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https://www.readbyqxmd.com/read/28444455/prevalence-predictors-and-prognostic-implications-of-residual-impairment-of-functional-capacity-after-transcatheter-aortic-valve-implantation
#1
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
BACKGROUND: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We sought to investigate the prevalence, the predictors, and the prognostic impact of residual impairment of functional capacity after TAVI. METHODS AND RESULTS: Out of 790 patients undergoing TAVI with impaired functional capacity (NYHA II-IV) at baseline, NYHA functional class improved in 592 (86...
April 25, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28418954/aortic-root-abscess-clearly-shown-on-111in-leukocyte-scan-but-less-obvious-on-transesophageal-echocardiogram
#2
Harleen Kaur, John Seitz, Mitchel Muhleman, David Cragg, Feng Qing
A 79-year-old man with history of aortic stenosis, status post bioprosthetic aortic valve replacement, episodes of bacteremia, and endocarditis presented to hospital with fever. Clinical assessment led to suspicion of possible endocarditis. Initial interpretation of transesophageal echocardiogram was inconclusive without vegetation in mitral/aortic valve. An In-leukocyte scan demonstrated increased uptake in the area of aortic valve, suggestive of infection. Further review of the transesophageal echocardiogram showed signs of annular abscess...
April 17, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28412115/outcome-of-isolated-aortic-valve-replacement-in-patients-with-classic-and-paradoxical-low-flow-low-gradient-aortic-stenosis
#3
Ana Lopez-Marco, Harriet Miller, Pankaj Kumar, Saeed Ashraf, Afzal Zaidi, Farah Bhatti, Adrian Ionescu, Aprim Youhana
OBJECTIVE: To analyze operative outcomes and mid-term results after isolated aortic valve replacement (AVR) in low-flow, low-gradient aortic stenosis (LFLG AS) by comparing the 2 subcategories (classic low-flow, low-gradient aortic stenosis [CLFLG] and paradoxical low-flow, low-gradient aortic stenosis [PLFLG]). METHODS: This was a retrospective analysis of prospectively collected data for all isolated AVR in LFLG AS performed in our center during the last 13 years (n = 198; CLFLG AS, n = 66, 33% and PLFLG AS, n = 132, 67%)...
March 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28386460/reversal-of-abnormal-cardiac-parameters-following-mitral-valve-replacement-for-severe-mitral-stenosis-in-relation-to-pulmonary-artery-pressure-a-retrospective-study-of-noninvasive-parameters-early-and-late-pattern
#4
REVIEW
Usha T Parvathy, Rajesh Rajan, Alexander Georgevich Faybushevich
BACKGROUND AND OBJECTIVES: Although the regression of pulmonary hypertension (PH) in mitral stenosis (MS) has been studied over varying periods postintervention, corresponding studies on the cardiac chamber alterations after surgery are very limited. We sought to determine the degree of reversal of these and the clinical status in connection with that of pulmonary artery pressures (PAPs) in the early and late postoperative periods. METHODS: The preoperative, early, and 1-year postoperative data - functional class (FC), cardiothoracic ratio (CTR) in chest X-ray (CXR), and echocardiographically left atrium (LA), right atrium (RA), right ventricle (RV), left ventricle (LV), and pulmonary artery (PA) dimensions, PAP, tricuspid regurgitation (TR) - of 50 patients who had mitral valve replacement (MVR) for MS with PH were retrospectively analyzed for correlations with PAP (Pearson's), and their change (t-test), in relation to that in PAP...
June 1, 2016: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28380656/early-results-of-surgical-simultaneous-therapy-for-significant-carotid-artery-stenosis-and-heart-disease
#5
Marc Irqsusi, Alessandro Vannucchi, Julius Beckers, Stefan Kasseckert, Stefan Waldhans, Sebastian Vogt, Rainer G H Moosdorf
Background The purpose of this single-center, retrospective study was to review the early outcome with defined endpoints of myocardial infarction, brain injury, and death after coronary bypass grafting and simultaneous carotid endarterectomy with or without combined valve replacement. Methods During the preoperative investigation 52 (44 males, 8 females) patients were examined by cardiac catheterization within the scope of their coronary status. In addition, all patients underwent echocardiography, CT angiography of the supra-aortic vessels, and full description of their neurologic status...
April 5, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28374178/current-status-of-catheter-based-treatment-of-mitral-valve-regurgitation
#6
REVIEW
Mario Gössl, Robert S Farivar, Richard Bae, Paul Sorajja
PURPOSE OF REVIEW: This review examines the current status of catheter-based repair and replacement for mitral valve disease, with a focus on native primary and secondary mitral valve regurgitation. RECENT FINDINGS: Transcatheter mitral valve repair with the MitraClip®, with >40,000 performed procedures worldwide, has significantly advanced the field of transcatheter therapy for mitral valve regurgitation. Transcatheter mitral valve replacement remains in the early stages of development, mainly due to the complex anatomy and physiology of the mitral valve...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28338550/respiratory-system-function-in-patients-after-minimally-invasive-aortic-valve-replacement-surgery-a-case-control-study
#7
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Janusz Andres
OBJECTIVE: The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. METHODS: Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. RESULTS: Complications of the respiratory system occurred in 16...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28332088/simple-technique-of-repair-for-barlow-syndrome-with-posterior-resection-and-chordal-transfer-via-minimally-invasive-approach-primary-experience-in-a-consecutive-series-of-22-patients
#8
H Kamiya, Payam Akhyari, J-P Minol, A C Ites, T Weinreich, S Sixt, P Rellecke, U Boeken, A Albert, A Lichtenberg
OBJECTIVE: Current techniques for mitral valve repair (MVR) in Barlow's disease require high level of surgical expertise due to a complex anatomy. A novel and simple standardized technique that particularly considers the pathological changes of the mitral valve in Barlow's disease has been developed. METHODS: Between 2009 and 2013, 22 patients underwent minimally invasive MVR for Barlow's disease and severe mitral regurgitation (MR). A simple, standardized technique was applied, including resection of P2 segment of posterior mitral leaflet (PML) with preservation of the shortest chordae, transfer of the preserved chordae to A2, and implantation of a semi-rigid open ring...
March 22, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28329140/the-impact-of-frailty-on-patient-centered-outcomes-following-aortic-valve-replacement
#9
Brian R Kotajarvi, Marissa J Schafer, Elizabeth J Atkinson, Megan M Traynor, Charles J Bruce, Kevin L Greason, Rakesh M Suri, Jordan D Miller, Nathan K LeBrasseur
Background: Frailty confers risk for surgical morbidity and mortality. Whether patient-reported measures of health, well-being, or quality of life respond differently to surgery in non-frail and frail individuals is unknown. Methods: Older adults with severe aortic stenosis presenting for surgery were assessed for frailty using Cardiovascular Health Study Criteria. Patient-reported measures of functional capacity (Duke Activity Status Index [DASI]), physical and mental health (Medical Outcomes Study Short Form-Physical and Mental Component Scales [SF-12 PCS and SF-12 MCS, respectively]), well-being (linear analogue self-assessment [LASA]), and quality of life (LASA) were administered before and 3 months after surgery...
March 10, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28329122/prognostic-implications-of-left-ventricular-asymmetry-in-patients-with-asymptomatic-aortic-valve-stenosis
#10
Per Ejlstrup Sigvardsen, Linnea Hornbech Larsen, Helle Gervig Carstensen, Mathias Sørgaard, Louise Hindsø, Christian Hassager, Lars Køber, Rasmus Møgelvang, Klaus Fuglsang Kofoed
Aims: Left ventricular (LV) regional hypertrophy in the form of LV asymmetry is a common finding in patients with aortic valve stenosis. The aim of this study was to test the hypothesis that LV asymmetry predicts future symptomatic status and indication for aortic valve replacement (AVR) in patients with asymptomatic aortic valve stenosis. Methods and results: In total, 114 patients with asymptomatic aortic valve stenosis (peak velocity > 2.5 m/s assessed by echocardiographic screening and LV ejection fraction > 50%) were enrolled in the study...
February 18, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#11
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28302715/late-thrombosis-of-a-mitral-bioprosthetic-valve-with-associated-massive-left-atrial-thrombus
#12
Preetham Muskula, Rigoberto Ramirez, A Michael Borkon, Michael L Main
An 84-year-old man presented 5 years following bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg) was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (> 4 cm in diameter) (see Figures 1A-D, and video files 1-4)...
March 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28296050/a-heart-within-a-heart
#13
Edward T Carreras, Maya Barghash, Michael M Givertz, Deepak L Bhatt
A 44-year-old man with a history of end-stage dilated cardiomyopathy status-post orthotopic cardiac transplant 14 years ago presented for coronary angiography in preparation for re-operative tricuspid valve replacement. Coronary angiography revealed an anomalous origin of the left coronary artery, with a common coronary trunk arising from the right coronary cusp and bifurcating into right and left main coronary arteries. Interestingly, the right and left coronary arteries coursed to form the shape of a heart, hence, a heart within a heart! © 2017 Wiley Periodicals, Inc...
March 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28292589/tricuspid-valve-repair-and-pulmonary-valve-replacement-in-adults-with-repaired-tetralogy-of-fallot
#14
François Roubertie, Pierre-Emmanuel Séguéla, Zakaria Jalal, Xavier Iriart, Xavier Roques, Bernard Kreitmann, Mohammed Al-Yamani, Xavier Pillois, Jean-Benoît Thambo
BACKGROUND: Pulmonary valve replacement (PVR) often is performed in adults with repaired tetralogy of Fallot (TOF). For patients who have tricuspid regurgitation (TR), tricuspid valve (TV) repair associated to PVR is still debated. OBJECTIVE: We sought to evaluate perioperative factors related to TV repair when performed at the time of PVR in patients with repaired TOF. METHODS: We retrospectively reviewed 104 patients with repaired TOF (or its equivalent) who underwent PVR (2002-2014)...
February 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28283226/differential-impact-of-net-atrioventricular-compliance-on-clinical-outcomes-in-patients-with-mitral-stenosis-according-to-cardiac-rhythm
#15
In-Jeong Cho, Hyuk-Jae Chang, Soo Yeon Lee, Chi Young Shim, Geu-Ru Hong, Namsik Chung
BACKGROUND: Net atrioventricular compliance (Cn), a parameter for the net compliance of the left atrium and left ventricle, is known to be a useful predictor of outcomes in patients with mitral stenosis (MS). The present study aimed to evaluate whether the impact of Cn on symptom status and clinical outcomes, as well as its contribution toward systolic pulmonary artery pressure (SPAP), differed according to cardiac rhythm. METHODS: We retrospectively reviewed patients (N = 308) with rheumatic pure MS...
March 7, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28281857/engineering-challenges-and-the-future-prospects-of-transcatheter-mitral-valve-replacement-technologies-a-comprehensive-review-of-case-studies
#16
Ranjitha Rebecca Jeevan, Bhaskar Mohan Murari
Catheter based Interventional procedures have become an indispensable treatment option for patients contraindicated for surgical heart valve replacement . The broad spectrum of disease that affect the mitral valve have increased the need for a transcatheter mitral valve replacement (TMVR) device. As complex as the mitral valve anatomy is, so are challenges in the development of a TMVR device. Areas covered: This review article analyses the challenges in the development of the TMVR device from an engineering perspective of material and device design...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28275558/myocardial-strain-and-symptom-severity-in-severe-aortic-stenosis-insights-from-cardiovascular-magnetic-resonance
#17
Tarique Al Musa, Akhlaque Uddin, Peter P Swoboda, Pankaj Garg, Timothy A Fairbairn, Laura E Dobson, Christopher D Steadman, Anvesha Singh, Bara Erhayiem, Sven Plein, Gerald P McCann, John P Greenwood
BACKGROUND: Symptomatic severe aortic stenosis (AS) is a class I indication for replacement in patients when left ventricular ejection fraction (LVEF) is preserved. However, symptom reporting is often equivocal and decision making can be challenging. We aimed to quantify myocardial deformation using cardiovascular magnetic resonance (CMR) in patients classified by symptom severity. METHODS: Forty-two patients with severe AS referred to heart valve clinic were studied using tagged CMR imaging...
February 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28267085/hemolytic-anemia-due-to-right-ventricular-to-pulmonary-artery-conduit-stenosis
#18
Sudha Rao, Julie A Creaden, Shunyou Gong, Cynthia Rigsby, John M Costello
Hemolytic anemia is a well-recognized complication in patients with left-sided mechanical heart valves. It is rare to see hemolysis with a bioprosthetic valve in the right ventricular outflow tract. We report a 4-year-old-girl with history of truncus arteriosus status-post repair who developed hemolytic anemia as a result of a calcified and obstructed bioprosthetic right ventricular to pulmonary artery-valved conduit. The hemolysis was alleviated by replacing the obstructed conduit with a larger valved conduit...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28266162/short-term-results-of-alcohol-septal-ablation-as-a-bail-out-strategy-to-treat-severe-left-ventricular-outflow-tract-obstruction-after-transcatheter-mitral-valve-replacement-in-patients-with-severe-mitral-annular-calcification
#19
Mayra Guerrero, Dee Dee Wang, Dominique Himbert, Marina Urena, Amit Pursnani, Georges Kaddissi, Vijay Iyer, Michael Salinger, Tarun Chakravarty, Adam Greenbaum, Raj Makkar, Alec Vahanian, Ted Feldman, William O'Neill
OBJECTIVES: To evaluate the outcomes of the early experience of percutaneous alcohol septal ablation in patients with severe left ventricular outflow tract (LVOT) obstruction post transcatheter mitral valve replacement (TMVR). BACKGROUND: Severe LVOT obstruction with hemodynamic compromise is a complication of TMVR associated with high mortality. Percutaneous alcohol septal ablation has recently been described as a therapeutic option in this setting. METHODS: Multicenter retrospective review of clinical outcomes of patients undergoing alcohol septal ablation to treat LVOT obstruction after TMVR for severe mitral stenosis with severe mitral annular calcification...
March 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28265210/transcatheter-aortic-valve-replacement-comprehensive-review-and-present-status
#20
REVIEW
Sameer Arora, Jacob A Misenheimer, Radhakrishnan Ramaraj
Aortic stenosis is the most common valvular heart disease in the developed world. About 7% of the population over age 65 years suffers from degenerative aortic stenosis. The prognosis of patients with symptomatic severe aortic stenosis is dismal without valve replacement. Even though the American College of Cardiology recommends aortic valve replacement to treat this condition as a class I recommendation, approximately one third of these patients over the age of 75 years are not referred for surgery. Typically, this is from concern about prohibitive surgical risk associated with patient frailty, comorbidities, age, and severe left ventricular dysfunction...
February 2017: Texas Heart Institute Journal
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