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Current status of heart valve replacement

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https://www.readbyqxmd.com/read/27777298/management-of-systemic-right-ventricular-failure-in-patients-with-congenitally-corrected-transposition-of-the-great-arteries
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
https://www.readbyqxmd.com/read/25345097/therapy-for-mucopolysaccharidosis-vi-maroteaux-lamy-syndrome-present-status-and-prospects
#16
REVIEW
Roberto Giugliani, Silvani Herber, Louise Lapagesse, Camargo de Pinto, Guilherme Baldo
Mucopolysaccharidosis VI (MPS VI) is a lysosomal storage disorder caused by deficient activity of Arylsulphatase B (ARSB). The disease is progressive and multisystemic, usually leading to death in the first decades of life. In addition to supportive management, specific treatments for MPS VI are the hematopoietic stem cell transplantation (HSCT) and enzyme replacement therapy (ERT). Both are effective for some aspects of the disease, but fail in correcting important clinical features, such as bone deformities and heart valve thickening...
September 2014: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/25206979/transcatheter-aortic-valve-implantation-our-experience-and-review-of-the-literature
#17
REVIEW
Kamil Mehmet Burgazlı, Ritvan Chasan, Ethem Kavukçu, Christiane Neuhof, Mehmet Bilgin, Nedim Soydan, Ali Erdoğan
Transcatheter Aortic Valve Implantation [TAVI] is widespread worldwide as an alternative therapy procedure to the patients suffering from severe aortic valve stenosis. However, we shouldn't forget that the conventional surgical aortic valve replacement is still the gold standard therapy for severe aortic valve stenosis. For the patients who cannot be treated conventionally because of high risk comorbid diseases and older age, TAVI is an effective alternative therapy method. The indications should be limited, concerning the high mortality rate, 10% within 30 days of intervention...
June 2012: Balkan Medical Journal
https://www.readbyqxmd.com/read/25189570/calcific-aortic-valve-disease-a-consensus-summary-from-the-alliance-of-investigators-on-calcific-aortic-valve-disease
#18
REVIEW
Katherine E Yutzey, Linda L Demer, Simon C Body, Gordon S Huggins, Dwight A Towler, Cecilia M Giachelli, Marion A Hofmann-Bowman, Douglas P Mortlock, Melissa B Rogers, Mehran M Sadeghi, Elena Aikawa
Calcific aortic valve disease (CAVD) is increasingly prevalent worldwide with significant morbidity and mortality. Therapeutic options beyond surgical valve replacement are currently limited. In 2011, the National Heart Lung and Blood Institute assembled a working group on aortic stenosis. This group identified CAVD as an actively regulated disease process in need of further study. As a result, the Alliance of Investigators on CAVD was formed to coordinate and promote CAVD research, with the goals of identifying individuals at risk, developing new therapeutic approaches, and improving diagnostic methods...
November 2014: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/25109700/the-current-status-of-fluoroscopy-and-echocardiography-in-the-diagnosis-of-prosthetic-valve-thrombosis-a-review-article
#19
REVIEW
Mustafa Ozan Gürsoy, Macit Kalçik, Süleyman Karakoyun, Mehmet Özkan
Prosthetic valve thrombosis (PVT) is a potentially life-threatening complication of heart valve replacement. Early diagnosis is crucial for the prevention of significantly morbid and lethal complications. Cinefluoroscopy (CF) and echocardiography have been widely used for diagnosing PVT. In recent years, the role of CF has declined since the introduction of transesophageal echocardiography and the great improvements in ultrasound technology including real time three-dimensional imaging. Nevertheless, both echocardiography and CF provide different kinds of information on prosthesis function, and therefore they are considered as complementary and not alternative...
January 2015: Echocardiography
https://www.readbyqxmd.com/read/24354078/aana-journal-course-update-for-nurse-anesthetists-part-4-transcatheter-aortic-valve-replacement
#20
REVIEW
Peggy Contrera, Mary Cushing
Aortic stenosis is the most frequently acquired heart disease, and the prevalence is rising because of the aging population. If the disease is left untreated, survival in symptomatic patients averages only 2 to 3 years. Surgical aortic valve replacement is the only definitive treatment, yet 30% of elderly patients are not considered candidates because the presence of comorbidities makes the risk of sternotomy and cardiopulmonary bypass prohibitively high. Transcatheter aortic valve replacement (TAVR) is an innovative, high-tech, less invasive alternative...
October 2013: AANA Journal
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