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Heart valve size

Andre Paixao, Mehmet Cilingiroglu
Paravalvular leak (PVL) remains as uncommon but serious complication after surgical prosthetic valve implantation. PVL when associated which congestive heart failure, hemolytic anemia, or infective endocarditis may require percutaneous treatment. High-surgical risk is common in this population. Dedicated PVL devices are lacking often limiting optimal treatment.
October 2016: Catheterization and Cardiovascular Interventions
Sarah Schalekamp-Timmermans, Jerome Cornette, Albert Hofman, Willem A Helbing, Vincent W V Jaddoe, Eric A P Steegers, Bero O Verburg
BACKGROUND: There are sex differences in the risk of development of cardiovascular disease (CVD). According to the developmental origins of health and disease paradigm (DOHaD), CVD originates in fetal life. This study examines fetal sex differences in cardiovascular development in utero. METHODS: In 1028 pregnant women, we assessed fetal circulation using pulsed wave Doppler examinations between 28 and 34 weeks gestation. To test associations between fetal sex and fetal circulation measurements, linear regression models were used adjusting for fetal size, gestational age, and fetal heart rate...
2016: Biology of Sex Differences
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)
Denise C Joffe, Thomas K Jones, Mark Reisman, Elizabeth Perpetua, Yuk Law, Andreas Schuler, G Burkhard Mackensen
We present the primary report of a paediatric patient who had placement of the MitraClip device for severe functional mitral regurgitation. The patient was a 14-year-old boy with symptomatic end-stage non-compaction type cardiomyopathy secondary to a mitochondrial cytopathy. He had severe mitral regurgitation, tricuspid valve regurgitation, a severely dilated LV with apical non-compaction, severe LV dysfunction and severe pulmonary hypertension. Despite optimal medical therapy he developed progressive symptoms of congestive heart failure and he was not a candidate for an assist device or cardiac transplantation...
October 10, 2016: EuroIntervention
Carlos M Mery, R Michael Nieto, Luis E De León, Shaine A Morris, Wei Zhang, John L Colquitt, Iki Adachi, Lauren C Kane, Jeffrey S Heinle, E Dean McKenzie, Charles D Fraser
BACKGROUND: Predictors for single ventricle palliation (SVP) or successful biventricular repair (BVR) in patients with borderline left-side heart structures are not well defined. The goal was to evaluate the role of echocardiography and intracardiac exploration in determining feasibility of BVR. METHODS: All neonates surgically treated from 1995 to 2015 with mitral valve (MV), aortic valve, or left ventricle end-diastolic dimension z score of -2 or less for whom management was controversial were included...
October 4, 2016: Annals of Thoracic Surgery
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
Charles H Bloodworth, Eric L Pierce, Thomas F Easley, Andrew Drach, Amir H Khalighi, Milan Toma, Morten O Jensen, Michael S Sacks, Ajit P Yoganathan
Computational modeling of the mitral valve (MV) has potential applications for determining optimal MV repair techniques and risk of recurrent mitral regurgitation. Two key concerns for informing these models are (1) sensitivity of model performance to the accuracy of the input geometry, and, (2) acquisition of comprehensive data sets against which the simulation can be validated across clinically relevant geometries. Addressing the first concern, ex vivo micro-computed tomography (microCT) was used to image MVs at high resolution (~40 micron voxel size)...
October 3, 2016: Annals of Biomedical Engineering
Michael Esser, Sergios Gatidis, Matthias Teufel, Inés Ketelsen, Konstantin Nikolaou, Jürgen F Schäfer, Ilias Tsiflikas
OBJECTIVE: The aim of this study was to compare image quality of anatomical cardiac details without electrocardiography triggering, sedation, or heart rate-regulating drugs in contrast-enhanced pediatric chest computed tomography (CT), using high-pitch CT (HPCT) versus conventional pitch-mode technique (multidetector CT [MDCT]). METHODS: After written informed consent, 55 patients (median age, 11 years; range, 3-17 years) were prospectively included in this institutional review board-approved study...
September 27, 2016: Journal of Computer Assisted Tomography
A Boswood, J Häggström, S G Gordon, G Wess, R L Stepien, M A Oyama, B W Keene, J Bonagura, K A MacDonald, M Patteson, S Smith, P R Fox, K Sanderson, R Woolley, V Szatmári, P Menaut, W M Church, M L O'Sullivan, J-P Jaudon, J-G Kresken, J Rush, K A Barrett, S L Rosenthal, A B Saunders, I Ljungvall, M Deinert, E Bomassi, A H Estrada, M J Fernandez Del Palacio, N S Moise, J A Abbott, Y Fujii, A Spier, M W Luethy, R A Santilli, M Uechi, A Tidholm, P Watson
BACKGROUND: Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown. HYPOTHESIS/OBJECTIVES: Administration of pimobendan (0.4-0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac-related death, or euthanasia...
September 28, 2016: Journal of Veterinary Internal Medicine
Robert W Loar, Athar M Qureshi, Christina Y Miyake, Santiago O Valdes, Jeffrey J Kim, Caridad M De la Uz
BACKGROUND: Percutaneous pulmonary valve implantation (PPVI) is utilized for dysfunctional right ventricular outflow tracts (RVOT) to relieve obstruction, regurgitation, and RV dysfunction. PPVI has not been reported to induce arrhythmias. This study is the first to report the incidence of ventricular tachycardia (VT) after PPVI. METHODS: This was a retrospective study of all patients who had PPVI at a single institution. All patients were admitted after PPVI for overnight telemetry monitoring...
September 26, 2016: Journal of Interventional Cardiology
Peter E Hammer, Erin G Roberts, Sitaram M Emani, Pedro J Del Nido
OBJECTIVES: Neither heart valve repair methods nor current prostheses can accommodate patient growth. Normal aortic and pulmonary valves have 3 leaflets, and the goal of valve repair and replacement is typically to restore normal 3-leaflet morphology. However, mammalian venous valves have bileaflet morphology and open and close effectively over a wide range of vessel sizes. We propose that they might serve as a model for pediatric heart valve reconstruction and replacement valve design...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
Divya Ratan Verma, Yash Pershad, Ashish Pershad, Kenith Fang, George Gellert, Michael F Morris
BACKGROUND: Computed tomography (CT) has become the standard imaging modality for pre-procedural aortic annular sizing prior to transcatheter aortic valve replacement (TAVR). We hypothesized that the accuracy of CT derived annular measurements would be greater at sites with higher TAVR procedural volume. METHODS: Within a large integrated health system, TAVR was performed at low (<40 cases), intermediate (40-75 cases), and high-volume sites (>75 cases). 181 patients underwent TAVR with a Sapien XT transcatheter heart valve (THV)...
August 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Lennart van Gils, Didier Tchetche, Azeem Latib, Carmelo Sgroi, Ganesh Manoharan, Helge Möllmann, Nicolas M Van Mieghem
Transcatheter aortic valve implantation (TAVI) has evolved from an exclusive, highly complex and hazardous procedure into a mature, safe and streamlined therapy for patients with severe aortic stenosis (AS). Various successive device iterations and product refinements have created a dynamic and competitive field with a spectrum of different CE-marked transcatheter heart valve (THV) designs. This review provides a practical overview of current CE-marked THVs with a focus on respective sizing algorithms and delivery strategies...
September 18, 2016: EuroIntervention
Matheus Simonato, Ali N Azadani, John Webb, Jonathon Leipsic, Ran Kornowski, Alec Vahanian, David Wood, Nicolo Piazza, Susheel Kodali, Jian Ye, Brian Whisenant, Diego Gaia, Mina Aziz, Tilak Pasala, Julinda Mehilli, Harindra C Wijeysundera, Didier Tchetche, Neil Moat, Rui Teles, Anna Sonia Petronio, David Hildick-Smith, Uri Landes, Stephan Windecker, Yaron Arbel, Oscar Mendiz, Raj Makkar, Elaine Tseng, Danny Dvir
AIMS: Transcatheter heart valve (THV) implantation in failed bioprosthetic valves (valve-in-valve [ViV]) offers an alternative therapy for high-risk patients. Elevated post-procedural gradients are a significant limitation of aortic ViV. Our objective was to assess the relationship between depth of implantation and haemodynamics. METHODS AND RESULTS: Commercially available THVs used for ViV were included in the analysis (CoreValve Evolut, SAPIEN XT and the Portico valve)...
September 18, 2016: EuroIntervention
A A Sakrana, M M Nasr, G A Ashamallah, R A Abuelatta, H A Naeim, M E Tahlawi
AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO)...
November 2016: Clinical Radiology
Montaser Elsawy Abd Elaziz, Islam Moheb Ibrahim
BACKGROUND: Mitral valve regurgitation leads to deterioration of left ventricular functions if not treated early. We aimed to study the effect of mitral valve replacement on normalization of ejection fraction, remodeling of left ventricular dimensions, and left atrial reduction in patients with chronic mitral regurgitation. METHODS: Between December 2012 and August 2014, 45 patients with chronic mitral regurgitation underwent isolated mitral valve replacement. None of the patients had any other severe valvular or concomitant disease or severe coronary heart  disease...
2016: Heart Surgery Forum
Nasir Al-Allawi, Ameen M Mohammad, Shakir Jamal
To determine the frequency, clinical and laboratory associations of pulmonary hypertension in Iraqi Kurds with sickle cell anemia, a total of ninety four such patients attending a major hemoglobinopathy center in Iraqi Kurdistan were enrolled. All patients were re-evaluated clinically and had their blood counts, HbF, serum ferritin, LDH, renal and liver function assessed. Transthoracic Doppler echocardiography with measurement of tricuspid valve regurgitant jet velocity (TRV) was performed. A TRV in excess of 2...
2016: PloS One
Nicolas Debry, Arnaud Sudre, Ibrahim Elquodeimat, Cédric Delhaye, Guillaume Schurtz, Antoine Bical, Mohamad Koussa, Khalil Fattouch, Thomas Modine
BACKGROUND: Postprocedural aortic regurgitations following transcatheter aortic valve implantation (TAVI) procedures remain an issue. Benefit of oversizing strategies to prevent them isn't well established. We compared different level of oversizing in our cohort of consecutive patients to address if severe oversizing compared to normal sizing had an impact on post-procedural outcomes. METHODS: From January 2010 to August 2013, consecutive patients were referred for TAVI with preoperative Multislice-CT (MSCT) and the procedures were achieved using Edwards Sapien(®) or Corevalve devices(®)...
September 2016: Journal of Geriatric Cardiology: JGC
Nicolaj C Hansson, Erik L Grove, Henning R Andersen, Jonathon Leipsic, Ole N Mathiassen, Jesper M Jensen, Kaare T Jensen, Philipp Blanke, Tina Leetmaa, Mariann Tang, Lars R Krusell, Kaj E Klaaborg, Evald H Christiansen, Kim Terp, Christian J Terkelsen, Steen H Poulsen, John Webb, Hans Erik Bøtker, Bjarne L Nørgaard
BACKGROUND: There is increasing focus on transcatheter heart valve (THV) thrombosis. However, there are limited data on incidence, clinical implications and predisposing factors of THV thrombosis following transcatheter aortic valve replacement (TAVR). OBJECTIVES: We assessed the incidence, potential predictors, and clinical implications of THV thrombosis determined by contrast-enhanced multidetector computed tomography (MDCT) after TAVR. METHODS: Among 460 consecutive patients undergoing TAVR with the Edwards Sapien XT or Sapien 3 (Edwards Lifesciences, Irvine, CA, USA) valves, 405 (88%) underwent MDCT in addition to transthoracic and transesophageal echocardiography 1-3 months post-TAVR...
August 18, 2016: Journal of the American College of Cardiology
Brian C Gulack, Ehsan Benrashid, Robert D B Jaquiss, Andrew J Lodge
BACKGROUND: Outcomes after surgical pulmonary valve replacement (PVR) in patients with congenital cardiac disease are limited by long-term valve deterioration, which may be hastened by turbulent flow. The use of the Trifecta valve (St. Jude Medical, Little Canada, MN) at our institution (Duke University Medical Center, Durham, NC) appears to result in low postimplantation transvalvular gradients. This study was performed to compare the early transvalvular gradient associated with the Trifecta valve with that associated with two other valves commonly used for PVR...
August 25, 2016: Annals of Thoracic Surgery
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