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https://www.readbyqxmd.com/read/29325012/systematic-review-of-the-cost-effectiveness-of-transcatheter-interventions-for-valvular-heart-disease
#1
Gialama Fotini, Prezerakos Panagiotis, Apostolopoulos Vasilis, Nikolaos Maniadakis
Objectives: Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. Methods: The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#2
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29234617/transcatheter-mitral-valve-implantation-in-open-heart-surgery-an-off-label-technique
#3
Jacopo Alfonsi, Giacomo Murana, Anna Corsini, Carlo Savini, Roberto Di Bartolomeo, Davide Pacini
Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova SOLO; LivaNova PLC, London, UK)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29214718/coronary-artery-disease-revascularization-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-real-world-results-from-the-east-denmark-heart-registry
#4
Oscar Millan-Iturbe, Fadi J Sawaya, Jacob Lønborg, Danny H F Chow, Gintautas Bieliauskas, Thomas Engstrøm, Lars Søndergaard, Ole De Backer
Transcatheter aortic valve replacement (TAVR) has become an established therapeutic option for patients with symptomatic, severe aortic stenosis. The optimal treatment strategy for concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. This study aimed to describe the degree of CAD, revascularization strategies, and long-term clinical outcomes in a large-scale all-comers TAVR-population. Nine hundred and forty-four consecutive patients underwent TAVR. Obstructive CAD was reported in 224 patients (23...
December 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29211217/application-of-unilateral-pectoralis-major-muscle-flap-in-the-treatment-of-sternal-wound-dehiscence
#5
Grazielle de Souza Horácio, Pedro Soler Coltro, Antonio Albacete, Juliano Baron Almeida, Vinícius Zolezi da Silva, Ivan de Rezende Almeida, Alfredo José Rodrigues, Jayme Adriano Farina
OBJECTIVE: This study aims to report the use of the unilateral pectoralis major muscle flap for the treatment of the sternal wound dehiscence. METHODS: A retrospective study including patients who underwent unilateral pectoralis major muscle flap was performed for the treatment of sternotomy dehiscence due to coronary artery bypass, valve replacement, congenital heart disease correction and mediastinitis, between 1997 and 2016. Data from the epidemiological profile of patients, length of hospital stay, postoperative complications and mortality rate were obtained...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29191615/percutaneous-mitral-valve-technology-what-is-on-the-horizon
#6
Sadip Pant, Kendra J Grubb
Mitral valve disease is common, with mitral regurgitation (MR) being the most frequent pathology. The etiology of MR is diverse, but, if left untreated, MR results in left ventricular (LV) volume overload, leading to remodeling, dilation of the LV, pulmonary hypertension, heart failure, and death. Mitral regurgitation is a high-risk diagnosis, yet a minority of symptomatic patients are referred for discussion of surgical treatment options. Percutaneous repair options are under development to address this clinical need and emphasize correction of the underlying anatomical pathology to restore mitral valve coaptation...
November 27, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29174823/modified-balloon-aortic-valvuloplasty-in-fragile-symptomatic-patients-unsuitable-for-both-surgical-and-percutaneous-valve-replacement
#7
Gianluca Rigatelli, Fabio Dell'Avvocata, Luca Conte, Daniela Lanza, Sara Giatti, Pierluigi Del Santo, Loris Roncon, Giuseppe Faggian
BACKGROUND: Balloon Aortic valvuloplasty (BAV) is considered as a bridge therapy to percutaneous valve implantation or a palliative treatment in patients with aortic valve stenosis (AVS). Potential risk of complications, in particular in fragile patients, is still not negligible. AIM: To describe the technique and outcomes of modified BAV in fragile symptomatic patients unsuitable for other treatments using no-pacing and minimally invasive approach. METHODS: Symptomatic fragile patients with severe aortic valve stenosis judged unsuitable by the heart team for surgical or percutaneous valve implantation from 1 September 2013 to 1 September 2017 were offered modified BAV...
October 19, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29136138/calcific-aortic-valve-stenosis-hard-disease-in-the-heart-a-biomolecular-approach-towards-diagnosis-and-treatment
#8
Frederique E C M Peeters, Steven J R Meex, Marc R Dweck, Elena Aikawa, Harry J G M Crijns, Leon J Schurgers, Bas L J H Kietselaer
Calcific aortic valve stenosis (CAVS) is common in the ageing population and set to become an increasing economic and health burden. Once present, it inevitably progresses and has a poor prognosis in symptomatic patients. No medical therapies are proven to be effective in holding or reducing disease progression. Therefore, aortic valve replacement remains the only available treatment option. Improved knowledge of the mechanisms underlying disease progression has provided us with insights that CAVS is not a passive disease...
November 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29121410/medication-management-of-patients-undergoing-transcatheter-aortic-valve-replacement
#9
Bethany A Kalich, J Erin Ledford, Ian B Hollis
Aortic stenosis (AS) is the most common form of valvular heart disease. A detailed diagnostic workup is necessary to promptly stage and classify disease severity to determine the optimal management. Medical therapy and valvuloplasty are options that fail to delay or reverse disease progression. Surgical aortic valve replacement (SAVR) is curative but has significant limitations for some patient populations. A newer option, transcatheter aortic valve replacement (TAVR), has become more widely available to patients with intermediate- or high-operative risk...
November 9, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29118948/transcatheter-heart-valve-in-valve-implantation-with-edwards-sapien-bioprosthetic-valve-for-different-degenerated-bioprosthetic-valve-positions-first-iranian-viv-report-with-mid-term-follow-up
#10
Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29100642/medium-term-outcomes-after-implantation-of-expanded-polytetrafluoroethylene-valved-conduit
#11
Yoshio Ootaki, Allison S Welch, Michael J Walsh, Michael D Quartermain, Derek A Williams, Ross M Ungerleider
BACKGROUND: Pulmonary valve replacement is becoming the most frequent congenital heart surgery performed on adolescents and young adults. Numerous surgical options are available, including autologous pericardium, mechanical valves, allografts, and bioprosthetic valves. Each option has limitations with durability and freedom from reintervention for stenosis or insufficiency, particularly in the pediatric population. The purpose of this study was to analyze our uniquely designed, expanded polytetrafluoroethylene (ePTFE) valved conduit (VC) for right ventricular outflow tract reconstruction...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29072064/transcatheter-aortic-valve-implantation-tavi-in-2017-recent-advances-and-future-development
#12
Florian Hecker, Mani Arsalan, Won-Keun Kim, Thomas Walther
Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis (AS) who are at high or prohibitive surgical risk. In the past years, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement (SAVR) in the treatment of intermediate risk patients. Besides optimized patient screening, advanced imaging and increased examiner experience, transcatheter heart valve (THV) design addressed several key issues like vascular complications, pacemaker implantation and paravalvular leakage rates and improved considerably over time...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29062740/outcomes-of-surgical-and-transcatheter-aortic-valve-replacement-in-the-octogenarians-surgery-still-the-gold-standard
#13
Sameer A Hirji, Fernando Ramirez-Del Val, Ahmed A Kolkailah, Julius I Ejiofor, Siobhan McGurk, Ritam Chowdhury, Jiyae Lee, Pinak B Shah, Piotr S Sobieszczyk, Sary F Aranki, Marc P Pelletier, Prem S Shekar, Tsuyoshi Kaneko
BACKGROUND: Contemporary options for aortic valve replacement (AVR) include transcatheter and surgical approaches (TAVR and SAVR). As evidence accrues for TAVR in high and intermediate risk patients, some clinicians advocate that all patients aged over 80 years should only receive TAVR. Our aim was to investigate the utility of SAVR and minimally invasive AVR (mAVR) among octogenarians in the current era of TAVR. METHODS: From 2002 to 2015, 1,028 octogenarians underwent isolated AVR; 306 TAVR and 722 SAVR, of which 378 patients underwent mAVR...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28980492/computational-methods-for-the-aortic-heart-valve-and-its-replacements
#14
Rana Zakerzadeh, Ming-Chen Hsu, Michael S Sacks
Replacement with a prosthetic device remains a major treatment option for the patients suffering from heart valve disease, with prevalence growing resulting from an ageing population. While the most popular replacement heart valve continues to be the bioprosthetic heart valve (BHV), its durability remains limited. There is thus a continued need to develop a general understanding of the underlying mechanisms limiting BHV durability to facilitate development of a more durable prosthesis. In this regard, computational models can play a pivotal role as they can evaluate our understanding of the underlying mechanisms and be used to optimize designs that may not always be intuitive...
October 23, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28976383/-approach-to-mitral-valve-diseases-in-the-elderly
#15
Dilek Yeşilbursa
Valvular disease continues to be an important cause of morbidity and mortality across the globe with an increasing number of elderly patients affected by degenerative valvular diseases. Mitral valve disease is the most common of the valvular heart disorders, particularly in ageing populations, with a prevalence of more than 10% in people aged older than 75 years. Mitral regurgitation (MR) is divided into either primary (or organic) or secondary (or functional) MR. It is necessary to distinguish primary from secondary MR because these diseases differ not only by their cause, but also by their prognosis and management...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28950325/management-of-tricuspid-valve-regurgitation-position-statement-of-the-european-society-of-cardiology-working-groups-of-cardiovascular-surgery-and-valvular-heart-disease
#16
Manuel J Antunes, José Rodríguez-Palomares, Bernard Prendergast, Michele De Bonis, Raphael Rosenhek, Nawwar Al-Attar, Fabio Barili, Filip Casselman, Thierry Folliguet, Bernard Iung, Patrizio Lancellotti, Claudio Muneretto, Jean-François Obadia, Luc Pierard, Piotr Suwalski, Pepe Zamorano
Tricuspid regurgitation (TR) is a very frequent manifestation of valvular heart disease. It may be due to the primary involvement of the valve or secondary to pulmonary hypertension or to the left-sided heart valve disease (most commonly rheumatic and involving the mitral valve). The pathophysiology of secondary TR is complex and is intrinsically connected to the anatomy and function of the right ventricle. A systematic multimodality approach to diagnosis and assessment (based not only on the severity of the TR but also on the assessment of annular size, RV function and degree of pulmonary hypertension) is, therefore, essential...
December 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28942384/transcatheter-mitral-valve-replacement-device-landscape-and-early-results
#17
Amisha Patel, Vinayak Bapat
Mitral regurgitation (MR) is the second most common valvular heart disease in the western world with a prevalence in the USA alone of two to four million people. MR is age-dependent and hence the MR burden is expected to increase with the increase in life expectancy observed in Europe and the USA. Medical and surgical treatment has been the cornerstone of the treatment as untreated MR results in poor prognosis. However, only a fraction of patients are offered surgical treatment due to high risk. With the success of transcatheter aortic valve implantation (TAVI), many transcatheter options have emerged to provide a less invasive option for these patients...
September 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28913586/evolving-indications-for-transcatheter-aortic-valve-interventions
#18
REVIEW
Anna Franzone, Thomas Pilgrim, Stefan Stortecky, Stephan Windecker
PURPOSE OF REVIEW: The purpose of this review was to summarize recent progress in the field of transcatheter aortic valve replacement (TAVR), discuss expansion of indications, and identify areas of future clinical applications. RECENT FINDINGS: Favorable clinical outcomes as well as continued refinement of transcatheter heart valve technology have prompted the continuous expansion of indications for TAVR. The results of randomized clinical trials comparing the safety and efficacy of TAVR relative to conventional surgical aortic valve replacement (SAVR) in lower- than high-risk patients have recently been published, and trials among lower-risk categories are ongoing...
September 14, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28906136/redo-quadruple-valve-repair-after-ross-procedure-a-viable-option
#19
V Rao Parachuri, Srilakshmi M Adhyapak, Devi Prasad Shetty
Quadruple-valve repair or replacement is associated with significant morbidity and mortality because the clinical situation of severe disease of all 4 valves implies incipient myocardial damage. We report a case of redo quadruple-valve repair in a patient with rheumatic heart disease who had undergone the Ross procedure 14 years earlier. He presented with heart failure. Cardiac evaluation revealed severe disease of all 4 valves, necessitating surgery. Because he was in advanced heart failure and all 4 valves were suitable for repair, a quadruple-valve repair was performed...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28853220/hemodynamic-evaluation-of-a-biological-and-mechanical-aortic-valve-prosthesis-using-patient-specific-mri-based-cfd
#20
Florian Hellmeier, Sarah Nordmeyer, Pavlo Yevtushenko, Jan Bruening, Felix Berger, Titus Kuehne, Leonid Goubergrits, Marcus Kelm
Modeling different treatment options before a procedure is performed is a promising approach for surgical decision making and patient care in heart valve disease. This study investigated the hemodynamic impact of different prostheses through patient-specific MRI-based CFD simulations. Ten time-resolved MRI data sets with and without velocity encoding were obtained to reconstruct the aorta and set hemodynamic boundary conditions for simulations. Aortic hemodynamics after virtual valve replacement with a biological and mechanical valve prosthesis were investigated...
August 29, 2017: Artificial Organs
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