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structural valve deterioration

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...
June 12, 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
Jelle Fleerakkers, Marc Schepens, Willem Ranschaert, Paul Verrelst, Eric Graulus
OBJECTIVES: Our goal was to analyse the haemodynamic and clinical results after implantation of the Freedom SOLO stentless aortic valve replacement by assessing the immediate postoperative results regarding mortality, discharge echocardiographic gradients and reoperation rates and by evaluating these results in the medium term. METHODS: This study was designed as a single-centre retrospective observational trial. Clinical and echocardiographic data were collected retrospectively from 625 patients undergoing an aortic valve replacement using the Freedom Solo stentless valve (LivaNova, London, UK) at the Sint-Jan Hospital, Bruges, between May 2009 and May 2017...
May 24, 2018: European Journal of Cardio-thoracic Surgery
Victor X Mosquera, Miguel González-Barbeito, Alberto Bouzas-Mosquera, José M Herrera-Noreña, Carlos Velasco, Jorge Salgado-Fernández, Ramón Calviño-Santos, Nicolás Vázquez-González, José M Vázquez-Rodríguez, José J Cuenca-Castillo
OBJECTIVES: Bioprostheses with pericardial leaflets mounted externally on the stent pose a high risk for valve-in-valve (ViV) procedures. This study analyzed the efficacy and safety of ViV procedures for treating structural valve deterioration (SVD) in Mitroflow bioprostheses. METHODS: Between January 2012 and August 2017, 11 patients (mean age 80.3 ± 5.6 years) were treated for SVD of Mitroflow bioprostheses with transcatheter ViV procedures (six transapical [TA] and five transfemoral [TF]) using balloon expandable bioprostheses...
July 2018: Journal of Cardiac Surgery
Kostantinos Zannis, Konstantinos Diplaris, Jean-Luc Monin, Nizar Khelil, Mathieu Debauchez, Patrice Dervanian, Emmanuel Lansac, Daniel Czirom, Milena Noghin, Leila Mankoubi, Nicolas Amabile
BACKGROUND: Concerns have been previously raised regarding the potential early degenera- tion of the Mitroflow (Sorin, Italy) bioprostheses. We aimed to evaluate our clinical experience with the Mitroflow LXA prosthesis for aortic valve replacement. METHODS: We prospectively analyzed data from 227 consecutive patients (133 males, mean age 73.9± 9.2 y ) implanted with the Mitroflow LXA between February 2007 and October 2011. Follow up data were obtained by contacting the referring cardiologists...
May 22, 2018: Journal of Cardiovascular Surgery
Guglielmo Stefanelli, Fabrizio Pirro, Giuseppe Danniballe, Alina Olaru, Marco Meli, Luca Weltert
BACKGROUND: The study aim was to investigate the hemodynamic behavior over time and ease of implant and durability of the Sorin Pericarbon Freedom (SPF)® stentless pericardial aortic xenograft. METHODS: Between March 2003 and April 2010, a total of 251 consecutive, non-selected patients (mean age 70.1 years; range: 17-89 years; 17.1% aged >80 years) received a SPF bioprosthesis as an aortic valve substitute at the authors' institution. All implantations were performed by a single surgeon using a classical, double-line, subcoronary implant technique...
September 2017: Journal of Heart Valve Disease
Francesco Nappi, Antonio Nenna, Tommasangelo Petitti, Cristiano Spadaccio, Ivancarmine Gambardella, Mario Lusini, Massimo Chello, Christophe Acar
OBJECTIVE: The most efficient surgical approach to severe aortic valve disease in the young adult is still debated: cryopreserved aortic allograft offers excellent hemodynamic and avoid anticoagulation, but long-term durability is influenced by structural valve deterioration (SVD). This study aimed to describe long-term results of aortic allografts and to identify factors influencing long-term durability. METHODS: From January 1993 to August 2010, 210 patients underwent aortic allograft replacement via the free-hand subcoronary implantation technique (N = 55) or root replacement with coronary reimplantation (N = 155)...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
Kazunori Ota, Koyu Tanaka, Naoki Asano, Shigeyoshi Gon, Masahito Saito, Kazuho Niimi, Hiromichi Inoue, Motohiko Tamura, Yuji Matsumura, Toshihiro Ohata, Hirotsugu Fukuda, Hiroshi Takano
Although nonstructural dysfunction of a bioprosthesis caused by pannus formation or native valve attachment has been well described, structural valve deterioration( SVD) caused by calcification or tear of a bioprosthesis, especially a bovine pericardial valve, is very rare in the tricuspid position. We report a case of redo tricuspid valve surgery for SVD 14 years after tricuspid valve replacement( TVR) using a Carpentier-Edwards Perimount (CEP) pericardial valve. A 71-year-old woman was referred to our hospital because of exertional dyspnea and pre-syncope...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Ross M Reul, Mahesh K Ramchandani, Michael J Reardon
Surgical aortic valve replacement is the gold standard procedure to treat patients with severe, symptomatic aortic valve stenosis or insufficiency. Bioprosthetic valves are used for surgical aortic valve replacement with a much greater prevalence than mechanical valves. However, bioprosthetic valves may fail over time because of structural valve deterioration; this often requires intervention due to severe bioprosthetic valve stenosis or regurgitation or a combination of both. In select patients, transcatheter aortic valve replacement is an alternative to surgical aortic valve replacement...
July 2017: Methodist DeBakey Cardiovascular Journal
Erik W Holy, Julia Kebernik, Mohammad Abdelghani, Simon F Stämpfli, Jens Hellermann, Abdelhakim Allali, Mohamed El-Mawardy, Susanne Sachse, Thomas F Lüscher, Felix C Tanner, Gert Richardt, Mohamed Abdel-Wahab
AIMS: Long-term results of transcatheter aortic valve implantation (TAVI), in particular the incidence of bioprosthetic valve failure (BVF), are uncertain. This study presents data derived from a long-term, structured follow-up programme of the self-expanding CoreValve device utilising standardised definitions and core lab adjudication of valve performance. METHODS AND RESULTS: The study prospectively included all 152 patients who had undergone TAVI with the self-expanding CoreValve up to December 2011 at the Heart Center, Bad Segeberg, Germany...
July 20, 2018: EuroIntervention
Erwan Salaun, Marie-Annick Clavel, Josep Rodés-Cabau, Philippe Pibarot
The main limitation of bioprosthetic valves is their limited durability, which exposes the patient to the risk of aortic valve reintervention. Transcatheter aortic valve implantation (TAVI) is considered a reasonable alternative to surgical aortic valve replacement (SAVR) in patients with intermediate or high surgical risk. TAVI is now rapidly expanding towards the lower risk populations. Although the results of midterm durability of the transcatheter bioprostheses are encouraging, their long-term durability remains largely unknown...
August 2018: Heart: Official Journal of the British Cardiac Society
João Pedro Monteiro, Diogo Rijo, Sara Simões Costa, Rodolfo Pereira, Ricardo Ferraz, Miguel Guerra
INTRODUCTION: Bioprosthesis are increasingly used for aortic valve replacement (AVR), as a result of increasing elderly patients, as well as, continuous improvements in durability and hemodynamic performance of pericardial prosthesis. The Trifecta aortic prosthesis is a latest-generation trileaflet stented pericardial valve designed for supra-annular placement in the aortic position. This study establishes the safety and early clinical and hemodynamic performance of the Trifecta valve...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Sara Simões Costa, Diogo Rijo, João Pedro Monteiro, Daniel Martins, Nelson Santos Paulo, Luis Vouga, Miguel Guerra
INTRODUCTION: Isolated aortic valve replacement (AVR) in elderly patients is associated with increased operative risk, due to higher prevalence of associated risk factors and other comorbidities, making outcome prediction essential. In patients with symptomatic severe aortic disease, advanced age is often a reason for a transcatheter rather than surgical aortic valve replacement. In the era of TAVI, there has been renewed interest in the outcomes of conventional AVR for high and intermediate risk patients...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Rui J Cerqueira, Renata Melo, Soraia Moreira, Francisca A Saraiva, Marta Andrade, Elson Salgueiro, Jorge Almeida, Mário J Amorim, Paulo Pinho, André Lourenço, Adelino F Leite-Moreira
INTRODUCTION: To compare stentless Freedom Solo and stented Trifecta aortic bioprostheses regarding hemodynamic profile, left ventricular mass regression, early and late postoperative outcomes and survival. METHODS: Longitudinal cohort study of consecutive patients undergoing aortic valve replacement (from 2009 to 2016) with either Freedom Solo or Trifecta at one centre. Local databases and national records were queried. Postoperative echocardiography (3-6 months) was obtained for hemodynamic profile (mean transprosthetic gradient and effective orifice area) and left ventricle mass determination...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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