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structural valve deterioration

Dreyer Bester, Lezelle Botes, Johannes Jacobus van den Heever, Harry Kotze, Pascal Dohmen, Jose Luis Pomar, Francis Edwin Smit
Cryopreserved pulmonary homograft (CPH) implantation remains the gold standard for reconstruction of the right ventricular outflow tract (RVOT). Harvesting homografts < 24-h post mortem is the international norm, thereby largely excluding cadaveric donors. This study examines the structural integrity and stability of ovine pulmonary homografts harvested after a 48-h post mortem period, cryopreserved and then implanted for up to 180 days. Fifteen ovine pulmonary homografts were harvested 48-h post mortem and cryopreserved...
October 11, 2018: Cell and Tissue Banking
Réda Belhaj Soulami, Amedeo Anselmi, Jacques Tomasi, Jean-Philippe Verhoye
Structural valve deterioration is a well-studied phenomenon in bioprosthetic heart valves. Conversely, structural valve deterioration after transcatheter aortic valve implantation is not as well-elucidated. Therefore, late surgical explantation after transcatheter aortic valve implantation is an infrequent procedure, and thus, surgical findings and management of such cases remain unclear, particularly in patients previously labelled as 'inoperable' or at 'high risk'. Herein, we report the case of a late surgical explantation of a transcatheter heart valve (THV) 7 years after its implantation in a patient with a porcelain aorta and periprosthetic regurgitation...
October 4, 2018: European Journal of Cardio-thoracic Surgery
Younes Moutakiallah, Mahdi Aithoussa, Noureddine Atmani, Aniss Seghrouchni, Azeddine Moujahid, Abdedaïm Hatim, Iliyasse Asfalou, Zouhair Lakhal, Abdelatif Boulahya
BACKGROUND: The reoperation for isolated tricuspid regurgitation in rheumatic population is rare and still unclear and controversial because of the rarity of publications. The aim of this study was to analyze short and long-term results and outcome of tricuspid valve surgery after left-sided valve surgery in rheumatic patients. METHODS: Twenty six consecutive rheumatic patients who underwent isolated tricuspid valve surgery after left-sided valve surgery between January 2000 and January2017 were retrospectively registered in the study...
October 4, 2018: Journal of Cardiothoracic Surgery
Marta Andrade, Francisca Saraiva, Mário J Amorim, Benjamim Marinho, Rui J Cerqueira, André P Lourenço, Paulo Pinho, Jorge Almeida, Adelino F Leite-Moreira
OBJECTIVE: To report the hemodynamic profile and short- and medium-term outcomes of Freedom Solo and Solo Smart stentless aortic valves implanted at our center. METHODS: Between 2009 and 2015, all patients undergoing aortic valve replacement using Solo stentless valves at our center were enrolled. Clinical and echocardiographic follow-up was carried out six months postoperatively. Survival and major events, including structural valve deterioration and non-structural valve dysfunction, endocarditis, reoperation and stroke, were assessed through medical records or telephone interview with the referring cardiologist up to November 2015 (mean and maximum follow-up 39±22 and 78 months, respectively)...
September 28, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
M M Kreusser, S T Pleger, H Abu Sharar, N A Geis, R Bekeredjian, H A Katus, P W Raake
BACKGROUND: The Cardioband system enables percutaneous surgical-like direct mitral valve annuloplasty and, thereby, repair of severe functional mitral valve regurgitation (MR) in patients with advanced systolic heart failure (HF) and dilation of the left ventricular (LV) annulus. Since the device is anchored by screws in the LV annulus, limited myocardial injury is likely to occur. METHODS AND RESULTS: Five patients (Society of Thoracic Surgeons score: 2.7 ± 0...
September 25, 2018: Herz
Thomas G Gleason, Michael J Reardon, Jeffrey J Popma, G Michael Deeb, Steven J Yakubov, Joon S Lee, Neal S Kleiman, Stan Chetcuti, James B Hermiller, John Heiser, William Merhi, George L Zorn, Peter Tadros, Newell Robinson, George Petrossian, G Chad Hughes, J Kevin Harrison, John V Conte, Mubashir Mumtaz, Jae K Oh, Jian Huang, David H Adams
BACKGROUND: The CoreValve US Pivotal High Risk Trial was the first randomized trial to show superior 1-year mortality of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (SAVR) among high operative mortality-risk patients. OBJECTIVES: The authors sought to compare TAVR to SAVR for mid-term 5-year outcomes of safety, performance, and durability. METHODS: Surgical high-risk patients were randomized (1:1) to TAVR with the self-expanding bioprosthesis or SAVR...
September 18, 2018: Journal of the American College of Cardiology
Sara Calandrini, Eugenio Aulisa
Venous valves are bicuspidal valves that ensure that blood in veins only flows back to the heart. To prevent retrograde blood flow, the two intraluminal leaflets meet in the center of the vein and occlude the vessel. In fluid-structure interaction (FSI) simulations of venous valves, the large structural displacements may lead to mesh deteriorations and entanglements, causing instabilities of the solver and, consequently, the numerical solution to diverge. In this paper, we propose an arbitrary Lagrangian-Eulerian (ALE) scheme for FSI simulations designed to solve these instabilities...
September 18, 2018: International Journal for Numerical Methods in Biomedical Engineering
Giuliano Costa, Corrado Tamburino, Marco Barbanti
With the expanding indication of transcatheter aortic valve implantation (TAVI) to younger, lower risk population, transcatheter aortic valve (TAV) long-term durability is becoming an emerging issue to face with. Recently, the standardization of structural valve deterioration (SVD) definition by a join committee of the European Association of Percutaneous Cardiovascular Interventions (EAPCI), the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) has permitted to evaluate for the first time the rates of TAV durability with comparable endpoint...
September 13, 2018: Minerva Cardioangiologica
Andreas Martens, Erik Beckmann, Tim Kaufeld, Felix Fleissner, Julia Neuser, Wilhelm Korte, Constanze Merz, Heike Krueger, Axel Haverich, Malakh Shrestha
OBJECTIVES: Valve-sparing aortic root replacement (VSARR) is recommended for patients with aortic root dilatation and preserved aortic valve cusp morphology. The durability of VSARR in Marfan patients has been questioned. The aim of our study was to establish the long-term outcomes of VSARR in Marfan patients. METHODS: Between 1993 and 2015, 582 patients underwent VSARR (David I reimplantation) at our institution. Of these patients, 104 had Marfan disease. Thirteen surgeons performed the procedures in this group...
August 30, 2018: European Journal of Cardio-thoracic Surgery
Hélène Eltchaninoff, Eric Durand, Marco Barbanti, Mohamed Abdel-Wahab
Aortic bioprostheses are increasingly used both for surgery, as an alternative to mechanical valves, and for transcatheter implantation in patients with severe aortic stenosis. Transcatheter aortic valve implantation (TAVI) has been widely adopted for the treatment of severe symptomatic aortic stenosis in elderly (>75 years) patients who are at risk for surgery and who have favourable transfemoral access. It is already under evaluation in low-risk patients. The aim of this review is to present an update on definitions and to assess the various forms of transcatheter heart valve failure and their management: structural valve deterioration, non-structural deterioration, thrombosis and endocarditis...
August 31, 2018: EuroIntervention
E Mara Vollema, Tadafumi Sugimoto, Mylène Shen, Lionel Tastet, Arnold C T Ng, Rachid Abou, Nina Ajmone Marsan, Bart Mertens, Raluca Dulgheru, Patrizio Lancellotti, Marie-Annick Clavel, Philippe Pibarot, Philippe Genereux, Martin B Leon, Victoria Delgado, Jeroen J Bax
Importance: The optimal timing to operate in patients with asymptomatic severe aortic stenosis (AS) remains controversial. Left ventricular global longitudinal strain (LV GLS) may help to identify patients who might benefit from undergoing earlier aortic valve replacement. Objective: To investigate the prevalence of impaired LV GLS, the natural course of LV GLS, and its prognostic implications in patients with asymptomatic severe AS with preserved left ventricular ejection fraction (LVEF)...
September 1, 2018: JAMA Cardiology
Alberto Repossini, Lorenzo Di Bacco, Laszlo Gazdag, Herko Grubitzsch, Theodor Fischlein, Alessandra Stara, Claudio Muneretto, Giuseppe Santarpino
BACKGROUND:  The Freedom SOLO (FS) stentless bovine-pericardial prosthesis with a supra-annular implantation technique can be a viable option for patients with endocarditic annular destruction. We assessed early- and long-term outcomes following the use of this prosthesis in extensive aortic valve endocarditis. METHODS:  From 2006 to 2016, 59 patients with extensive aortic endocarditis underwent aortic valve replacement (AVR) with FS (cumulative follow-up 263 patients-years) in three European centers; all patients presented annular tissue infection, while 54...
August 16, 2018: Thoracic and Cardiovascular Surgeon
Seung Hyun Kim, Hak Ju Kim, Ho Young Hwang
A 73-year-old woman who underwent combined bioprosthetic mitral valve replacement, tricuspid ring annuloplasty, and coronary artery bypass grafting 12 years previously visited our clinic due to aggravated dyspnea caused by structural valve deterioration of the mitral prosthesis. Because aortic or femoral artery cannulation and cross-clamping would have a high risk of stroke owing to severe calcification of the ascending aorta and ilio-femoral vessels, and because there was a risk of redo sternotomy due to the patent bypass grafts, a comprehensive approach including axillary artery cannulation, a minimally invasive right thoracotomy approach, and a clampless hypothermic fibrillatory arrest technique was used during redo mitral valve replacement...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Yoshimori Araki, Chikao Teramoto, Yasunobu Konishi, Takafumi Terada, Osamu Kawaguchi
We present a case of left ventricular outflow tract (LVOT) obstruction after double valve re-replacement with bioprostheses. A 72-year-old man, who had undergone double valve replacement (DVR) with bioprosthetic valves 9 years previously, underwent re-replacement of valves because of structural valve deterioration. However, owing to LVOT obstruction related to the bioprosthesis in the mitral position, acute pulmonary edema occurred immediately after surgery. LVOT obstruction was diagnosed by emergent cardiac catheterization...
August 9, 2018: Annals of Thoracic and Cardiovascular Surgery
Amedeo Anselmi, Vito Giovanni Ruggieri, Réda Belhaj Soulami, Erwan Flécher, Thierry Langanay, Hervé Corbineau, Alain Leguerrier, Jean-Philippe Verhoye
BACKGROUND:  Aortic valve replacement (AVR) in small aortic roots remains a surgical dilemma with a higher risk of patient-prosthesis mismatch (PPM). The Perimount Magna Ease aortic valve (PMEAV) represents an attractive device in such cases. We examined the early hemodynamic performance, the mid-term outcomes of the PMEAV, and the impact of PPM on outcome and functional class. METHODS:  We performed a retrospective analysis of prospectively collected in-hospital data, and a prospective single-center follow-up of 849 patients who received a 19 to 23 mm PMEAV (2008-2014)...
August 1, 2018: Thoracic and Cardiovascular Surgeon
Stefania Blasi, Giacomo Ravenni, Michele Celiento, Andrea De Martino, Aldo D Milano, Uberto Bortolotti
BACKGROUND:  The Mitroflow pericardial bioprosthesis (MPB) has been recently associated with a high incidence of early structural failures, questioning its validity as cardiac valve substitute. We have therefore reviewed our experience with this device. MATERIALS AND METHODS:  A total of 398 patients with a mean age of 75 ± 7 years (58% above the age of 75 years) had aortic valve replacement with a Mitroflow prosthesis (2005-2015). Most patients had calcific aortic stenosis (86%) and were in sinus rhythm (89%)...
July 30, 2018: Thoracic and Cardiovascular Surgeon
Omar Aldalati, Amit Kaura, Habib Khan, Rafal Dworakowski, Jonathan Byrne, Mehdi Eskandari, Ranjit Deshpande, Mark Monaghan, Olaf Wendler, Philip MacCarthy
BACKGROUND: The durability of TAVR prostheses has come under major scrutiny since the move towards lower risk patients. We sought to compare the rate of structural valve deterioration (SVD) over time between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). METHODS: We included all TAVR and SAVR patients (age ≥ 75 years) that were performed in our centre from 2005 until 2015. Applying the internationally "agreed on" definitions of SVD, we surveyed all available serial echocardiographic follow-ups...
October 1, 2018: International Journal of Cardiology
Erwan Salaun, Haïfa Mahjoub, Abdellaziz Dahou, Patrick Mathieu, Éric Larose, Jean-Pierre Després, Josep Rodés-Cabau, Benoit J Arsenault, Rishi Puri, Marie-Annick Clavel, Philippe Pibarot
BACKGROUND: Dysmetabolic profile has been associated with native aortic valve stenosis. However, there are limited data on the effects of an atherogenic milieu and its potential implications on the structural and hemodynamic deterioration of aortic bioprosthetic valves. OBJECTIVES: This prospective longitudinal study sought to determine the predictors and impact on outcomes of hemodynamic valve deterioration (HVD) of surgically implanted aortic bioprostheses. METHODS: A total of 137 patients with an aortic bioprosthesis implanted for a median time of 6...
July 17, 2018: Journal of the American College of Cardiology
Deepa Sritharan, Parinaz Fathi, Jason D Weaver, Stephen M Retta, Changfu Wu, Nandini Duraiswamy
After implantation of a transcatheter bioprosthetic heart valve its original circular circumference may become distorted, which can lead to changes in leaflet coaptation and leaflets that are stretched or sagging. This may lead to early structural deterioration of the valve as seen in some explanted transcatheter heart valves. Our in vitro study evaluates the effect of leaflet deformations seen in elliptical configurations on the damage patterns of the leaflets, with circular valve deformation as the control...
September 2018: Cardiovascular Engineering and Technology
David Attias, Mohammed Nejjari, Francesco Nappi, Julien Dreyfus, Mackram F Eleid, Charanjit S Rihal
The optimal management of aortic surgical bioprosthesis presenting with severe symptomatic structural valve deterioration is currently a matter of debate. Over the past 20 years, the number of implanted bioprostheses worldwide has been rapidly increasing at the expense of mechanical prostheses. A large proportion of patients, however, will require intervention for bioprosthesis structural valve deterioration. Current options for older patients who often have severe comorbidities include either transcatheter valve-in-valve (TVIV) implantation or redo valve surgery...
June 2, 2018: European Journal of Cardio-thoracic Surgery
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