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Current status of heart valve replacement

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https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/26304936/circulating-microrna-profiling-needs-further-refinement-before-clinical-use-in-patients-with-aortic-stenosis
#13
Sean Coffey, Michael J A Williams, L Vicky Phillips, Gregory T Jones
BACKGROUND: Aortic stenosis (AS) is a progressive condition leading to heart failure and death without treatment. No medical therapy currently exists for AS, and a major management challenge is deciding on the correct timing of aortic valve replacement. MicroRNAs (miRNAs) are short noncoding RNAs that are stable in the circulation. We wished to use miRNAs as biomarkers of disease in AS. METHODS AND RESULTS: We performed microarray-based whole miRNome profiling of 24 participants with AS and 27 control participants...
August 2015: Journal of the American Heart Association
https://www.readbyqxmd.com/read/26234456/contemporary-outcomes-of-surgery-for-aortic-root-aneurysms-a-propensity-matched-comparison-of-valve-sparing-and-composite-valve-graft-replacement
#14
COMPARATIVE STUDY
Mario Gaudino, Christopher Lau, Monica Munjal, Dimitrios Avgerinos, Leonard N Girardi
OBJECTIVE: The study objective was to give an overview of the current state of the art of the surgical treatment of aortic root pathologies in a high-volume center. METHODS: From May 1997 to January 2014, aortic root replacement was performed in 890 consecutive patients; 289 received a mechanical composite valved graft, 421 received a biologic composite valved graft, and 180 received a valve-sparing reconstruction. Propensity matching analysis was used to neutralize the differences in baseline characteristics between patients assigned to the different procedures...
November 2015: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25890579/causes-of-death-and-mortality-and-evaluation-of-prognostic-factors-in-patients-with-severe-aortic-stenosis-in-an-aging-society
#15
Shiro Miura, Takeshi Arita, Hiraku Kumamaru, Takenori Domei, Kyohei Yamaji, Yoshimitsu Soga, Shinichi Shirai, Michiya Hanyu, Kenji Ando
BACKGROUND: Severe aortic stenosis (AS) is now predominantly a disease of the elderly, with significant mortality and morbidity. In order to investigate the burden of severe AS in the current population, we assessed mortality, causes of death, clinical event rates, and prognostic factors of patients diagnosed with severe AS. METHODS: A total of 519 consecutive patients (mean age, 78±9 years) with severe AS (aortic valve area <1.0 cm(2)) were retrospectively analyzed...
May 2015: Journal of Cardiology
https://www.readbyqxmd.com/read/25748873/surgical-treatment-of-functional-ischemic-mitral-regurgitation
#16
Henrik Jensen
In many ways we are at a crossroad in terms of what constitutes optimal FIMR treatment: is CABG combined with mitral valve ring annuloplasty better than CABG alone in moderate FIMR? Is mitral valve repair really better than replacement? And does adding a valvular repair or subvalvular reverse remodeling procedure shift that balance? In the present thesis I aim to shed further light on these questions by addressing the current status and future perspectives of the surgical treatment of FIMR. CURRENT SURGICAL TREATMENT FOR FIMR...
March 2015: Danish Medical Journal
https://www.readbyqxmd.com/read/25632837/treatment-of-mechanical-valve-thrombosis-in-the-right-heart-overview-of-the-requirements-for-the-new-thrombolytic-protocols
#17
Baris Sensoy, Uğur Canpolat, Serkan Cay, Ozcan Ozeke, Kadri Acikgoz, Ozgur Kus, Omac Tufekcioglu
Prosthetic valve thrombosis (PVT) is a rare but serious complication of implanted mechanical valves. Intravenous thrombolytic treatment has emerged as an alternative to surgical therapy in the management of patients with stuck valves. As tricuspid valve replacement is a rare venture, the indications for such therapy and appropriate patient selection are evolving. As the type, dose, and route of administration of thrombolytic agents differ, major complications can be seen in the rapid infusion protocols. In patients with PVT, especially with right-sided valves, thrombolysis with intravenous slow infusion has given discrete, successive sessions guided by serial transthoracic echocardiography and cine/fluoroscopy which may be achieved with a low risk of complications and a high rate of success...
March 2015: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/25503561/current-status-of-right-ventricular-outflow-tract-reconstruction-complete-translation-of-a-review-article-originally-published-in-kyobu-geka-2014-67-65-77
#18
REVIEW
Yusuke Yamamoto, Masaaki Yamagishi, Takako Miyazaki
Right ventricular outflow tract (RVOT) reconstruction is becoming more prevalent as the number of adult patients who require repeated surgery long after definitive repair of congenital heart defects during childhood has increased. Early primary repair and annulus-preserving surgery have been the two current strategies of RVOT reconstruction from the viewpoint of timing and indications for surgical intervention; however, the long-term outcomes of both procedures remain unknown. Although various materials have been used for pulmonary valve replacement during RVOT reconstruction, deficient durability due primarily to immunological rejection frequently arises, particularly when implanted into young patients...
March 2015: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/25495815/preoperative-evaluation-before-mitraclip%C3%A2-present-and-future-perspective
#19
REVIEW
Gemma Salerno, Frank Patrick Schmidt, Maurizio Cappelli Bigazzi, Chiara Sordelli, Renato Bianchi, Paolo Golino, Paolo Calabrò, Maria Giovanna Russo, Raffaele Calabrò, Giuseppe Pacileo
Mitral regurgitation (MR) is the second most common heart valve disease worldwide. Currently, the management of MR is based on medical therapy (including biventricular pacing), surgery (mitral valve replacement or repair) and percutaneous therapy. However, in spite of guideline recommendations, 50% of individuals assessed in the Euro Heart Survey were not referred to surgical intervention due to comorbidities or real or perceived high risks for cardiac surgery; thus, in recent years, the focus of research has shifted to the development of percutaneous approaches to treat severe MR in order to restore valve function in a minimally invasive fashion...
November 2014: Future Cardiology
https://www.readbyqxmd.com/read/25443788/polymeric-heart-valves-for-surgical-implantation-catheter-based-technologies-and-heart-assist-devices
#20
REVIEW
Deon Bezuidenhout, David F Williams, Peter Zilla
Efficient function and long-term durability without the need for anticoagulation, coupled with the ability to be accommodated in many different types of patient, are the principal requirements of replacement heart valves. Although the clinical use of valves appeared to have remained steady for several decades, the evolving demands for the elderly and frail patients typically encountered in the developed world, and the needs of much younger and poorer rheumatic heart disease patients in the developing world have now necessitated new paradigms for heart valve technologies and associated materials...
January 2015: Biomaterials
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