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https://www.readbyqxmd.com/read/29074049/the-dynamic-cardiac-biosimulator-a-method-for-training-physicians-in-beating-heart-mitral-valve-repair-procedures
#1
Alberto M Leopaldi, Krzysztof Wrobel, Giovanni Speziali, Sjoerd van Tuijl, Agne Drasutiene, W Randolph Chitwood
OBJECTIVE: Previously, cardiac surgeons and cardiologists learned to operate new clinical devices for the first time in the operating room or catheterization laboratory. We describe a biosimulator that recapitulates normal heart valve physiology with associated real-time hemodynamic performance. METHODS: To highlight the advantages of this simulation platform, transventricular extruded polytetrafluoroethylene artificial chordae were attached to repair flail or prolapsing mitral valve leaflets...
September 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28964151/complex-blood-flow-patterns-in-an-idealized-left-ventricle-a-numerical-study
#2
Anna Tagliabue, Luca Dedè, Alfio Quarteroni
In this paper, we study the blood flow dynamics in a three-dimensional (3D) idealized left ventricle of the human heart whose deformation is driven by muscle contraction and relaxation in coordination with the action of the mitral and aortic valves. We propose a simplified but realistic mathematical treatment of the valves function based on mixed time-varying boundary conditions (BCs) for the Navier-Stokes equations modeling the flow. These switchings in time BCs, from natural to essential and vice versa, model either the open or the closed configurations of the valves...
September 2017: Chaos
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#3
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#4
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28535761/the-emerging-role-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-hypertensive-heart-disease
#5
REVIEW
Sophie Mavrogeni, Vasiliki Katsi, Vasiliki Vartela, Michel Noutsias, George Markousis-Mavrogenis, Genovefa Kolovou, Athanasios Manolis
BACKGROUND: Arterial hypertension is the commonest cause of cardiovascular death. It may lead to hypertensive heart disease (HHD), including heart failure (HF), ischemic heart disease (IHD) and left ventricular hypertrophy (LVH). MAIN BODY: According to the 2007 ESH/ESC guidelines, the recommended imaging technique is echocardiography (echo), when a more sensitive detection of LVH than that provided by ECG, is needed. Cardiovascular Magnetic Resonance (CMR), a non-invasive, non-radiating technique, offers the following advantages, beyond echo: a) more reliable and reproducible measurements of cardiac parameters such as volumes, ejection fraction and cardiac mass b) more accurate differentiation of LVH etiology by providing information about tissue characterisation c) more accurate evaluation of myocardial ischemia, specifically if small vessels disease is present d) technique of choice for diagnosis of renovascular, aortic tree/branches lesions and quantification of aortic valve regurgitation e) technique of choice for treatment evaluation in clinical trials...
May 23, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28503410/the-ideal-substitute-for-tricuspid-valve-replacement-in-patients-with-congenital-heart-disease-an-unsolved-dilemma
#6
EDITORIAL
Andrea Garatti, Alessandro Giamberti, Alessandro Frigiola, Lorenzo Menicanti
No abstract text is available yet for this article.
April 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28393785/modifying-risks-to-improve-outcome-in-cardiac-surgery-an-anesthesiologist-s-perspective
#7
REVIEW
Murali Chakravarthy
Challenging times are here for cardiac surgical and anesthesia team. The interventional cardiologist seem to have closed the flow of 'good cases' coming up for any of the surgery,; successful percutaneous interventions seem to be offering reasonable results in these patients, who therefore do not knock on the doors of the surgeons any more . It is a common experience among the cardiac anesthesiologists and surgeons that the type of the cases that come by now are high risk. That may be presence of comorbidities, ongoing medical therapies, unstable angina, uncontrolled heart failure and rhythm disturbances; and in patients with ischemic heart disease, the target coronaries are far from ideal...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28150054/the-pursuit-of-engineering-the-ideal-heart-valve-replacement-or-repair-a-special-issue-of-the-annals-of-biomedical-engineering
#8
EDITORIAL
Lakshmi Prasad Dasi, Jane Grande-Allen, Karyn Kunzelman, Ellen Kuhl
No abstract text is available yet for this article.
February 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28112765/a-microfluidic-circulatory-system-integrated-with-capillary-assisted-pressure-sensors
#9
Yangfan Chen, Ho Nam Chan, Sean A Michael, Yusheng Shen, Yin Chen, Qian Tian, Lu Huang, Hongkai Wu
The human circulatory system comprises a complex network of blood vessels interconnecting biologically relevant organs and a heart driving blood recirculation throughout this system. Recreating this system in vitro would act as a bridge between organ-on-a-chip and "body-on-a-chip" and advance the development of in vitro models. Here, we present a microfluidic circulatory system integrated with an on-chip pressure sensor to closely mimic human systemic circulation in vitro. A cardiac-like on-chip pumping system is incorporated in the device...
January 23, 2017: Lab on a Chip
https://www.readbyqxmd.com/read/27995570/hydrodynamic-assessment-of-aortic-valves-prepared-from-porcine-small-intestinal-submucosa
#10
Sharan Ramaswamy, Makensley Lordeus, Omkar V Mankame, Lilliam Valdes-Cruz, Steven Bibevski, Sarah M Bell, Ivan Baez, Frank Scholl
Infants and children born with severe cardiac valve lesions have no effective long term treatment options since currently available tissue or mechanical prosthetic valves have sizing limitations and no avenue to accommodate the growth of the pediatric patient. Tissue engineered heart valves (TEHVs) which could provide for growth, self-repair, infection resistance, and long-term replacement could be an ideal solution. Porcine small intestinal submucosa (PSIS) has recently emerged as a potentially attractive bioscaffold for TEHVs...
March 2017: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27834758/current-status-of-tissue-engineering-heart-valve
#11
REVIEW
Toshiharu Shinoka, Hideki Miyachi
The development of surgically implantable heart valve prostheses has contributed to improved outcomes in patients with cardiovascular disease. However, there are drawbacks, such as risk of infection and lack of growth potential. Tissue-engineered heart valve (TEHV) holds great promise to address these drawbacks as the ideal TEHV is easily implanted, biocompatible, non-thrombogenic, durable, degradable, and ultimately remodels into native-like tissue. In general, three main components used in creating a tissue-engineered construct are (1) a scaffold material, (2) a cell type for seeding the scaffold, and (3) a subsequent remodeling process driven by cell accumulation and proliferation, and/or biochemical and mechanical signaling...
November 2016: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27780764/biodegradable-and-biomimetic-elastomeric-scaffolds-for-tissue-engineered-heart-valves
#12
REVIEW
Yingfei Xue, Vinayak Sant, Julie Phillippi, Shilpa Sant
Valvular heart diseases are the third leading cause of cardiovascular disease, resulting in more than 25,000 deaths annually in the United States. Heart valve tissue engineering (HVTE) has emerged as a putative treatment strategy such that the designed construct would ideally withstand native dynamic mechanical environment, guide regeneration of the diseased tissue and more importantly, have the ability to grow with the patient. These desired functions could be achieved by biomimetic design of tissue-engineered constructs that recapitulate in vivo heart valve microenvironment with biomimetic architecture, optimal mechanical properties and possess suitable biodegradability and biocompatibility...
January 15, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/27703574/aortic-annular-enlargement-during-aortic-valve-replacement
#13
Selman Dumani, Ermal Likaj, Laureta Dibra, Stavri Llazo, Ali Refatllari
In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27570204/planar-biaxial-testing-of-heart-valve-cusp-replacement-biomaterials-experiments-theory-and-material-constants
#14
Michel R Labrosse, Reza Jafar, Janet Ngu, Munir Boodhwani
OBJECTIVES: Aortic valve (AV) repair has become an attractive option to correct aortic insufficiency. Yet, cusp reconstruction with various cusp replacement materials has been associated with greater long-term repair failures, and it is still unknown how such materials mechanically compare with native leaflets. We used planar biaxial testing to characterize six clinically relevant cusp replacement materials, along with native porcine AV leaflets, to ascertain which materials would be best suited for valve repair...
November 2016: Acta Biomaterialia
https://www.readbyqxmd.com/read/27498079/synchronous-ventricular-pacing-with-direct-capture-of-the-atrioventricular-conduction-system-functional-anatomy-terminology-and-challenges
#15
Siva K Mulpuru, Yong-Mei Cha, Samuel J Asirvatham
Right ventricular apical pacing is associated with an increased incidence of heart failure, atrial fibrillation, and overall mortality. As a result, pacing the ventricles in a manner that closely mimics normal AV conduction with an intact His-Purkinje system has been explored. Recently, the sustainable benefits of selective His-bundle stimulation have been demonstrated and proposed as the preferred method of ventricular stimulation for appropriate patients. Ideally, conduction system pacing should be selective without myocardial capture, overcome distal bundle branch block when present, and not compromise tricuspid valve function...
November 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27491910/aortic-valve-sparing-in-different-aortic%C3%A2-valve-and-aortic-root-conditions
#16
REVIEW
Tirone E David
The development of aortic valve-sparing operations (reimplantation of the aortic valve and remodeling of the aortic root) expanded the surgical armamentarium for treating patients with aortic root dilation caused by a variety of disorders. Young adults with aortic root aneurysms associated with genetic syndromes are ideal candidates for reimplantation of the aortic valve, and the long-term results have been excellent. Incompetent bicuspid aortic valves with dilated aortic annuli are also satisfactorily treated with the same type of operation...
August 9, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27443841/pulse-duplicator-hydrodynamic-testing-of-bioengineered-biological-heart-valves
#17
Eric E Buse, Stephen L Hilbert, Richard A Hopkins, Gabriel L Converse
There are many heart valve replacements currently available on the market; however, these devices are not ideal for pediatric patients with congenital heart valve defects. Decellularized valve substitutes offer potential for improved clinical outcomes and require pre-clinical testing guidelines and testing systems suitable for non-crosslinked, biological heart valves. The objective of this study was to assess the hydrodynamic performance of intact, bioengineered pulmonary valves using a custom pulse duplicator capable of testing intact biological valved conduits...
December 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27439413/current-management-of-ebstein-s-anomaly-in-the-adult
#18
REVIEW
Lucy M Safi, Richard R Liberthson, Ami Bhatt
Ebstein's anomaly is a congenital malformation of the tricuspid valve and the right heart with a spectrum of clinical and morphologic presentations. Minor anomalies of the tricuspid valve may not be recognized until adulthood whereas major anomalies leading to heart failure and cyanosis require surgical intervention earlier in life. Echocardiography is the imaging modality of choice for both diagnosis and management of patients with Ebstein's anomaly. Surgical correction includes tricuspid valve repair or replacement and associated findings such as interatrial communications and arrhythmias should be addressed at the time of surgery...
September 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27437653/development-and-validation-of-a-risk-prediction-model-for-in-hospital-mortality-after-transcatheter-aortic-valve-replacement
#19
Fred H Edwards, David J Cohen, Sean M O'Brien, Eric D Peterson, Michael J Mack, David M Shahian, Frederick L Grover, E Murat Tuzcu, Vinod H Thourani, John Carroll, J Matthew Brennan, Ralph G Brindis, John Rumsfeld, David R Holmes
IMPORTANCE: Patient selection for transcatheter aortic valve replacement (TAVR) should include assessment of the risks of TAVR compared with surgical aortic valve replacement (SAVR). Existing SAVR risk models accurately predict the risks for the population undergoing SAVR, but comparable models to predict risk for patients undergoing TAVR are currently not available and should be derived from a population that underwent TAVR. OBJECTIVE: To use a national population of patients undergoing TAVR to develop a statistical model that will predict in-hospital mortality after TAVR...
April 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27422199/effects-of-combined-cryopreservation-and-decellularization-on-the-biomechanical-structural-and-biochemical-properties-of-porcine-pulmonary-heart-valves
#20
Karolina Theodoridis, Janina Müller, Robert Ramm, Katja Findeisen, Birgit Andrée, Sotirios Korossis, Axel Haverich, Andres Hilfiker
UNLABELLED: Non-fixed, decellularized allogeneic heart valve scaffolds seem to be the best choice for heart valve replacement, their availability, however, is quite limited. Cryopreservation could prolong their shelf-life, allowing for their ideal match to a recipient. In this study, porcine pulmonary valves were decellularized using detergents, either prior or after cryopreservation, and analyzed. Mechanical integrity was analyzed by uniaxial tensile testing, histoarchitecture by histological staining, and composition by DNA, collagen (hydroxyproline) and GAG (chondroitin sulfate) quantification...
October 1, 2016: Acta Biomaterialia
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