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Next-generation heart valves

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https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#1
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28170357/on-x-valve-the-next-generation-aortic-valve
#2
Rahul Chaudhary, Jalaj Garg, Parasuram Krishnamoorthy, Neeraj Shah, Bruce A Feldman, Matthew W Martinez, Ronald Freudenberger
The On-X valve is a newer generation mechanical bileaflet valve. Its key features include the use of pure pyrolytic carbon (devoid of silicon), a length-to-diameter ratio similar to a native valve, an inlet flared orifice, a leaflet opening up to 90 degrees, a shorter leaflet closing angle, a 2-point leaflet contact, and an actuated pivot. These features have translated into increased strength, improved valve hemodynamics, reduced hemolysis, and thrombogenicity. The 2014 American Heart Association/American College of Cardiology guidelines for the management of patients with valvular heart disease recommend an international normalized ratio (INR) of 2...
March 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#3
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28057890/in-vitro-3d-model-and-mirna-drug-delivery-to-target-calcific-aortic-valve-disease
#4
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/27934611/a-multicentre-european-registry-to-evaluate-the-direct-flow-medical-transcatheter-aortic-valve-system-for-the-treatment-of-patients-with-severe-aortic-stenosis
#5
Christoph K Naber, Stylianos A Pyxaras, Hüseyin Ince, Peter Frambach, Antonio Colombo, Christian Butter, Fernando Gatto, Ulrich Hink, Georg Nickenig, Giuseppe Bruschi, Guus Brueren, Didier Tchétché, Peter Den Heijer, Wolfgang Schillinger, Smita Scholtz, Jan Van der Heyden, Thierry Lefèvre, Martine Gilard, Karl-Heinz Kuck, Joachim Schofer, Dimitar Divchev, Helmut Baumgartner, Federico Asch, Daniel Wagner, Azeem Latib, Federico De Marco, Stephan Kische
AIMS: Our aim was to assess the clinical outcomes of the Direct Flow Medical Transcatheter Aortic Valve System (DFM-TAVS), when used in routine clinical practice. METHODS AND RESULTS: This is a prospective, open-label, multicentre, post-market registry of patients treated with DFM-TAVS according to approved commercial indications. Echocardiographic and angiographic data were evaluated by an independent core laboratory and adverse events were adjudicated and classified according to VARC-2 criteria by an independent clinical events committee...
December 10, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27873034/on-the-mechanics-of-transcatheter-aortic-valve-replacement
#6
Lakshmi P Dasi, Hoda Hatoum, Arash Kheradvar, Ramin Zareian, S Hamed Alavi, Wei Sun, Caitlin Martin, Thuy Pham, Qian Wang, Prem A Midha, Vrishank Raghav, Ajit P Yoganathan
Transcatheter aortic valves (TAVs) represent the latest advances in prosthetic heart valve technology. TAVs are truly transformational as they bring the benefit of heart valve replacement to patients that would otherwise not be operated on. Nevertheless, like any new device technology, the high expectations are dampened with growing concerns arising from frequent complications that develop in patients, indicating that the technology is far from being mature. Some of the most common complications that plague current TAV devices include malpositioning, crimp-induced leaflet damage, paravalvular leak, thrombosis, conduction abnormalities and prosthesis-patient mismatch...
February 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/27844463/fluid-structure-interaction-study-of-transcatheter-aortic-valve-dynamics-using-smoothed-particle-hydrodynamics
#7
Wenbin Mao, Kewei Li, Wei Sun
Computational modeling of heart valve dynamics incorporating both fluid dynamics and valve structural responses has been challenging. In this study, we developed a novel fully-coupled fluid-structure interaction (FSI) model using smoothed particle hydrodynamics (SPH). A previously developed nonlinear finite element (FE) model of transcatheter aortic valves (TAV) was utilized to couple with SPH to simulate valve leaflet dynamics throughout the entire cardiac cycle. Comparative simulations were performed to investigate the impact of using FE-only models vs...
December 2016: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/27807680/genetics-of-congenital-heart-disease-past-and-present
#8
REVIEW
Iolanda Muntean, Rodica Togănel, Theodora Benedek
Congenital heart disease is the most common congenital anomaly, representing an important cause of infant morbidity and mortality. Congenital heart disease represents a group of heart anomalies that include septal defects, valve defects, and outflow tract anomalies. The exact genetic, epigenetic, or environmental basis of congenital heart disease remains poorly understood, although the exact mechanism is likely multifactorial. However, the development of new technologies including copy number variants, single-nucleotide polymorphism, next-generation sequencing are accelerating the detection of genetic causes of heart anomalies...
November 2, 2016: Biochemical Genetics
https://www.readbyqxmd.com/read/27707468/does-sudden-unexplained-nocturnal-death-syndrome-remain-the-autopsy-negative-disorder-a-gross-microscopic-and-molecular-autopsy-investigation-in-southern-china
#9
Liyong Zhang, David J Tester, Di Lang, Yili Chen, Jinxiang Zheng, Rui Gao, Robert F Corliss, Shuangbo Tang, John W Kyle, Chao Liu, Michael J Ackerman, Jonathan C Makielski, Jianding Cheng
OBJECTIVE: To look for previously unrecognized cardiac structural abnormalities and address the genetic cause for sudden unexplained nocturnal death syndrome (SUNDS). METHODS: Data for 148 SUNDS victims and 444 controls (matched 1:3 on sex, race, and age of death within 1 year) were collected from Sun Yat-sen University from January 1, 1998, to December 31, 2014, to search morphological changes. An additional 17 patients with Brugada syndrome (BrS) collected from January 1, 2006, to December 31, 2014, served as a comparative disease cohort...
November 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27583373/genetics-of-bicuspid-aortic-valve-aortopathy
#10
Maria G Andreassi, Alessandro Della Corte
PURPOSE OF REVIEW: The incidence of aortic dilation and acute complications (rupture and dissection) is higher in patients with a bicuspid aortic valve (BAV), the most frequent congenital heart defect.The present review focuses on the current knowledge in the genetics of BAV, emphasizing the clinical implications for early detection and personalized care. RECENT FINDINGS: BAV is a highly heritable trait, but the genetic causes remain largely elusive. NOTCH1 is the only proven candidate gene to be associated with both familial and sporadic BAV...
November 2016: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27466029/resolving-fine-cardiac-structures-in-rats-with-high-resolution-diffusion-tensor-imaging
#11
Irvin Teh, Darryl McClymont, Rebecca A B Burton, Mahon L Maguire, Hannah J Whittington, Craig A Lygate, Peter Kohl, Jürgen E Schneider
Cardiac architecture is fundamental to cardiac function and can be assessed non-invasively with diffusion tensor imaging (DTI). Here, we aimed to overcome technical challenges in ex vivo DTI in order to extract fine anatomical details and to provide novel insights in the 3D structure of the heart. An integrated set of methods was implemented in ex vivo rat hearts, including dynamic receiver gain adjustment, gradient system scaling calibration, prospective adjustment of diffusion gradients, and interleaving of diffusion-weighted and non-diffusion-weighted scans...
July 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27460051/-interdisciplinary-differential-treatment-of-structural-heart-disease-when-operation-and-when-catheter-based-intervention
#12
S Yücel, H Ince, S Kische, M A Sherif, H Bushnaq, A Bärisch, A Öner
The demographic changes in society lead to an increasing number of patients with aortic valve stenosis and mitral regurgitation. Simultaneously the higher age of patients is associated with an increase in multimorbidity with a high surgical risk so that they cannot be referred to surgery. Besides the current gold standard of surgery, minimally invasive therapeutic options are increasingly becoming established for these patients. For the differentiated indications and therapeutic success, a multidisciplinary heart team assumes an important role...
August 2016: Herz
https://www.readbyqxmd.com/read/27215927/learning-curves-for-transapical-transcatheter-aortic-valve-replacement-in-the-partner-i-trial-technical-performance-success-and-safety
#13
Rakesh M Suri, Sa'ar Minha, Oluseun Alli, Ron Waksman, Charanjit S Rihal, Lowell P Satler, Kevin L Greason, Rebecca Torguson, Augusto D Pichard, Michael Mack, Lars G Svensson, Jeevanantham Rajeswaran, Ashley M Lowry, John Ehrlinger, Stephanie L Mick, E Murat Tuzcu, Vinod H Thourani, Raj Makkar, David Holmes, Martin B Leon, Eugene H Blackstone
OBJECTIVES: Introduction of hybrid techniques, such as transapical transcatheter aortic valve replacement (TA-TAVR), requires skills that a heart team must master to achieve technical efficiency: the technical performance learning curve. To date, the learning curve for TA-TAVR remains unknown. We therefore evaluated the rate at which technical performance improved, assessed change in occurrence of adverse events in relation to technical performance, and determined whether adverse events after TA-TAVR were linked to acquiring technical performance efficiency (the learning curve)...
September 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27190101/early-clinical-and-echocardiographic-outcomes-after-sapien-3-transcatheter-aortic-valve-replacement-in-inoperable-high-risk-and-intermediate-risk-patients-with-aortic-stenosis
#14
Susheel Kodali, Vinod H Thourani, Jonathon White, S Chris Malaisrie, Scott Lim, Kevin L Greason, Mathew Williams, Mayra Guerrero, Andrew C Eisenhauer, Samir Kapadia, Dean J Kereiakes, Howard C Herrmann, Vasilis Babaliaros, Wilson Y Szeto, Rebecca T Hahn, Philippe Pibarot, Neil J Weissman, Jonathon Leipsic, Philipp Blanke, Brian K Whisenant, Rakesh M Suri, Raj R Makkar, Girma M Ayele, Lars G Svensson, John G Webb, Michael J Mack, Craig R Smith, Martin B Leon
AIMS: Based on randomized trials using first-generation devices, transcatheter aortic valve replacement (TAVR) is well established in the treatment of high-risk (HR) patients with severe aortic stenosis (AS). To date, there is a paucity of adjudicated, prospective data evaluating outcomes with newer generation devices and in lower risk patients. We report early outcomes of a large, multicentre registry of inoperable, HR, and intermediate-risk (IR) patients undergoing treatment with the next-generation SAPIEN 3 transcatheter heart valve (THV)...
July 21, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27173864/percutaneous-pulmonary-valve-replacement-using-completely-tissue-engineered-off-the-shelf-heart-valves-six-month-in-vivo-functionality-and-matrix-remodelling-in-sheep
#15
Boris Schmitt, Hendrik Spriestersbach, Darach O H-Icí, Torben Radtke, Marco Bartosch, Heiner Peters, Matthias Sigler, Laura Frese, Petra E Dijkman, Frank P T Baaijens, Simon P Hoerstrup, Felix Berger
AIMS: The objective was to implant a stented decellularised tissue-engineered heart valve (sdTEHV) percutaneously in an animal model, to assess its in vivo functionality and to examine the repopulation and remodelling of the valvular matrix by the recipient's autologous cells. METHODS AND RESULTS: Prototypes of sdTEHV were cultured in vitro, decellularised and percutaneously implanted into the pulmonary position in 15 sheep. Functionality was assessed monthly by intracardiac echocardiography (ICE)...
May 17, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27135150/importance-of-the-left-ventricular-outflow-tract-in-the-need-for-pacemaker-implantation-after-transcatheter-aortic-valve-replacement
#16
Ramón Rodríguez-Olivares, Lennart van Gils, Nahid El Faquir, Zouhair Rahhab, Luigi F M Di Martino, Sander van Weenen, John de Vries, Tjebbe W Galema, Marcel L Geleijnse, Ricardo P J Budde, Eric Boersma, Peter P de Jaegere, Nicolas M Van Mieghem
BACKGROUND: The interaction of left ventricular outflow tract (LVOT) and transcatheter heart valve (THV) is complex and may be device design specific. We sought to study LVOT characteristics and its relation with permanent pacemaker implantation (PPI) after transcatheter aortic valve replacement (TAVR). METHODS: We studied 302 patients with a median age of 81years [75-84]. Computed tomography was used to assess LVOT in terms of amount of calcium, perimeter and device size relative to LVOT...
August 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27101906/bicuspid-aortic-valve-stenosis-favorable-early-outcomes-with-a-next-generation-transcatheter-heart-valve-in-a-multicenter-study
#17
MULTICENTER STUDY
Gidon Y Perlman, Philipp Blanke, Danny Dvir, Gregor Pache, Thomas Modine, Marco Barbanti, Erik W Holy, Hendrik Treede, Philipp Ruile, Franz-Josef Neumann, Caterina Gandolfo, Francesco Saia, Corrado Tamburino, George Mak, Christopher Thompson, David Wood, Jonathon Leipsic, John G Webb
OBJECTIVES: This study evaluated the results of transcatheter aortic valve replacement (TAVR) in bicuspid aortic stenosis (AS) using a new-generation TAVR device. BACKGROUND: A bicuspid AS is often considered a relative contraindication to TAVR. Although initial reports have demonstrated feasibility using early-generation devices, outcomes have not matched those seen with tricuspid AS. Paravalvular aortic regurgitation (AR) has been particularly problematic. METHODS: We collected baseline characteristics, procedural data, and 30-day clinical follow-up findings from 8 centers in Europe and Canada that had performed TAVR in bicuspid AS using the SAPIEN 3 valve...
April 25, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/26912574/small-intestinal-submucosa-extracellular-matrix-cormatrix%C3%A2-in-cardiovascular-surgery-a-systematic-review
#18
REVIEW
Zahra Mosala Nezhad, Alain Poncelet, Laurent de Kerchove, Pierre Gianello, Caroline Fervaille, Gebrine El Khoury
Extracellular matrix (ECM) derived from small intestinal submucosa (SIS) is widely used in clinical applications as a scaffold for tissue repair. Recently, CorMatrix® porcine SIS-ECM (CorMatrix Cardiovascular, Inc., Roswell, GA, USA) has gained popularity for 'next-generation' cardiovascular tissue engineering due to its ease of use, remodelling properties, lack of immunogenicity, absorbability and potential to promote native tissue growth. Here, we provide an overview of the biology of porcine SIS-ECM and systematically review the preclinical and clinical literature on its use in cardiovascular surgery...
June 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/26901910/first-explantation-of-direct-flow-medical-transcatheter-valve
#19
Smita Scholtz, Dieter Horstkotte, Jan Gummert, Jochen Börgermann, Werner Scholtz
Next-generation transcatheter heart valves are designed to overcome procedure-related adverse events such as vascular complications and annulus rupture, and to minimize paravalvular regurgitation. The Direct Flow Medical valve is fully repositionable and shows promising results. The case is presented of Direct Flow Medical valve implantation in a patient with a functional bicuspid aortic valve. Multiple repositioning maneuvers failed to overcome the anatomic difficulties, and this resulted in a moderately high persisting gradient and moderate paravalvular leakage...
May 2015: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/26847116/predictors-of-permanent-pacemaker-implantations-and-new-onset-conduction-abnormalities-with-the-sapien-3-balloon-expandable-transcatheter-heart-valve
#20
Oliver Husser, Costanza Pellegrini, Thorsten Kessler, Christof Burgdorf, Hannah Thaller, N Patrick Mayr, Albert M Kasel, Adnan Kastrati, Heribert Schunkert, Christian Hengstenberg
OBJECTIVES: This study investigates the influence of implantation depth and prosthesis oversizing on conduction abnormalities (CA) and permanent pacemaker implantation (PPI) after SAPIEN 3 (Edwards Lifesciences, Irvine, California) implantation. BACKGROUND: CA and PPIs are frequent complications after transcatheter aortic valve replacement with a next-generation balloon-expandable transcatheter heart valve (SAPIEN 3). The potential underlying mechanisms are incompletely understood...
February 8, 2016: JACC. Cardiovascular Interventions
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