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https://www.readbyqxmd.com/read/28387791/contemporary-results-of-hemiarch-replacement
#1
Ivancarmine Gambardella, Mario Gaudino, Christopher Lau, Monica Munjal, Antonino Di Franco, Lucas B Ohmes, Fawad Hameedi, Cristiano Spadaccio, Leonard N Girardi
OBJECTIVES: Our goal was to report on early and midterm outcomes of hemiarch replacement performed in a high-volume centre. METHODS: We extrapolated hemiarch replacements from our institutional aortic database. We also analysed the impact of aortic disease (dissection vs aneurysm) on the outcomes of de novo hemiarch replacement. RESULTS: A total of 756 patients underwent hemiarch replacement between 1997 and 2016. After elimination of cases involving the aortic root/valve and redo cases, we identified 426 cases of de novo -isolated hemiarch replacement (369 aneurysms and 57 dissections)...
April 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28382803/impact-of-previous-cardiac-surgery-in-patients-undergoing-transcatheter-aortic-valve-implantation-a-systematic-review
#2
Sharaf-Eldin Shehada, Yacine Elhmidi, Nazan Puluca, Öznur Öztürk, Ender Demircioglu, Daniel Wendt, Heinz Jakob, Matthias Thielmann
INTRODUCTION: Redo surgical aortic valve replacement after prior cardiac surgery is usually related to a higher risk of mortality and morbidity. Transcatheter aortic valve implantation (TAVI) became an alternative therapy for those patients in the past couple of years. EVIDENCE ACQUISITION: We aimed in this study to analyze the outcomes of patients undergoing TAVI after a prior cardiac surgery especially those who underwent coronary artery bypass grafting (CABG) and to see if TAVI offers any advantages for those patients than conventional surgical aortic valve replacement...
April 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366467/aortic-root-replacement-for-children-with-loeys-dietz-syndrome
#3
Nishant D Patel, Diane Alejo, Todd Crawford, Narutoshi Hibino, Harry C Dietz, Duke E Cameron, Luca A Vricella
BACKGROUND: Loeys-Dietz syndrome (LDS) is an aggressive aortopathy with a proclivity for aortic aneurysm rupture and dissection at smaller diameters than other connective tissue disorders. We reviewed our surgical experience of children with LDS to validate our guidelines for prophylactic aortic root replacement (ARR). METHODS: We reviewed all children (younger than 18 years) with a diagnosis of LDS who underwent ARR at our institution. The primary endpoint was mortality, and secondary endpoints included complications and the need for further interventions...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28359487/new-presentation-of-hemolysis-after-papillary-muscles-approximation-for-mitral-valve-repair
#4
Anas Sarraj, Corazón-Mabel Calle Valda, Daniel-Edgardo Muñoz, Guillermo Reyes
Hemolysis is a well-recognized complication after prosthetic valve replacement, especially with perivalvular leaks. Hemolytic anemia associated with mitral valve (MV) repair is less common. We report the case of a young man with severe hemolytic anemia caused by turbulence of blood flow through a very small quadrangle orifice due to early failure of MV repair. The patient underwent redo MV biologic prosthesis replacement and tricuspid valve annuloplasty. The hemolysis completely disappeared few months later...
April 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28347580/aorto-right-atrial-fistula-after-sutureless-valve-implantation
#5
Jessica G Y Luc, Michiko Maruyama, Surita Sidhu, Jayan Nagendran
Aortic valve replacement with sutureless valves has many potential applications including in redo surgery, minimally invasive scenarios, and heavily calcified aortic roots. Herein we report a case of the development of an aorto-right atrial fistula after replacement of a Medtronic Freestyle stentless subcoronary bioprosthesis (Medtronic Inc, Minneapolis, MN) with a Perceval sutureless valve (LivaNova PLC, London, UK). This eventually necessitated repair with repeat surgery and aortic valve replacement with a stented valve...
January 20, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28329200/clinical-trends-in-surgical-minimally-invasive-and-transcatheter-aortic-valve-replacement%C3%A2
#6
Tom C Nguyen, Matthew D Terwelp, Vinod H Thourani, Yelin Zhao, Nidal Ganim, Carson Hoffmann, Monica Justo, Anthony L Estrera, Richard W Smalling, Prakash Balan, Joseph Lamelas
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (MIAVR) have emerged as alternatives to surgical aortic valve replacement (SAVR) via traditional sternotomy. However, their effect on clinical practice remains unclear. The study's objective is to describe clinical trends between TAVR, MIAVR and SAVR in patients with severe aortic stenosis (AS). METHODS: This retrospective observational study analyzed trends in isolated severe aortic valve replacement (AVR) among three high volume TAVR, MIAVR and SAVR centres in the United States...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328570/concomitant-valve-in-valve-transcatheter-aortic-valve-replacement-and-left-ventricular-assist-device-implantation
#7
Takashi Murashita, David L Joyce, Alberto Pochettino, John M Stulak, Lyle D Joyce
Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28302715/late-thrombosis-of-a-mitral-bioprosthetic-valve-with-associated-massive-left-atrial-thrombus
#8
Preetham Muskula, Rigoberto Ramirez, A Michael Borkon, Michael L Main
An 84-year-old man presented 5 years following bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg) was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (> 4 cm in diameter) (see Figures 1A-D, and video files 1-4)...
March 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28296135/assessment-of-trans-aortic-pressure-gradient-using-a-coronary-pressure-wire-in-patients-with-mechanical-aortic-and-mitral-valve-prostheses
#9
Nisharahmed Kherada, Juan Carlos Brenes, Annapoorna S Kini, George D Dangas
Accurate evaluation of trans-aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non-invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans-valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28290167/simple-interrupted-suturing-for-redo-mitral-valve-replacement
#10
Hiroshi Furukawa, Taishi Tamura, Takeshi Honda, Hiroki Takiuchi, Masahiko Kuinose, Kazuo Tanemoto
BACKGROUND: An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR). METHODS: Among 336 mitral valve surgery patients at the authors' institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28238237/immediate-early-and-late-failure-after-transcatheter-aortic-valve-implantation-how-to-deal-with-the-inoperable
#11
Sabina PW Guenther, Maximilian A Pichlmaier, Erik Bagaev, Florian Herrmann, René Schramm, Steffen Massberg, Christian Hagl, Nawid Khaladj
BACKGROUND: Currently, the use of transcatheter aortic valve implantation (TAVI) is constantly increasing, whilst cardiosurgical back-up varies substantially. Besides immediate conversion to surgical aortic valve replacement (SAVR) for periprocedural complications, SAVR for TAV failure may be necessary within the early or late post-implant course. The etiology, incidence, risk-stratification, management and outcome for both scenarios are largely unclear. The study aim was to provide details of the authors' experience of SAVR after the failure of TAVI at a single institution...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28237287/single-antiplatelet-therapy-in-patients-with-contraindication-to-dual-antiplatelet-therapy-after-transcatheter-aortic-valve-implantation
#12
Antonio Mangieri, Richard J Jabbour, Claudio Montalto, Matteo Pagnesi, Damiano Regazzoli, Marco B Ancona, Francesco Giannini, Akihito Tanaka, Letizia Bertoldi, Fabrizio Monaco, Eustachio Agricola, Manuela Giglio, Roberto Mattioli, Luca Ferri, Matteo Montorfano, Alaide Chieffo, Ottavio Alfieri, Antonio Colombo, Azeem Latib
There is limited evidence to support decision-making regarding discharge antiplatelet therapy after transcatheter aortic valve implantation (TAVI). The aim of this study was to assess the outcome of patients discharged on single-antiplatelet therapy (SAPT) or dual-antiplatelet therapy (DAPT) after TAVI. Consecutive patients were identified by retrospective review of a dedicated TAVI database of a single high-volume center in Milan, Italy, from January 2009 to May 2015. Our primary end point was the rate of net adverse clinical events defined as a composite of all-cause mortality, major bleeding requiring hospitalization, cerebrovascular accidents, redo-TAVI or surgical aortic valve replacement, and valve thrombosis...
April 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28219552/unusual-gastrointestinal-bleeding-after-sutureless-aortic-valve-replacement-a-word-of-caution
#13
Jules Iquille, Joseph Nader, Eric Colpart, Thierry Caus
We report the clinical case of a male patient who presented, after an aortic valve replacement with a rapid deployment bioprosthesis, a Heyde-like syndrome, secondary to a moderate aortic paravalvular leakage. All the digestive and hematologic investigations confirmed the diagnosis. A redo surgery to fill the paravalvular gap was accomplished and the postoperative course was uneventful, with a normalization of the biological parameters. To our knowledge, this is the first described case of such a complication with the new generation of sutureless bioprosthesis...
March 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28194732/late-post-avr-progression-of-bicuspid-aortopathy-link-to-hemodynamics
#14
Shiho Naito, Tatiana Gross, Kushtrim Disha, Yskert von Kodolitsch, Hermann Reichenspurner, Evaldas Girdauskas
BACKGROUND AND AIM OF THE STUDY: The ascending aortic dilatation may progress after aortic valve replacement (AVR) in bicuspid aortic valve (BAV) patients. Our aim was to evaluate rheological flow patterns and histological characteristics of the aneurysmal aorta in BAV patients at the time of reoperative aortic surgery. MATERIALS AND METHODS: 13 patients (mean age: 42 ± 9 years, 10 (77%) male) with significant progression of proximal aortopathy after isolated AVR surgery for BAV disease (i...
February 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28174055/transcatheter-jenavalve-implantation-in-a-stentless-prosthesis-a-challenging-case-after-4-previous-aortic-procedures
#15
Sandro Sponga, Enzo Mazzaro, Rodrigo Bagur, Ugolino Livi
A 40-year-old man underwent 4 aortic surgeries because of endocarditis and subsequent prosthesis dehiscence. At the last recurrence he presented with acute severe aortic regurgitation of a Pericarbon Freedom (LivaNova plc, London, UK) stentless bioprosthesis and a morphologically disarranged aortic root. He also presented with left ventricular dysfunction and a very low origin of the left coronary artery. Therefore, a fifth redo aortic valve replacement was considered at high surgical risk. Accordingly, before listing the patient for a heart transplantation, a transcatheter valve-in-valve implantation with the JenaValve (JenaValve Technology, GmbH, Munich, Germany) prosthesis was performed...
November 11, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28138196/superior-septal-approach-versus-left-atrial-approach-for-mitral-valve-replacement-a-retrospective-cohort-study
#16
Tooba Ansar, Taimur Asif Ali, Saneeha Shahid, Saulat Hasnain Fatimi, Ghulam Murtaza
OBJECTIVE: To compare the outcomes of superior septal approach and left atrial approach for mitral valve replacement. METHODS: This retrospective cohort study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients who had undergone isolated mitral valve replacement from May 2003 to April 2012. Cases were reviewed for the outcomes [primary: loss of normal sinus rhythm; secondary: complications, residual defect and mortality]...
February 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28096837/sutureless-aortic-valve-and-mitral-valve-repair-in-redo-cases-really-an-off-label-approach
#17
Júlia Čanádyová, Aleš Mokráček, Vojtěch Kurfirst
Sutureless aortic valve replacement (AVR) was developed as an alternative treatment option to conventional open-heart surgery and transcatheter aortic valve implantation for "gray zone" patients. The need for concurrent mitral valve surgery is generally viewed as a contraindication to sutureless AVR. The purpose of this brief paper is to report our experiences with sutureless valves in patients after previous cardiac procedures with degenerated aortic bioprostheses and concomitant mitral valve disease.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28070934/long-term-outcomes-after-mechanical-aortic-valve-replacement-with-aortic-root-enlargement-in-adolescents
#18
Zhiwei Xu, Qiuxia Shi, Ju Mei, Yan Tan
BACKGROUND: Deciding which prosthetic aortic valve to choose is difficult in adolescents who have not yet met their full growth potential. The aim of this study was to assess long-term outcomes following mechanical aortic valve replacement with aortic root enlargement in adolescents. METHODS: Between September 1997 and December 2006, 58 consecutive adolescents (49 male, 9 female, median age 15.5, range 13 to 17 years) underwent mechanical aortic valve replacement with aortic root enlargement...
January 10, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28067715/incidence-risk-factors-clinical-impact-and-management-of-bioprosthesis-structural-valve-degeneration
#19
Nancy Côté, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Structural valve deterioration is the major cause of bioprosthesis failure and is increasing over time. We present an overview of incidence, mechanisms, predictors, clinical impact, and management of bioprosthetic valve structural degeneration. RECENT FINDINGS: Early degeneration caused by calcification and destruction of connective tissue of the prosthesis is controlled by multiple mechanisms, from mechanical stress to infiltration of lipids and inflammatory cells, and activation of the immune system...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28062549/redo-procedures-for-degenerated-stentless-aortic-xenografts-and-the-role-of-valve-in-valve-transcatheter-techniques
#20
Herko Grubitzsch, Sebastian Zobel, Torsten Christ, Sebastian Holinski, Karl Stangl, Sascha Treskatsch, Volkmar Falk, Michael Laule
OBJECTIVES: This study evaluates reinterventions for degenerated stentless aortic xenografts. METHODS: Between 2010 and 2015, 52 consecutive patients (age 72.3 ± 9.7 years, EuroSCORE II 11.1 ± 8.9%) underwent reintervention for failed stentless aortic valves (60% porcine, 40% pericardial, 87% sub-coronary, 81% isolated/combined regurgitation). RESULTS: Based on age, EuroSCORE II, the presence of pulmonary hypertension, renal failure, a patent internal mammary artery graft and required concomitant procedures, the heart team assigned 25 patients to reoperation and 27 to valve-in-valve transcatheter aortic valve implantation (ViV-TAVI)...
April 1, 2017: European Journal of Cardio-thoracic Surgery
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