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https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#1
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#2
REVIEW
Arash Salemi, Berhane M Worku
Transcatheter aortic valve replacement (TAVR) has become a widely accepted therapeutic option for patients with severe, symptomatic aortic stenosis at intermediate, high, or extreme risk for conventional surgery as determined through a heart team approach. Two valve prostheses are currently available and the Food and Drug Administration (FDA) approved in the United States for TAVR: the self-expandable Medtronic CoreValve (Medtronic, Inc., Minneapolis, MN, USA) and the balloon-expandable Edwards Sapien Valve (Edwards Lifesciences, Irvine CA, USA)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28536830/transcatheter-aortic-valve-implantation-in-patients-on-corticosteroid-therapy
#3
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Keitaro Mahara, Itaru Takamisawa, Jun Shimizu, Shuichiro Takanashi, Morimasa Takayama
Transcatheter aortic valve implantation (TAVI) is recommended for patients who are inoperable or at high risk for surgical aortic valve replacement (SAVR). Corticosteroid therapy is considered to be a risk factor for SAVR, but there is a paucity of information about TAVI in patients taking corticosteroids. The aim of this study is to elucidate the outcome of TAVI in patients on chronic corticosteroid therapy, compared with SAVR. We retrospectively analyzed patients on corticosteroid therapy who underwent TAVI (n = 21) or SAVR (n = 30) for severe aortic stenosis in Sakakibara Heart Institute...
May 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28521923/safety-and-efficacy-of-transcatheter-aortic-valve-replacement-in-the-treatment-of-pure-aortic-regurgitation-in-native-valves-and-failing-surgical-bioprostheses-results-from-an-international-registry-study
#4
Fadi J Sawaya, Marcus-André Deutsch, Moritz Seiffert, Sung-Han Yoon, Pablo Codner, Upul Wickramarachchi, Azeem Latib, A Sonia Petronio, Josep Rodés-Cabau, Maurizio Taramasso, Marco Spaziano, Johan Bosmans, Luigi Biasco, Darren Mylotte, Mikko Savontaus, Peter Gheeraert, Jason Chan, Troels H Jørgensen, Horst Sievert, Marco Mocetti, Thierry Lefèvre, Francesco Maisano, Antonio Mangieri, David Hildick-Smith, Ran Kornowski, Raj Makkar, Sabine Bleiziffer, Lars Søndergaard, Ole De Backer
OBJECTIVES: The aim of this study was to evaluate the use of transcatheter heart valves (THV) for the treatment of noncalcific pure native aortic valve regurgitation (NAVR) and failing bioprosthetic surgical heart valves (SHVs) with pure severe aortic regurgitation (AR). BACKGROUND: Limited data are available about the "off-label" use of transcatheter aortic valve replacement (TAVR) to treat pure severe AR. METHODS: The study population consisted of patients with pure severe AR treated by TAVR at 18 different centers...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28451038/-myxoma-involving-posterolateral-leaflet-about-a-case
#5
Fouad Nya, Abdessamad Abdou, Mehdi Bamous, Younes Moutakiallah, Noureddine Atmani, Aniss Seghrouchni, Mahdi Aithoussa, Abdellatif Boulahya
Cardiac myxomas are the most common type of primary cardiac tumors. They mainly affect the interatrial septum and exceptionally the heart valves. Surgical excision remains the only therapeutic alternative. We here report the case of a 69-year old patient with no significant pathological history suffering from NYHA class II-III dyspnea associated with lipothymia. Transthoracic echocardiography showed a tight calcified aortic narrowing with aortic valve gradient of 58 mmHg. A sessile mass of 15mm diameter inserted into the posterolateral leaflet, without stenosis or mitral regurgitation evoking an atypical localization of myxomaor or fibroelastoma was detected at the level of the mitral valve...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28441151/recent-clinical-trials-in-valvular-heart-disease
#6
Daniel Kiss, Saif Anwaruddin
PURPOSE OF REVIEW: With widespread adoption of transcatheter aortic valve replacement, there has been a change in the approach to management of valvular heart disease. New interest has taken hold in transcatheter therapies for valvular heart disease, as well as research into pathophysiology and progression of disease. Additionally, several key trials have further refined our understanding of surgical management of valvular heart disease. This review will elucidate recent clinical trial data leading to changes in practice...
April 24, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28430791/the-medically-managed-patient-with-severe-symptomatic-aortic-stenosis-in-the-tavr-era-patient-characteristics-reasons-for-medical-management-and-quality-of-shared-decision-making-at-heart-valve-treatment-centers
#7
Kumar Dharmarajan, Jill Foster, Megan Coylewright, Philip Green, John P Vavalle, Osman Faheem, Pei-Hsiu Huang, Amar Krishnaswamy, Vinod H Thourani, Lisa A McCoy, Tracy Y Wang
BACKGROUND: Little is known about patients with severe symptomatic aortic stenosis (AS) who receive medical management despite evaluation at a heart valve treatment center. OBJECTIVE: We identified patient characteristics associated with medical management, physician-reported reasons for selecting medical management, and patients' perceptions of their involvement and satisfaction with treatment selection. METHODS AND RESULTS: Of 454 patients evaluated for AS at 9 established heart valve treatment centers from December 12, 2013 to August 19, 2014, we included 407 with severe symptomatic AS...
2017: PloS One
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#8
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28384909/immediate-outcome-of-balloon-mitral-valvuloplasty-with-jomiva-balloon-during-pregnancy
#9
Shanmuga Sundaram Rathakrisnnan, Ramona Ramasamy, Tamilarasu Kaliappan, Rajendiran Gopalan, Ramasmy Palanimuthu, Premkrishna Anandhan
INTRODUCTION: Rheumatic mitral stenosis is the most common Valvular Heart Disease encountered during pregnancy. Balloon Mitral Valvuloplasty (BMV) is one of the treatment option available if the symptoms are refractory to the medical management and the valve anatomy is suitable for balloon dilatation. BMV with Inoue balloon is the most common technique being followed worldwide. Over the wire BMV is a modified technique using Joseph Mitral Valvuloplasty (JOMIVA) balloon catheter which is being followed in certain centres...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28359556/valve-replacement-surgery-in-severe-chronic-kidney-disease
#10
Min Ho Ju, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee, Joon Bum Kim
BACKGROUND: The impact of prosthetic choices in patients with severe chronic kidney disease (CKD) on long-term outcomes has not been well established. METHODS: The study involved 152 adult patients (61.6±14.1yrs.; 64 females) undergoing heart valve surgery who had stage 4 (n=87) or 5 CKD (end-stage; n=65) based on Kidney Disease Outcomes Quality Initiative Guidelines. To reduce the impact of selection bias between mechanical (n=92) and bio-prostheses groups (n=60), propensity score analyses were conducted...
March 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28341764/transesophageal-echocardiographic-guidance-of-transcatheter-closure-of-the-aortic-valve-in-a-patient-with-left-ventricular-assist-device-related-severe-aortic-regurgitation
#11
Preetham Muskala, Taiyeb M Khumri, Michael L Main
A 68 year-old man with a severe ischemic cardiomyopathy underwent left ventricular assist device (LVAD) implantation (Heart Mate II device) for destination therapy. He presented 49 months following LVAD implant with worsening heart failure symptoms and new severe aortic regurgitation. Given high risk for both surgical and transcatheter aortic valve replacement, he was admitted for transcatheter closure of the aortic valve under transesophageal echocardiographic (TEE) guidance. TEE imaging revealed severe aortic regurgitation (see Figure 1A and 1B, and multimedia files 1 and 2)...
March 24, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28329159/concomitant-therapy-off-pump-coronary-revascularization-and-transcatheter-aortic-valve-implantation
#12
Samir Ahad, Kristina Wachter, Christian Rustenbach, Alina Stan, Stephan Hill, Tim Schäufele, Adrian Ursulescu, Ulrich F W Franke, Hardy Baumbach
OBJECTIVES: Significant coronary artery disease (CAD) is common among patients evaluated for transcatheter aortic valve implantation (TAVI). Only little data exist on outcome of patients undergoing concomitant off-pump coronary revascularization and TAVI. The goal of this study was to analyse the impact of concomitant off-pump revascularization on early clinical outcome and 2-year follow-up of patients undergoing TAVI. METHODS: A total of 70 patients with significant CAD and aortic valve stenosis were included between January 2011 and January 2016...
March 10, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28296021/first-transcatheter-valve-in-valve-implantation-in-an-apicoaortic-conduit
#13
Gidon Y Perlman, Jian Ye, Philipp Blanke, John G Webb
Apicoaortic conduit surgery is an option for treating severe aortic stenosis. The implanted conduit valve may eventually fail and require replacement; this is usually performed by repeat surgery. Treating the conduit valve with a standard transcatheter heart valve is an option that has become feasible in recent years. We describe a case of a failed 23 mm CE bioprosthesis that was successfully treated with a 23 mm Sapien XT valve as a valve-in-valve procedure. © 2017 Wiley Periodicals, Inc.
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290168/early-results-of-rheumatic-mitral-valve-repair
#14
Giuseppe Petrone, Panagiotis Theodoropoulos, Prakash P Punjabi
BACKGROUND: Mitral valve repair (MVr) in rheumatic heart disease (RHD) remains challenging. The present authors' surgical experience of MVr in 56 patients with RHD operated in between January 2011 and September 2014 is reported. METHODS: Among the patients (mean age 32 ± 11 years), 11 were in NYHA functional class II, 32 in class III, and seven in class IV. An adequate or oversized autologous pericardial patch was sutured to extend the coaptating edge of both the anterior leaflet (in 18 patients) and the posterior leaflet (in 30 patients)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290162/tavr-in-intermediate-risk-patients-a-review-of-the-partner-2-trial-and-its-future-implications
#15
Sameer Arora, Cassandra J Ramm, Jacob A Misenheimer, John P Vavalle
BACKGROUND: Following publication of the results of the PARTNER trial, the American College of Cardiology/American Heart Association recognized the success of transcatheter aortic valve replacement (TAVR) by incorporating it as a feasible option in high-surgical risk patients, and recommending it as the standard of care for patients at prohibitive risk of surgery. Although this was recognized as a major success in the field of percutaneous valve replacement, surgical aortic valve replacement (SAVR) continued to be realized as the procedure of choice for low and intermediate surgical risk patients...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28289246/the-heart-and-great-vessels
#16
Ekene Onwuka, Nakesha King, Eric Heuer, Christopher Breuer
Cardiovascular disease is the leading cause of mortality worldwide. We have made large strides over the past few decades in management, but definitive therapeutic options to address this health-care burden are still limited. Given the ever-increasing need, much effort has been spent creating engineered tissue to replaced diseased tissue. This article gives a general overview of this work as it pertains to the development of great vessels, myocardium, and heart valves. In each area, we focus on currently studied methods, limitations, and areas for future study...
March 13, 2017: Cold Spring Harbor Perspectives in Medicine
https://www.readbyqxmd.com/read/28281857/engineering-challenges-and-the-future-prospects-of-transcatheter-mitral-valve-replacement-technologies-a-comprehensive-review-of-case-studies
#17
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/28279501/long-term-follow-up-after-trans-catheter-tricuspid-valve-in-valve-replacement-with-balloon-expandable-aortic-valves
#18
Roberto Scarsini, Mattia Lunardi, Gabriele Pesarini, Fausto Castriota, Mauro Feola, Valeria Ferrero, Giuseppe Faggian, Corrado Vassanelli, Flavio Ribichini
BACKGROUND: Transcatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon-expandable aortic valve stents and the long-term follow-up. METHODS AND RESULTS: From January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves...
May 15, 2017: International Journal of Cardiology
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/28214000/comparison-of-results-of-tricuspid-valve-repair-versus-replacement-for-severe-functional-tricuspid-regurgitation
#20
Jeong Yoon Jang, Ran Heo, Sahmin Lee, Joon Bum Kim, Dae-Hee Kim, Sung-Cheol Yun, Jong-Min Song, Jae-Kwan Song, Jae-Won Lee, Duk-Hyun Kang
The optimal decision regarding whether to repair or replace the tricuspid valve (TV) remains controversial in patients with very severe functional tricuspid regurgitation (TR). We sought to compare clinical outcomes of TV repair versus replacement for very severe TR associated with severe TV tethering. We included 96 consecutive patients (20 men, 58 ± 11 years of age) who had both severe tethering of TV and very severe functional TR and consequently underwent TV surgery during left-sided valve surgery. TV repair was performed on 79 patients (repair group), whereas 17 patients underwent TV replacement (replacement group)...
March 15, 2017: American Journal of Cardiology
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