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Lifetime heart valve

Richard W Harbron, Claire-Louise Chapple, John J O'Sullivan, Kate E Best, Amy Berrington de González, Mark S Pearce
OBJECTIVES: To estimate the risk of developing cancer in relation to the typical radiation doses received from a range of X-ray guided cardiac catheterisations in children, taking variable survival into account. METHODS: Radiation doses were estimated for 2749 procedures undertaken at five UK hospitals using Monte Carlo simulations. The lifetime attributable risk (LAR) of cancer incidence was estimated using models developed by the Biological Effects of Ionising Radiation committee, based on both normal life expectancy, and as a function of attained age, from 20 to 80 years, to take reduced life expectancy into account...
August 18, 2016: Heart: Official Journal of the British Cardiac Society
Despina Bournele, Dimitris Beis
Cardiovascular disease (CVD) is one of the leading causes of death worldwide. The most significant risk factors associated with the development of heart diseases include genetic and environmental factors such as hypertension, high blood cholesterol levels, diabetes, smoking, and obesity. Coronary artery disease accounts for the highest percentage of CVD deaths and stroke, cardiomyopathies, congenital heart diseases, heart valve defects and arrhythmias follow. The causes, prevention, and treatment of all forms of cardiovascular disease remain active fields of biomedical research, with hundreds of scientific studies published on a weekly basis...
August 8, 2016: Heart Failure Reviews
J-M Bourget, R Zegdi, J Lin, P Wawryko, Y Merhi, C Convelbo, J Mao, Y Fu, T Xu, N O Merkel, L Wang, L Germain, Z Zhang, R Guidoin
INTRODUCTION: Transcathether heart valve replacement has gained considerable acceptance during the last decades. It is now part of the armamentarium for aortic valve replacement. The procedure proved to be highly efficient. However the issues of the blood compatibility and tissue durability were not raised and the adverse events were probably under-reported, according to observations of thrombosis after deployment. MATERIAL AND METHOD: Bovine pericardium leaflets were sewn inside a 26mm diameter stainless steel stent to manufacture these valves (one control and two experimental)...
July 13, 2016: Morphologie: Bulletin de L'Association des Anatomistes
Yuli Y Kim, Emily Ruckdeschel
Residual right ventricular outflow tract and pulmonary valve disease is common in adults with repaired tetralogy of Fallot. Chronic severe pulmonary regurgitation as a result of surgical repair can lead to myriad complications including right ventricular dysfunction, decreased exercise tolerance, right heart failure and symptomatic arrhythmias. The aim of restoring pulmonary valve integrity is to preserve right ventricular size and function with the intent of mitigating the development of symptoms and poor long-term outcomes...
October 1, 2016: Heart: Official Journal of the British Cardiac Society
Debora Kehl, Benedikt Weber, Simon Philipp Hoerstrup
Valvular heart disease remains to be a major cause of death worldwide with increasing prevalence, mortality, and morbidity. Current heart valve replacements are associated with several limitations due to their nonviable nature. In this regard, heart valve tissue engineering has shown to represent a promising concept in order to overcome these limitations and replace diseased cardiac valves with living, autologous constructs. These bioengineered valves hold potential for in situ remodeling, growth, and repair throughout the patient's lifetime without the risk of thromboembolic complications and adverse immune responses...
July 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Daniel S Puperi, Ronan W O'Connell, Zoe E Punske, Yan Wu, Jennifer L West, K Jane Grande-Allen
Advanced tissue engineered heart valves must be constructed from multiple materials to better mimic the heterogeneity found in the native valve. The trilayered structure of aortic valves provides the ability to open and close consistently over a full human lifetime, with each layer performing specific mechanical functions. The middle spongiosa layer consists primarily of proteoglycans and glycosaminoglycans, providing lubrication and dampening functions as the valve leaflet flexes open and closed. In this study, hyaluronan hydrogels were tuned to perform the mechanical functions of the spongiosa layer, provide a biomimetic scaffold in which valve cells were encapsulated in 3D for tissue engineering applications, and gain insight into how valve cells maintain hyaluronan homeostasis within heart valves...
May 9, 2016: Biomacromolecules
M Serrani, J Brubert, J Stasiak, F De Gaetano, A Zaffora, M L Costantino, G D Moggridge
Styrene-based block copolymers are promising materials for the development of a polymeric heart valve prosthesis (PHV), and the mechanical properties of these polymers can be tuned via the manufacturing process, orienting the cylindrical domains to achieve material anisotropy. The aim of this work is the development of a computational tool for the optimization of the material microstructure in a new PHV intended for aortic valve replacement to enhance the mechanical performance of the device. An iterative procedure was implemented to orient the cylinders along the maximum principal stress direction of the leaflet...
June 2016: Journal of Biomechanical Engineering
Keping Chen, Xiaolin Zheng, Yan Dai, Hao Wang, Yue Tang, Tingyu Lan, Jinping Zhang, Yi Tian, Baojie Zhang, Xiaohong Zhou, Matthew Bonner, Shu Zhang
AIMS: The miniaturized leadless pacemaker has recently emerged as a bradycardia therapy in humans, and many patients may need at least two pacemakers in their lifetime. Thus, the present study assessed the effect of two leadless pacemakers in the right ventricle (RV) on cardiac function in a swine model. METHODS AND RESULTS: Fourteen mini pigs were chronically studied. Each animal received two sequential leadless pacemakers in the RV with 1 month between two separate implantations...
January 31, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Emily Steed, Francesco Boselli, Julien Vermot
Mechanical forces are instrumental to cardiovascular development and physiology. The heart beats approximately 2.6 billion times in a human lifetime and heart valves ensure that these contractions result in an efficient, unidirectional flow of the blood. Composed of endocardial cells (EdCs) and extracellular matrix (ECM), cardiac valves are among the most mechanically challenged structures of the body both during and after their development. Understanding how hemodynamic forces modulate cardiovascular function and morphogenesis is key to unraveling the relationship between normal and pathological cardiovascular development and physiology...
July 2016: Biochimica et Biophysica Acta
Shunsuke Miyahara, Yutaka Okita
Marfan syndrome is a heritable, systemic disorder of the connective tissue with a high penetrance, named after Dr. Antoine Marfan. The most clinically important manifestations of this syndrome are cardiovascular pathologies which cause life-threatening events, such as acute aortic dissections, aortic rupture and regurgitation of the aortic valve or other artrioventricular valves leading to heart failure. These events play important roles in the life expectancy of patients with this disorder, especially prior to the development of effective surgical approaches for proximal ascending aortic disease...
September 2016: Surgery Today
Mohammad M Ansari, Rhanderson Cardoso, Daniel Garcia, Satinder Sandhu, Eric Horlick, Derek Brinster, Giuseppe Martucci, Nicolo Piazza
Due to recurrent right ventricular outflow tract (RVOT) dysfunction, patients with complex congenital heart disease of the RVOT traditionally require multiple surgical interventions during their lifetimes. Percutaneous pulmonary valve implantation (PPVI) has been developed as a nonsurgical alternative for the treatment of right ventricular to pulmonary artery stenosis or pulmonary regurgitation. PPVI has been shown to be a safe and effective procedure in patients with dysfunctional surgical RVOT conduits. In this population, PPVI has the potential to improve symptoms, functional capacity, and biventricular hemodynamics...
November 17, 2015: Journal of the American College of Cardiology
Kristofer Skoglund, Peter Eriksson, Gunnar Svensson, Mikael Dellborg
Reconstruction of the right ventricular outflow tract with a homograft is an established surgical method in congenital heart disease. Studies from children and adolescents suggest that homograft durability is shorter than the life expectancy of the patient; therefore, durability in adults is addressed in this systematic review. The PubMed database was searched in May 2012 and repeated in May 2015 with the terms 'homograft AND pulmonary valve', generating 665 hits. We included only studies involving more than 50 patients with a mean or median age >18 years...
January 2016: Interactive Cardiovascular and Thoracic Surgery
D G Buys, C Greig, S C Brown
Congenital heart lesions involving the right ventricular outflow tract (RVOT) are a common problem in paediatric cardiology. These patients need multiple surgical interventions in the form of valved conduits over a lifetime. Surgical re-valvulation was the standard treatment option until the introduction of percutaneous pulmonary valves over a decade ago. These valves can be used to prolong the lifespan of conduits and reduce the number of re-operations. The Melody(®) valve (Medtronic, Minneapolis, MN, USA) was introduced as the first dedicated percutaneous pulmonary valve...
July 2015: Cardiovascular Journal of Africa
Athar M Qureshi, Lourdes R Prieto
Patients with congenital heart disease and pulmonary valve disease need multiple procedures over their lifetimes to replace their pulmonary valves. Chronic pulmonary stenosis, regurgitation, or both have untoward effects on ventricular function and on the clinical status of these patients. To date, all right ventricle-pulmonary artery conduits have had relatively short lifespans. Percutaneous pulmonary valve implantation, although relatively new, will probably reduce the number of operative procedures that these patients will have to undergo over a lifetime...
June 2015: Texas Heart Institute Journal
Andreas Eicken, Stephan Schubert, Alfred Hager, Jürgen Hörer, Doff B McElhinney, John Hess, Peter Ewert, Felix Berger
BACKGROUND: Severe tricuspid valve (TV) dysfunction may lead to surgical TV replacement with a biological valve prosthesis in patients with congenital heart disease. To expand the lifetime of this valve and reduce the number of surgeries, percutaneous TV implantation (PTVI) may be an effective alternative to repeated surgery. We report on our 2-center experience with PTVI. METHODS AND RESULTS: Between 2008 and 2014, 17 percutaneous valves were implanted in 16 patients with TV bioprosthesis dysfunction (9 females) from 2 centers...
April 2015: Circulation. Cardiovascular Interventions
Sebastian Góreczny, Andreas Eicken, Peter Ewert, Gareth John Morgan, Sohrab Fratz
Despite advances in surgical techniques, right ventricular outflow tract (RVOT) conduits are prone to fail over time. Percutaneous pulmonary valve implantation was introduced to expand the lifetime of these conduits and to decrease the number of open heart operations during a patient's lifetime. The procedure can be performed with excellent results; however, serious complications such as coronary arterial compression and conduit rupture have been reported. We present percutaneous treatment of a patient after Ross-Konno operation with RVOT conduit dysfunction and a potentially problematic course of the left anterior descending artery...
2014: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Eileen O'Meara, Nicolas Thibodeau-Jarry, Anique Ducharme, Jean Lucien Rouleau
At least 1 in 5 Canadians will experience heart failure (HF) during their lifetimes, with an average 1-year mortality rate of 23.4%. Hospitalizations for HF are projected to increase 3-fold from 1996 to 2050. HF can be associated with either reduced ejection fraction (HFrEF) or preserved ejection fraction (HFpEF), with the latter becoming increasingly common. The prognosis of both groups is equally concerning, but clinical trials testing pharmacologic therapies for HFpEF have been disappointing. We briefly discuss established therapies for HF and then focus on emerging therapies, challenges, and opportunities...
December 2014: Canadian Journal of Cardiology
Li-Jin Pu, Yu Wang, Ling Zhao, Zhi-Ling Luo, Bao-Tong Hua, Ming-Hua Han, Shu-Min Li, Jun Yang, Lin Li, Yun-Zhu Peng, Tao Guo
BACKGROUND: The aim of this study was to investigate the effect of cardiac resynchronization therapy (CRT) with right ventricular (RV) sense triggered left ventricular (LV) pacing for chronic heart failure (CHF). METHODS: Thirty patients who were eligible for the Class I indication of CRT were enrolled and the informed consents were signed. Left ventricular ejection fraction (LVEF), diastolic mitral flow velocity time integral (VTI), mitral regurgitation flow VTI, and aortic valve flow VTI were measured with GE Vivid 7 (GE Medical, Milwaukee, WI, USA) before and after CRT...
2015: Cardiology Journal
Stamatia Kalogirou, Nikos Malissovas, Enrico Moro, Francesco Argenton, Didier Y R Stainier, Dimitris Beis
AIMS: Valvular heart disease is responsible for considerable morbidity and mortality. Cardiac valves develop as the heart contracts, and they function throughout the lifetime of the organism to prevent retrograde blood flow. Their precise morphogenesis is crucial for cardiac function. Zebrafish is an ideal model to investigate cardiac valve development as it allows these studies to be carried out in vivo through non-invasive imaging. Accumulating evidence suggests a role for contractility and intracardiac flow dynamics in cardiac valve development...
October 1, 2014: Cardiovascular Research
Roberto Salvatori
Medical therapy with dopaminergic agonists (DAs) has been used for several decades for the treatment of both micro- and macroprolactinomas, without much differentiation between the two conditions. While most cases respond well to DAs in terms of prolactin normalization and control of tumor growth, DAs are often needed for many years, or even for lifetime. Concerns have been raised recently about the possible side effects of long-term use of these medications on the anatomy and function of the heart valves. While macroprolactinomas are rarely surgically curable, pituitary surgery in expert hands is a safe and effective method to permanently cure microprolactinomas, with long-term cure rates around 70 %...
December 2014: Endocrine
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