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Prosthetic heart valve technology

Claudio Capelli, Chiara Corsini, Dario Biscarini, Francesco Ruffini, Francesco Migliavacca, Alfred Kocher, Guenther Laufer, Andrew M Taylor, Silvia Schievano, Martin Andreas, Gaetano Burriesci, Claus Rath
Surgical aortic valve replacement is the most common procedure of choice for the treatment of severe aortic stenosis. Bioprosthetic valves are traditionally sewed-in the aortic root by means of pledget-armed sutures during open-heart surgery. Recently, novel bioprostheses which include a stent-based anchoring system have been introduced to allow rapid implantation, therefore reducing the duration and invasiveness of the intervention. Different effects on the hemodynamics were clinically reported associated with the two technologies...
March 2017: Cardiovascular Engineering and Technology
Lakshmi P Dasi, Hoda Hatoum, Arash Kheradvar, Ramin Zareian, S Hamed Alavi, Wei Sun, Caitlin Martin, Thuy Pham, Qian Wang, Prem A Midha, Vrishank Raghav, Ajit P Yoganathan
Transcatheter aortic valves (TAVs) represent the latest advances in prosthetic heart valve technology. TAVs are truly transformational as they bring the benefit of heart valve replacement to patients that would otherwise not be operated on. Nevertheless, like any new device technology, the high expectations are dampened with growing concerns arising from frequent complications that develop in patients, indicating that the technology is far from being mature. Some of the most common complications that plague current TAV devices include malpositioning, crimp-induced leaflet damage, paravalvular leak, thrombosis, conduction abnormalities and prosthesis-patient mismatch...
February 2017: Annals of Biomedical Engineering
Matthew Moore, Glenn R Barnhart, Walter Randolph Chitwood, John A Rizzo, Candace Gunnarsson, Swetha R Palli, Eugene A Grossi
OBJECTIVE: The recent development of the EDWARDS INTUITY Elite™ (EIE) valve system enables the rapid deployment of a prosthetic surgical heart valve in an aortic valve replacement (AVR) procedure via both the minimally invasive (MISAVR) and conventional (CAVR) approaches. In order to understand its economic value, this study performed a cost evaluation of the EIE valve system used in a MIS rapid-deployment approach (MIS-RDAVR) vs MISAVR and CAVR, respectively, compared to standard prosthetic aortic valves...
October 2016: Journal of Medical Economics
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
Sandy Engelhardt, Ivo Wolf, Sameer Al-Maisary, Harald Schmidt, Hans-Peter Meinzer, Matthias Karck, Raffaele De Simone
PURPOSE: Analysis of mitral valve morphology during reconstruction is routinely based on visual assessment and subjective, poorly reproducible measurements. We prove the feasibility of a new intraoperative system for quantitative mitral valve analysis. DESCRIPTION: The proposed computer-based assistance system enables accurate intraoperative localization of anatomic landmarks on the mitral valve apparatus using optical tracking technology. Measurement and visualization strategies were specifically developed and tailored for mitral valve operations...
May 2016: Annals of Thoracic Surgery
Aleksander Sizarov, Younes Boudjemline
Correction of malformations affecting the right ventricular outflow tract often results in residual abnormalities that require valve implantation at a later stage to prevent right ventricular deterioration. In the paediatric population, the pathology of congenital valve stenosis or insufficiency is often complex, options for surgical repair are limited, and valve replacement remains the only-albeit unattractive-alternative. Prosthetic heart valve implantation can be performed either surgically or, nowadays, percutaneously...
May 2016: Archives of Cardiovascular Diseases
Glenn R Barnhart, Malakh Lal Shrestha
Aortic stenosis is the most common valvular heart disease in the Western world. It is caused primarily by age-related degeneration and progressive calcification typically detected in patients 65 years and older. In patients presenting with symptoms of heart failure, the average survival rate is only 2 years without appropriate treatment. Approximately one half of all patients die within the first 2 to 3 years of symptom onset. In addition, the age of the patients presenting for aortic valve replacement (AVR) is increased along with the demographic changes...
January 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Anna Kostopoulou, Panagiotis Karyofillis, Efthimios Livanis, George Karavolias, George Theodorakis, John Paraskevaides, Vassilis Voudris
Transcatheter aortic valve replacement (TAVR) is an expanding, catheter-based technology that allows the implantation of a prosthetic valve without requiring open heart surgery for the treatment of severe aortic stenosis (AS). The frequency of coronary artery disease (CAD) in patients (pts) with severe AS undergoing surgical treatment ranges from 30 to 50 %. This tends to be higher in pts undergoing TAVR with a prevalence of 49-76 % and is more prevalent with older age and the fact that TAVR is commonly performed in high-risk groups with more advanced cardiovascular disease...
February 2016: Current Treatment Options in Cardiovascular Medicine
Cristian Rosu, Edward G Soltesz
The lack of an ideal prosthetic heart valve leaves surgeons and their patients with a difficult choice at the time of valve replacement surgery. Current guidelines mainly emphasize patient age, contraindications to anticoagulation, and patient desires in their recommendations for the type of prosthesis to implant. Aortic valve replacement is the most frequently performed valve replacement, and 5 articles in recent years have presented important data on outcomes with different prosthesis types. The findings suggest that in young patients, transvalvular prosthesis gradients have an effect on long-term bioprosthesis durability...
2015: Seminars in Thoracic and Cardiovascular Surgery
Andrés M Pineda, Christos G Mihos, Sandeep Singla, Orlando Santana, John Rhodes, Robert J Sommer, Charanjit S Rihal, Nirat Beohar
The number of adults with congenital heart disease is expected to increase over the next decade. Although acquired defects are being increasingly recognized in adults, congenital heart disease remains the most common etiology. With advances in cardiac imaging, device technology, and transcatheter techniques, percutaneous closure is now feasible and safe for most intracardiac defects. Device closure is considered the first-line therapy for a variety of congenital intracardiac defects, including ostium secundum atrial septal defects and muscular ventricular septal defects...
December 2015: Journal of Invasive Cardiology
Lai Wei, Huan Liu, Liming Zhu, Ye Yang, Jiayu Zheng, Kefang Guo, Hong Luo, Weipeng Zhao, Xue Yang, Aikebaier Maimaiti, Chunsheng Wang
OBJECTIVES: This study introduces a newly designed transcatheter aortic valve system, the J-Valve system, and evaluates its application in patients with predominant aortic regurgitation without significant valve calcification. We also report the early results of one of the first series of transapical implantations of this device and aim to offer guidance on the technical aspects of the procedure. BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been widely used in high-risk patients for surgical aortic valve replacement...
December 21, 2015: JACC. Cardiovascular Interventions
Marco Barbanti, Anna Sonia Petronio, Federica Ettori, Azeem Latib, Francesco Bedogni, Federico De Marco, Arnaldo Poli, Carla Boschetti, Marco De Carlo, Claudia Fiorina, Antonio Colombo, Nedy Brambilla, Giuseppe Bruschi, Paola Martina, Claudia Pandolfi, Cristina Giannini, Salvatore Curello, Carmelo Sgroi, Simona Gulino, Martina Patanè, Yohei Ohno, Claudia Tamburino, Guilherme F Attizzani, Sebastiano Immè, Alessandra Gentili, Corrado Tamburino
OBJECTIVES: The purpose of this analysis was to assess 5-year outcomes of transcatheter aortic valve implantation (TAVI) using the current technology of the self-expanding CoreValve prosthesis (Medtronic Inc., Minneapolis, Minnesota). BACKGROUND: There is a paucity of evidence on long-term durability of currently available transcatheter heart valves. METHODS: Starting in June 2007, all consecutive patients with severe aortic stenosis undergoing TAVI with the third-generation 18-F CoreValve device in 8 Italian centers were prospectively included in the ClinicalService Project...
July 2015: JACC. Cardiovascular Interventions
Oliver Reuthebuch, Luca Koechlin, Beat A Kaufmann, Arnheid Kessel-Schaefer, Brigitta Gahl, Friedrich S Eckstein
OBJECTIVE: Since the first transcatheter aortic valve implantation (TAVI) in 2002, TAVI technique has gained an increasing popularity especially in high-risk patients. In this study, we present the first echocardiographic midterm outcome with the second-generation transapical JenaValve TAVI system (JenaValve Technology GmbH, Munich, Germany) in patients with aortic stenosis (AS). METHODS: Between November 2011 and November 2012, a total of 28 patients received transapical TAVI using the JenaValve...
September 2015: Thoracic and Cardiovascular Surgeon
Munirah Ismail, Foad Kabinejadian, Yen Ngoc Nguyen, Edgar Tay, Sangho Kim, Hwa Liang Leo
Severe tricuspid regurgitation (TR) is life-threatening but is often undertreated. Many patients with severe TR are denied heart valve replacement surgery because their old age or comorbidities predispose them to a higher risk of surgical complications associated with open-heart surgery. With the advent of transcatheter technology, it is now possible to deliver the valve to the desired location without the need for open-heart surgery. However, presently, there is no commercially available transcatheter tricuspid valve...
September 2015: Artificial Organs
Hsiao-Huang Chang, I-Ming Chen, Po-Lin Chen, Tsui-Lieh Hsu, Su-Man Lin, Ying-Hwa Chen
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement for patients with symptomatic severe aortic stenosis (AS) who have a high surgical risk. In Taiwan, this is the first study reporting TAVI outcomes at a single center offering two different transcatheter heart valve technologies via four types of approaches. Our aim was to compare 30-day and 6-month Valve Academic Research Consortium-2 (VARC-2) outcomes of the two valves...
June 2015: Journal of the Chinese Medical Association: JCMA
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
Candice Y Lee, Jude S Sauer, Heather R Gorea, Angelo J Martellaro, Peter A Knight
OBJECTIVE: This study compared the strength, consistency, and speed of prosthetic attachment sutures secured with automated fasteners with those of manual knots using an ex vivo porcine mitral valve annuloplasty model. A novel miniature pressure transducer system was developed to quantify pressures between sutured prosthetic rings and underlying cardiac tissue. METHODS: Sixteen mitral annuloplasty rings were sewn into ex vivo pig hearts. Eight rings were secured with the COR-KNOT device; and eight rings, with hand-tied knots using a knot pusher...
March 2014: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Mm Rozeik, Dj Wheatley, T Gourlay
The aortic valve operates in a complex haemodynamic environment, opening and closing over 100,000 times a day. When complications arise, such as aortic stenosis, prognosis can be very poor, leading to death within the first few years. Surgical valve replacement is currently the standard treatment for aortic stenosis. A thorough understanding of the anatomy and function of the native valve is imperative when developing a prosthetic replacement that can withstand the complex demands of the heart. This review focuses on the anatomy, structure and disease of the aortic valve and the implications for a transcatheter aortic valve replacement (TAVR)...
July 2014: Perfusion
Paolo Denti, Francesco Maisano, Ottavio Alfieri
The natural history of severe mitral regurgitation (MR) is unfavorable, leading to left ventricular failure, atrial fibrillation, stroke, and death. Many patients affected by severe regurgitation (MR) do not currently undergo surgery, mainly due to the perceived risk of the procedure (old age, impaired left ventricular function, and comorbidities). Mitral transcatheter interventions carry the hope of minimizing risks while preserving clinical efficacy of surgical repair, as an alternative to conventional treatment...
April 2014: Journal of Cardiovascular Translational Research
Anita Driessen-Mol, Maximilian Y Emmert, Petra E Dijkman, Laura Frese, Bart Sanders, Benedikt Weber, Nikola Cesarovic, Michele Sidler, Jori Leenders, Rolf Jenni, Jürg Grünenfelder, Volkmar Falk, Frank P T Baaijens, Simon P Hoerstrup
OBJECTIVES: This study sought to evaluate long-term in vivo functionality, host cell repopulation, and remodeling of "off-the-shelf" tissue engineered transcatheter homologous heart valves. BACKGROUND: Transcatheter valve implantation has emerged as a valid alternative to conventional surgery, in particular for elderly high-risk patients. However, currently used bioprosthetic transcatheter valves are prone to progressive dysfunctional degeneration, limiting their use in younger patients...
April 8, 2014: Journal of the American College of Cardiology
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