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Future of heart valve replacements

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https://www.readbyqxmd.com/read/28597998/a-novel-mechanical-mitral-valve-replacement-using-sapien-xt
#1
Megan Koehle, Justin A Strote, Mark Guadagnoli, J Bradley Oldemeyer
PATIENT PRESENTATION: We report the case of a 66 year old female who presented to our institution fourteen years after receiving a St. Jude Mechanical Mitral Valve Replacement. She presented in refractory NYHA class IV congestive heart failure with comorbidities of acute renal failure, liver failure, and mental status changes. She was found to have immobility of one of the mitral valve disks with resultant severe mitral stenosis with a mean pressure gradient of 12 mmHg. EVALUATION AND MANAGEMENT: The patient was found to have an STS predicted mortality of 39% with redo surgical MVR, and evaluation by the valve team led to a recommendation of a hybrid surgical and transcatheter procedure...
June 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28520540/virtual-surgery-for-conduit-reconstruction-of-the-right-ventricular-outflow-tract
#2
Chin Siang Ong, Yue-Hin Loke, Justin Opfermann, Laura Olivieri, Luca Vricella, Axel Krieger, Narutoshi Hibino
PURPOSE: Virtual surgery involves the planning and simulation of surgical reconstruction using three-dimensional (3D) modeling based upon individual patient data, augmented by simulation of planned surgical alterations including implantation of devices or grafts. Here we describe a case in which virtual cardiac surgery aided us in determining the optimal conduit size to use for the reconstruction of the right ventricular outflow tract. DESCRIPTION: The patient is a young adolescent male with a history of tetralogy of Fallot with pulmonary atresia, requiring right ventricle-to-pulmonary artery (RV-PA) conduit replacement...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28503975/body-image-after-heart-transplantation-compared-to-mechanical-aortic-valve-insertion
#3
Armin Hartmann, Claudia Heilmann, Josefine Kaps, Friedhelm Beyersdorf, Wolfgang Zeh, Wolfgang Albert, Michael Wirsching, Kurt Fritzsche, Andreas Joos
OBJECTIVE: Heart transplantation (HT) obviously affects body image and integrity. However, there are very few empirical data post-transplant. METHODS: In a cross-sectional study, 57 HT patients were compared with 47 subjects with mechanical aortic valve replacement (AVR) using the Dresden-Body-Image questionnaire (DKB) and specific questions regarding integration of the organ/device. In addition, affective symptoms and quality of life (QoL) were assessed (12-Item Short-Form Health Survey and Hospital Anxiety and Depression Scale, HADS)...
May 15, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/28473139/tricuspid-valve-dysfunction-following-pacemaker-or-cardioverter-defibrillator-implantation
#4
REVIEW
James D Chang, Warren J Manning, Elisa Ebrille, Peter J Zimetbaum
The potential for cardiac implantable electronic device leads to interfere with tricuspid valve (TV) function has gained increasing recognition as having hemodynamic and clinical consequences associated with incremental morbidity and death. The diagnosis and treatment of lead-related (as distinct from functional) tricuspid regurgitation pose unique challenges. Because of pitfalls in routine diagnostic imaging, a high level of clinical suspicion must be maintained to avoid overlooking the possibility that worsening heart failure is a consequence of mechanical interference with TV leaflet mobility or coaptation and is amenable to lead extraction or valve repair or replacement...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28457382/case-report-aortic-valve-replacement-after-jarvik-2000-left-ventricular-assist-device-implantation-in-long-time-survivor-with-severe-aortic-valve-regurgitation
#5
A Dokollari, M Cameli, C G Sassi, G Davoli, S Scolletta, C Ricci, P Lucatelli, S Mondillo, M Maccherini
BACKGROUND: There are limited clinical records in the literature regarding aortic valve replacement in left ventricular assist device (L-VAD) patients. Previously we had two cases of severe aortic valve regurgitation in patients with L-VAD support treated with Corvalve prosthesis insertion and Amplatzer closure procedure. Both patients died a few days after the procedure from complications not related to the procedure itself. PATIENT HISTORY: The patient was a male with previous coronary artery bypass graft surgery in 2001 that was complicated with postischemic dilated cardiomyopathy with severe heart failure (ejection fraction [EF], 20%)...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28412434/a-highly-predictive-risk-model-for-pacemaker-implantation-after-tavr
#6
Yoshio Maeno, Yigal Abramowitz, Hiroyuki Kawamori, Yoshio Kazuno, Shunsuke Kubo, Nobuyuki Takahashi, Geeteshwar Mangat, Kazuaki Okuyama, Mohammad Kashif, Tarun Chakravarty, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Raj R Makkar, Hasan Jilaihawi
OBJECTIVES: This study sought to develop a robust and definitive risk model for new permanent pacemaker implantation (PPMI) after SAPIEN 3 (third generation balloon expandable valve) (Edwards Lifesciences, Irvine, California) transcatheter aortic valve replacement (third generation balloon expandable valve TAVR), including calcification in the aortic-valvular complex (AVC). BACKGROUND: The association between calcium in the AVC and need for PPMI is poorly delineated after third generation balloon expandable valve TAVR...
April 7, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28290162/tavr-in-intermediate-risk-patients-a-review-of-the-partner-2-trial-and-its-future-implications
#7
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
#8
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
#9
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/28265822/systematic-review-of-model-based-economic-evaluations-of-heart-valve-implantations
#10
Simone A Huygens, Johanna J M Takkenberg, Maureen P M H Rutten-van Mölken
OBJECTIVE: To review the evidence on the cost-effectiveness of heart valve implantations generated by decision analytic models and to assess their methodological quality. METHODS: A systematic review was performed including model-based cost-effectiveness analyses of heart valve implantations. Study and model characteristics and cost-effectiveness results were extracted and the methodological quality was assessed using the Philips checklist. RESULTS: Fourteen decision-analytic models regarding the cost-effectiveness of heart valve implantations were identified...
March 6, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28248406/trans-catheter-aortic-valve-implantation-contemporary-practice-and-the-future
#11
REVIEW
Omar Aldalati, Philip MacCarthy, Rafał Dworakowski
With increasing life expectancy, the epidemic of valvular heart disease, especially aortic stenosis (AS), is becoming more prevalent. Transcatheter aortic valve implantation (TAVI) has emerged as an alternative therapy for patients with significant aortic valve disease. It offers a less invasive procedure in comparison to surgical aortic valve replacement (sAVR) and an attractive substitute from the patient's perspective. The evidence for TAVI in inoperable and high risk surgical patients is now established and in the intermediate risk group has been accumulating rapidly and is looking favourable for TAVI...
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28182589/bicuspid-aortic-valve-aortopathy-mechanistic-and-clinical-insights-from-recent-studies
#12
David G Guzzardi, Subodh Verma, Paul W M Fedak
PURPOSE OF REVIEW: This focused review summarizes key insights from the past 12 months of basic science and clinical research on bicuspid aortic valve (BAV)-associated aortopathy. RECENT FINDINGS: Recent studies in BAV-associated aortopathy support a heterogeneous spectrum of disease with distinct phenotypes. Basic science studies provide further support for the concept of regional differences in the severity of aortopathy within the aorta of BAV patients. Clinical studies compared outcomes of BAV patients after isolated aortic valve replacement and showed that those with primarily valvular insufficiency as compared with stenosis may be at greater risk for important aortic events over time...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28151005/allograft-heart-valves-current-aspects-and-future-applications
#13
REVIEW
Milan Lisy, Guenay Kalender, Katja Schenke-Layland, Kelvin G M Brockbank, Anna Biermann, Ulrich Alfred Stock
Human heart valve allografts continue to represent almost perfect substitutes for heart valves. They have optimal hemodynamic characteristics and are highly resistant to infections. The first clinical use of allograft heart valves was as homovitals being transplanted after antibiotic incubation without any preservation. Since 1968, relatively standardized frozen cryopreservation (SFC) has been employed, including storage in vapor-phase liquid nitrogen. Disadvantages, particularly in pediatric patients, are limited availability due to organ scarcity, inability to grow, degeneration, immune response, and long-term failure...
April 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28108064/stent-and-leaflet-stresses-in-a-26-mm-first-generation-balloon-expandable-transcatheter-aortic-valve
#14
Yue Xuan, Kapil Krishnan, Jian Ye, Danny Dvir, Julius M Guccione, Liang Ge, Elaine E Tseng
OBJECTIVE: Transcatheter aortic valve replacement is established therapy for high-risk and inoperable patients with severe aortic stenosis, but questions remain regarding long-term durability. Valve design influences durability. Increased leaflet stresses in surgical bioprostheses have been correlated with degeneration; however, transcatheter valve leaflet stresses are unknown. From 2007 to 2014, a majority of US patients received first-generation balloon-expandable transcatheter valves...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28057890/in-vitro-3d-model-and-mirna-drug-delivery-to-target-calcific-aortic-valve-disease
#15
REVIEW
Casper F T van der Ven, Pin-Jou Wu, Mark W Tibbitt, Alain van Mil, Joost P G Sluijter, Robert Langer, Elena Aikawa
Calcific aortic valve disease (CAVD) is the most prevalent valvular heart disease in the Western population, claiming 17000 deaths per year in the United States and affecting 25% of people older than 65 years of age. Contrary to traditional belief, CAVD is not a passive, degenerative disease but rather a dynamic disease, where initial cellular changes in the valve leaflets progress into fibrotic lesions that induce valve thickening and calcification. Advanced thickening and calcification impair valve function and lead to aortic stenosis (AS)...
February 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/27989051/pga-polyglycolic-acid-p4hb-poly-4-hydroxybutyrate-based-bioengineered-valves-in-the-rat-aortic-circulation
#16
Agnieszka A Książek, Katharyn J Mitchell, Nikola Cesarovic, Colin C Schwarzwald, Simon P Hoerstrup, Benedikt Weber
BACKGROUND: Bioengineered living autologous valves with remodeling and growth capacity represent a promising concept for future cardiac and venous valve repair. A meticulous understanding of the mechanisms involved in recellularization and remodeling is essential for the safe and efficient clinical translation of this technology. In this context, the first investigations of bioengineered vascular grafts in immune-incompetent or transgenic rodents represented an important step. However, the in-vivo assessment of bioengineered synthetic scaffold-based (biodegradable) valve replacements in rodent models has not been achieved to date...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27959615/developmental-mechanisms-of-aortic-valve-malformation-and-disease
#17
Bingruo Wu, Yidong Wang, Feng Xiao, Jonathan T Butcher, Katherine E Yutzey, Bin Zhou
Normal aortic valves are composed of valve endothelial cells (VECs) and valve interstitial cells (VICs). VICs are the major cell population and have distinct embryonic origins in the endocardium and cardiac neural crest cells. Cell signaling between the VECs and VICs plays critical roles in aortic valve morphogenesis. Disruption of major cell signaling pathways results in aortic valve malformations, including bicuspid aortic valve (BAV). BAV is a common congenital heart valve disease that may lead to calcific aortic valve disease (CAVD), but there is currently no effective medical treatment for this beyond surgical replacement...
February 10, 2017: Annual Review of Physiology
https://www.readbyqxmd.com/read/27815409/a-new-beating-heart-mitral-and-aortic-valve-assessment-model-with-implications-for-valve-intervention-training
#18
Wobbe Bouma, Jayant S Jainandunsing, Arash Khamooshian, Pim van der Harst, Massimo A Mariani, Ehsan Natour
OBJECTIVES: A thorough understanding of mitral and aortic valve motion dynamics is essential in mastering the skills necessary for performing successful valve intervention (open or transcatheter repair or replacement). We describe a reproducible and versatile beating-heart mitral and aortic valve assessment and valve intervention training model in human cadavers. METHODS: The model is constructed by bilateral ligation of the pulmonary veins, ligation of the supra-aortic arteries, creating a shunt between the descending thoracic aorta and the left atrial appendage with a vascular prosthesis, anastomizing a vascular prosthesis to the apex and positioning an intra-aortic balloon pump (IABP) in the vascular prosthesis, cross-clamping the descending thoracic aorta, and finally placing a fluid line in the shunt prosthesis...
November 3, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27749539/a-huge-saccular-aortic-aneurysm-compressing-right-coronary-artery-7-years-after-aortic-valve-replacement-due-to-bicuspid-aortic-valve-insufficiency-a-rare-case-report
#19
Sang Min Park, Haemin Jeong, Kyung-Soon Hong, Christopher Kim
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27721934/novel-concepts-in-radiation-induced-cardiovascular-disease
#20
REVIEW
Jason R Cuomo, Gyanendra K Sharma, Preston D Conger, Neal L Weintraub
Radiation-induced cardiovascular disease (RICVD) is the most common nonmalignant cause of morbidity and mortality among cancer survivors who have undergone mediastinal radiation therapy (RT). Cardiovascular complications include effusive or constrictive pericarditis, cardiomyopathy, valvular heart disease, and coronary/vascular disease. These are pathophysiologically distinct disease entities whose prevalence varies depending on the timing and extent of radiation exposure to the heart and great vessels. Although refinements in RT dosimetry and shielding will inevitably limit future cases of RICVD, the increasing number of long-term cancer survivors, including those treated with older higher-dose RT regimens, will ensure a steady flow of afflicted patients for the foreseeable future...
September 26, 2016: World Journal of Cardiology
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