of this prospective series. METHODS AND MATERIALS: Between 1987 and 2008, 29 children from 3 Paris institutions received pelvic radiation therapy after surgical placement of a STEP in the pelvis...
December 14, 2017: Practical Radiation Oncology
Alexander Lauten, Hans R Figulla, Axel Unbehaun, Neil Fam, Joachim Schofer, Torsten Doenst, Joerg Hausleiter, Marcus Franz, Christian Jung, Henryk Dreger, David Leistner, Brunilda Alushi, Anja Stundl, Ulf Landmesser, Volkmar Falk, Karl Stangl, Michael Laule
BACKGROUND: Transcatheter caval valve implantation is under evaluation as a treatment option for inoperable patients with severe tricuspid regurgitation (TR). The procedure involves the catheter-based implantation of bioprosthetic valves in the inferior vena cava and superior vena cava to treat symptoms associated with TR. This study is the first to evaluate the feasibility, safety, and efficacy of this interventional concept. METHODS AND RESULTS: Twenty-five patients (mean age, 73...
February 2018: Circulation. Cardiovascular Interventions
Axel Linke, David Holzhey, Helge Möllmann, Ganesh Manoharan, Ulrich Schäfer, Christian Frerker, Stephen G Worthley, A J van Boven, Simon Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Thomas Walther
BACKGROUND: The aim of the Portico TAVI (transcatheter aortic valve implantation) system study was to evaluate outcomes ≤1 year after implantation of a novel resheathable, self-expanding TAVI system in a multicenter patient population with severe aortic stenosis (AS). METHODS AND RESULTS: High-risk patients (n=222) with symptomatic severe AS (mean age, 83.0±4.6 years; 74.3% women) were enrolled across 12 centers in Europe and Australia. The study's primary end point was all-cause mortality at 30 days...
February 2018: Circulation. Cardiovascular Interventions
K H Soon, N H M Kooistra, M Voskuil, A O Kraaijeveld, P R Stella
No abstract text is available yet for this article.
February 9, 2018: Netherlands Heart Journal
Philippe J van Rosendael, Victoria Delgado, Jeroen J Bax
Aims: The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) with new-generation prostheses remains debated. This systematic review analyses the incidence of PPI after TAVI with new-generation devices and evaluates the electrical, anatomical, and procedural factors associated with PPI. In addition, the incidence of PPI after TAVI with early generation prostheses was reviewed for comparison...
February 6, 2018: European Heart Journal
Chekrallah Chamandi, Marco Barbanti, Antonio Munoz-Garcia, Azeem Latib, Luis Nombela-Franco, Enrique Gutiérrez-Ibanez, Gabriela Veiga-Fernandez, Asim N Cheema, Ignacio Cruz-Gonzalez, Vicenç Serra, Corrado Tamburino, Antonio Mangieri, Antonio Colombo, Pilar Jiménez-Quevedo, Jaime Elizaga, Gerard Laughlin, Dae-Hyun Lee, Bruno Garcia Del Blanco, Tania Rodriguez-Gabella, Josep-Ramon Marsal, Mélanie Côté, François Philippon, Josep Rodés-Cabau
OBJECTIVES: This study sought to evaluate the long-term clinical impact of permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). BACKGROUND: Conduction disturbances leading to PPI are common following TAVR. However, no data exist regarding the impact of PPI on long-term outcomes post-TAVR. METHODS: This was a multicenter study including a total of 1,629 patients without prior PPI undergoing TAVR (balloon- and self-expandable valves in 45% and 55% of patients, respectively)...
February 12, 2018: JACC. Cardiovascular Interventions
Xianbao Liu, Yuxin He, Qifeng Zhu, Feng Gao, Wei He, Lei Yu, Qijing Zhou, Minjian Kong, Jian'an Wang
OBJECTIVES: To explore assessment of supra-annular structure for self-expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS). BACKGROUND: Annulus-based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra-annular deformity, device selection for bicuspid AS has not been systemically studied. METHODS: Twelve patients with bicuspid AS who underwent TAVR with self-expanding THVs were included in this study...
February 5, 2018: Catheterization and Cardiovascular Interventions
Pablo Codner, Daniel Pugliese, Rémi Kouz, Amisha Patel, Cheng-Han Chen, Juan Terre, Kyle M Eudaley, Tamim Nazif, Torsten P Vahl, Isaac George, Omar K Khalique, Rebecca T Hahn, Martin B Leon, Susheel Kodali, Michael Borger
BACKGROUND: Transcatheter aortic valve replacement (TAVR) provides therapy for patients with severe aortic stenosis at extreme, high, or intermediate surgical risk. Transfemoral access has been the preferred access route; however, this approach is not suitable for many TAVR candidates. A suprasternal approach may allow for earlier ambulation and shorter hospital stay as compared with other, nontransfemoral approaches. METHODS: A total of 11 patients with unsuitable transfemoral access underwent suprasternal TAVR...
February 1, 2018: Annals of Thoracic Surgery
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