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Current status of heart valve replacement

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https://www.readbyqxmd.com/read/29134537/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-4-valvular-heart-surgery
#1
Kiyoharu Nakano, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
Data from the Japan cardiovascular surgery database from 2013 to 2014 were analyzed to demonstrate the mortality rate and choice of surgical procedures, especially concerning the selection of valve prosthesis for each valve position and patient age group, and the effects of preoperative complications on mortality and prosthetic valve selection. The proportion of each surgical procedure was compared for each patient age in the aortic, mitral, and tricuspid positions. The proportion of mechanical valve prostheses was 23...
November 13, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#2
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29041893/-transcatheter-implantation-of-mitral-valve-prostheses-current-status-of-the-problem
#3
M A Karaskov, Y I Zhuravleva, V A Bogachev-Prokophiev, P D Demidov
Mitral valve disease is highly prevalent and quickly leads to development of severe heart failure. Mitral valve disease of degenerative or ischemic etiology affects 7.5 and 9.3% of population older than 65 and 75 years, respectively. "Open" (with cardiopulmonary bypass) surgical repair or valve replacement are not possible in almost half of affected patients because of their complications and concomitant diseases responsible for extremely high risk of these interventions. In the last decade, minimally invasive endovascular technology - transcatheter aortic valve implantation (TAVI) - has been widely introduced for correction of aortic valve disease in similar category of patients...
August 2017: Kardiologiia
https://www.readbyqxmd.com/read/28877303/association-of-guideline-adherence-for-serial-evaluations-with-survival-and-adverse-clinical-events-in-patients-with-asymptomatic-severe-aortic-stenosis
#4
Aisha Ahmed, Paul Sorajja, Ross F Garberich, R Saeid Farivar, Kevin M Harris, Mario Gössl
Importance: For patients with asymptomatic severe aortic stenosis and normal left ventricular function, current practice guidelines empirically recommend serial evaluations every 6 to 12 months. The benefit of this clinical monitoring is unknown. Objective: To determine the association of guideline adherence with clinical outcomes in patients with asymptomatic severe aortic stenosis. Design, Setting, and Participants: This retrospective cohort study involved 300 patients with asymptomatic severe aortic stenosis who were seen in the ambulatory Minneapolis Heart Institute at Abbott Northwestern Hospital...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#5
Julius I Ejiofor, Robert C Neely, Maroun Yammine, Siobhan McGurk, Tsuyoshi Kaneko, Marzia Leacche, Lawrence H Cohn, Prem S Shekar
BACKGROUND: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). METHODS: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28642994/cardiovascular-magnetic-resonance-imaging-to-assess-myocardial-fibrosis-in-valvular-heart-disease
#6
Tomaz Podlesnikar, Victoria Delgado, Jeroen J Bax
The left ventricular (LV) remodeling process associated with significant valvular heart disease (VHD) is characterized by an increase of myocardial interstitial space with deposition of collagen and loss of myofibers. These changes occur before LV systolic function deteriorates or the patient develops symptoms. Cardiovascular magnetic resonance (CMR) permits assessment of reactive fibrosis, with the use of T1 mapping techniques, and replacement fibrosis, with the use of late gadolinium contrast enhancement...
June 22, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#7
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#8
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#9
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28374178/current-status-of-catheter-based-treatment-of-mitral-valve-regurgitation
#10
REVIEW
Mario Gössl, Robert S Farivar, Richard Bae, Paul Sorajja
PURPOSE OF REVIEW: This review examines the current status of catheter-based repair and replacement for mitral valve disease, with a focus on native primary and secondary mitral valve regurgitation. RECENT FINDINGS: Transcatheter mitral valve repair with the MitraClip®, with >40,000 performed procedures worldwide, has significantly advanced the field of transcatheter therapy for mitral valve regurgitation. Transcatheter mitral valve replacement remains in the early stages of development, mainly due to the complex anatomy and physiology of the mitral valve...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28281857/engineering-challenges-and-the-future-prospects-of-transcatheter-mitral-valve-replacement-technologies-a-comprehensive-review-of-case-studies
#11
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/28179592/five-year-clinical-outcome-of-asymptomatic-vs-symptomatic-severe-aortic-stenosis-after-aortic-valve-replacement
#12
MULTICENTER STUDY
Shinichi Shirai, Tomohiko Taniguchi, Takeshi Morimoto, Kenji Ando, Kengo Korai, Kenji Minakata, Michiya Hanyu, Fumio Yamazaki, Tadaaki Koyama, Tatsuhiko Komiya, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Tsukasa Inada, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Katsuhisa Ishii, Naritatsu Saito, Kazuo Yamanaka, Noboru Nishiwaki, Hiroyuki Nakajima, Toshihiko Saga, Shogo Nakayama, Genichi Sakaguchi, Atsushi Iwakura, Kotaro Shiraga, Koji Ueyama, Keiichi Fujiwara, Senri Miwa, Junichiro Nishizawa, Mitsuru Kitano, Hitoshi Kitayama, Ryuzo Sakata, Takeshi Kimura
BACKGROUND: There is discordance regarding the effect of symptom status before aortic valve replacement (AVR) on long-term outcome after AVR in severe aortic stenosis (AS).Methods and Results:The CURRENT AS registry is a multicenter retrospective registry enrolling 3,815 consecutive patients with severe AS. Among 1,196 patients managed with the initial AVR strategy, long-term clinical outcomes were compared between the symptomatic patients (n=905), and asymptomatic patients (n=291)...
March 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28007203/quality-of-life-after-transcatheter-aortic%C3%A2-valve-replacement-prospective-data-from-gary-german-aortic-valve-registry
#13
Rüdiger Lange, Andreas Beckmann, Till Neumann, Markus Krane, Marcus-André Deutsch, Sandra Landwehr, Joachim Kötting, Armin Welz, Ralf Zahn, Jochen Cremer, Hans R Figulla, Gerhard Schuler, David M Holzhey, Anne-Kathrin Funkat, Gerd Heusch, Stefan Sack, Miralem Pasic, Thomas Meinertz, Thomas Walther, Karl-Heinz Kuck, Friedhelm Beyersdorf, Michael Böhm, Helge Möllmann, Christian W Hamm, Friedrich W Mohr
OBJECTIVES: This study sought to analyze health-related quality-of-life (HrQoL) outcomes of patients undergoing transcatheter aortic valve replacement (TAVR) based on data from GARY (German Aortic Valve Registry). BACKGROUND: Typically, patients currently referred for and treated by TAVR are elderly with a concomitant variable spectrum of multiple comorbidities, disabilities, and limited life expectancy. Beyond mortality and morbidity, the assessment of HrQoL is of paramount importance not only to guide patient-centered clinical decision-making but also to judge this new treatment modality in this high-risk patient population...
December 26, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27777298/management-of-systemic-right-ventricular-failure-in-patients-with-congenitally-corrected-transposition-of-the-great-arteries
#14
REVIEW
Aleksei A Filippov, Pedro J Del Nido, Nikolay V Vasilyev
In recent decades, significant progress has been made in the diagnosis and management of congenitally corrected transposition of the great arteries (ccTGA). Nevertheless, gradual dysfunction and failure of the right ventricle (RV) in the systemic circulation remain the main contributors to mortality and disability for patients with ccTGA, especially after adolescence. Anatomic repair of ccTGA effectively resolves the problem of failure of the systemic RV and has good early and midterm results. However, this strategy is applicable primarily in infants and children up to their teens and has associated risks and limitations, and new challenges can arise in the late postoperative period...
October 25, 2016: Circulation
https://www.readbyqxmd.com/read/27242130/heart-valve-health-disease-replacement-and-repair-a-25-year-cardiovascular-pathology-perspective
#15
REVIEW
Frederick J Schoen, Avrum I Gotlieb
The past several decades have witnessed major advances in the understanding of the structure, function, and biology of native valves and the pathobiology and clinical management of valvular heart disease. These improvements have enabled earlier and more precise diagnosis, assessment of the proper timing of surgical and interventional procedures, improved prosthetic and biologic valve replacements and repairs, recognition of postoperative complications and their management, and the introduction of minimally invasive approaches that have enabled definitive and durable treatment for patients who were previously considered inoperable...
July 2016: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/27175453/annual-outcomes-with-transcatheter-valve-therapy-from-the-sts-acc-tvt-registry
#16
David R Holmes, Rick A Nishimura, Frederick L Grover, Ralph G Brindis, John D Carroll, Fred H Edwards, Eric D Peterson, John S Rumsfeld, David M Shahian, Vinod H Thourani, E Murat Tuzcu, Sreekanth Vemulapalli, Kathleen Hewitt, Joan Michaels, Susan Fitzgerald, Michael J Mack
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease. OBJECTIVES: This report provides an overview on current U.S. TVT practice and trends...
February 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27167776/bioengineered-living-cardiac-and-venous-valve-replacements-current-status-and-future-prospects
#17
REVIEW
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
https://www.readbyqxmd.com/read/27048769/perioperative-transoesophageal-echocardiography-current-status-and-future-directions
#18
REVIEW
Feroze Mahmood, Stanton Keith Shernan
Transoesophageal echocardiography (TOE) is used in the perioperative arena to monitor patients during life-threatening emergencies, cardiac and high-risk non-cardiac surgeries. It provides qualitative and quantitative information on valvular and ventricular functions, and dynamic cardiac anatomy can be displayed with a physiological perspective. This technology has evolved from two-dimensional (2D) to the ready availability of real-time three-dimensional (RT-3D) imaging in the operating rooms. Enhanced spatial and temporal resolutions with 3D imaging have most significantly impacted the quality of intraoperative surgical valve repair and replacement decisions...
August 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/26660091/-interventional-mitral-valve-replacement-current-status
#19
REVIEW
G Lutter, D Frank
Approximately 30 % of patients suffering from severe valvular heart disease, such as mitral valve regurgitation are non-compliant to the gold standard of minimally invasive surgery, reconstruction or valve replacement. The number of these mostly old patients with severe comorbidities is increasing; therefore, transcatheter interventions have been developed to address an unmet clinical need and may be an alternative therapeutic option to the reference standard. Apart from the successful MitraClip therapy, alternative transcatheter reconstruction technologies are being developed...
February 2016: Herz
https://www.readbyqxmd.com/read/26652232/annual-outcomes-with-transcatheter-valve-therapy-from-the-sts-acc-tvt-registry
#20
MULTICENTER STUDY
David R Holmes, Rick A Nishimura, Frederick L Grover, Ralph G Brindis, John D Carroll, Fred H Edwards, Eric D Peterson, John S Rumsfeld, David M Shahian, Vinod H Thourani, E Murat Tuzcu, Sreekanth Vemulapalli, Kathleen Hewitt, Joan Michaels, Susan Fitzgerald, Michael J Mack
BACKGROUND: The Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry has been a joint initiative of the STS and the ACC in concert with multiple stakeholders. The TVT Registry has important information regarding patient selection, delivery of care, science, education, and research in the field of structural valvular heart disease. OBJECTIVES: This report provides an overview on current U.S. TVT practice and trends...
December 29, 2015: Journal of the American College of Cardiology
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