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Andreas Eisenried, Raphael Klarwein, Harald Ihmsen, Andreas Wehrfritz, René Tandler, Christian Heim, Jörg Fechner
OBJECTIVE: Evaluate the accuracy and trending ability of the fourth-generation FloTrac/EV1000 (Edwards Lifesciences, Irvine, CA) system in patients with severe aortic valve stenosis by comparing FloTrac/EV1000-derived cardiac output (CCO-FT) with continuous thermodilution pulmonary artery catheter (CCO-PAC) measurements before and after surgical valve replacement. DESIGN: Prospective clinical study. SETTING: Anesthesia for cardiac surgery, operating room, single-center university hospital...
September 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
João Santos Silva, Carolina Torres, José Alberto Teixeira, Pedro Garcia, Paulo Calvinho
Primary mediastinal tumours with chest wall involvement represent technical challenges that may offer a survival benefit. Reconstruction with osteossynthesis material, bioprosthesis and muscle flaps is indicated to re-establish the excised component function. We report a case of a 30-year-old male with a primary mediastinal seminoma operated after chemotherapy with need for en bloc resection of the residual mass and manubrium with chest wall reconstruction. This type of surgery is rare and represents a technical challenge...
January 2018: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Max Wacker, Ingo Slottosch, Maximilian Scherner, Sam Varghese, Jens Wippermann
Over the last decade, aortic valve replacement with rapid-deployment biological bioprosthesis has become a common alternative technique to mechanical or biological stented valves for high-risk patients. A 63 year old patient underwent uncomplicated valve replacement with the Edwards Intuity valve. 2 months post operation, the patient had progredient dyspnea. Echocardiography showed a dislocated aortic valve reaching into the left ventricular outflow tract, impairing the anterior mitral valve leaflet. Both valves were replaced by a conventional stented bioprosthesis...
October 10, 2018: Annals of Thoracic Surgery
Brandon J Tefft, Joshua A Choe, Melissa D Young, Ryan S Hennessy, David W Morse, Jeffery A Bouchard, Herbert J Hedberg, Joseph F Consiglio, Dan Dragomir-Daescu, Robert D Simari, Amir Lerman
PURPOSE: Tissue engineered heart valves (TEHV) are being investigated to address the limitations of currently available valve prostheses. In order to advance a wide variety of TEHV approaches, the goal of this study was to develop a cardiac valve bioreactor system capable of conditioning living valves with a range of hydrodynamic conditions as well as capable of assessing hydrodynamic performance to ISO 5840 standards. METHODS: A bioreactor system was designed based on the Windkessel approach...
October 11, 2018: Cardiovascular Engineering and Technology
Farhang Yazdchi, Tsuyoshi Kaneko, Sary Aranki
No abstract text is available yet for this article.
August 31, 2018: Journal of Thoracic and Cardiovascular Surgery
Armah M Akuffu, Haige Zhao, Junnan Zheng, Yiming Ni
BACKGROUND: Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing mitral valve replacement (MVR) surgery. We aimed to investigate the incidence of PPM of the mitral position in our center and analyze the possible predictors of PPM as well as its effect on short-term outcomes. METHODS: We retrospectively examined all consecutive patients with isolated or concomitant MVR at our center from 2013 to 2015. PPM was defined as an indexed effective orifice area (iEOA) of ≤1...
October 3, 2018: Journal of Cardiothoracic Surgery
J Rodríguez-Capitán, V M Becerra-Muñoz, B Pérez-Villardón, G Sánchez-Espín, M Such-Martínez, A Flores-Marín, I Fernández-Pérez, A García-Bellón, C Porras-Martín, M J Mataró-López, J M Melero-Tejedor, E Rodríguez-Caulo, J J Otero-Forero, A Cordero-Aguilar, R López-Salguero, J J Gómez-Doblas, E de Teresa-Galván
BACKGROUND: The aim of our study was to assess the outcomes of surgical treatment for severe tricuspid regurgitation according to whether cardiac surgery had been performed before the tricuspid valve intervention. METHODS: Between 1996 and 2013, 201 consecutive patients with severe tricuspid regurgitation underwent tricuspid surgery at our center. Patients were classified according to whether or not they had undergone previous cardiac surgery, which 33% of the sample had...
October 1, 2018: Herz
Lluis Asmarats, François Dagenais, Elisabeth Bédard, Sergio Pasian, Rebecca T Hahn, José L Navia, Josep Rodés-Cabau
Despite the growing evidence with emerging transcatheter tricuspid valve repair therapies, the experience with transcatheter tricuspid valve replacement remains sparse. We describe a case of severe tricuspid regurgitation in a 79-year-old patient deemed unsuitable for isolated tricuspid valve surgery, successfully treated with a 40-mm self-expandable NaviGate (NaviGate Cardiac Structures, Inc, Lake Forest, CA) valved stent via a transatrial approach, with excellent result and hemodynamic performance at 4 months...
October 2018: Canadian Journal of Cardiology
Gopichand Mannam, Yugal Mishra, Rajan Modi, Alla Gopala Krishna Gokhale, Rajan Sethuratnam, Kaushal Pandey, Rajneesh Malhotra, Sumit Anand, Anushreeta Borah, Sushan Mukhopadhyay, Dhiren Shah, Tek Singh Mahant
BACKGROUND: Indian patients undergoing surgical aortic valve replacement (SAVR) differ from western populations with respect to aortic annulus size and valve disease morphology. The purpose of this post-market, non-randomized observational study was to evaluate the early hemodynamic performance of the Trifecta™ bioprosthesis (Abbott, previously St. Jude Medical, Minneapolis, US) in an Indian patient population. METHODS: From January 2014 to September 2015, 100 patients (mean age 64...
September 25, 2018: Journal of Cardiothoracic Surgery
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
John M Stulak, Vakhtang Tchantchaleishvili, Richard C Daly, Mackram F Eleid, Kevin L Greason, Joseph A Dearani, Lyle D Joyce, Alberto Pochettino, Hartzell V Schaff, Simon Maltais
OBJECTIVES: Although primary transcatheter valve interventions have demonstrated acceptable early- and intermediate-term outcomes, data are lacking to guide patient selection for transcatheter valve-in-valve therapy. Furthermore, very few surgical benchmarks have been established for repeat conventional biological valve replacement to refine momentum for broad application of transcatheter intervention for a degenerated bioprosthesis. METHODS: From January 1993 to July 2014, 694 patients underwent repeat biological valve replacement at our clinic...
October 2018: Journal of Thoracic and Cardiovascular Surgery
Mostafa Abbasi, Mohammed S Barakat, Danny Dvir, Ali N Azadani
Computational modeling and simulation has become more common in design and development of bioprosthetic heart valves. To have a reliable computational model, considering accurate mechanical properties of biological soft tissue is one of the most important steps. The goal of this study was to present a non-invasive material characterization framework to determine mechanical propertied of soft tissue employed in bioprosthetic heart valves. Using integrated experimental methods (i.e., digital image correlation measurements and hemodynamic testing in a pulse duplicator system) and numerical methods (i...
September 18, 2018: Annals of Biomedical Engineering
Mohammed Barakat, Danny Dvir, Ali N Azadani
Transcatheter aortic valves provide superior systolic hemodynamic performance in terms of valvular pressure gradient and effective orifice area compared with equivalent size surgical bioprostheses. However, in depth investigation of the flow field structures is of interest to examine the flow field characteristics and provide experimental evidence necessary for validation of computational models. The goal of this study was to compare flow field characteristics of the three most commonly used transcatheter and surgical valves using phase-locked particle image velocimetry (PIV)...
September 9, 2018: Artificial Organs
Ahmed Zaghloul, Corina Iorgoveanu, Aakash Desai, Molly Silkowski, Kathir Balakumaran
Prosthetic valve thrombosis, a serious complication of prosthetic valve replacement, can be lethal without proper treatment. Right-sided valve thrombosis is rare but several therapeutic modalities can be considered: anticoagulation therapy, fibrinolysis, or surgery. Here, we report a case of significant tricuspid valve thrombosis which failed fibrinolytic therapy requiring repeat sternotomy with repeat tricuspid valve replacement with a porcine bioprosthesis.
July 5, 2018: Curēus
Andreas Schaefer, Florian Deuschl, Lenard Conradi, Ulrich Schäfer
Valve-in-valve (ViV) procedures for failing bioprostheses carry a certain risk for device malfunction. We herein report a case of a failing Evolut R in a deteriorated Mitroflow, treated with a Sapien 3. An 81 year old female patient received surgical aortic valve replacement and was treated by ViV due to deterioration. Three years later, echocardiography revealed a pressure gradient of peak/mean 105/63 mmHg. Subsequently, a second ViV procedure with initial intentional rupture of the bioprosthetic stent was performed...
September 9, 2018: Catheterization and Cardiovascular Interventions
Flavien Vincent, Antoine Rauch, Hugues Spillemaeker, André Vincentelli, Camille Paris, Mickael Rosa, Annabelle Dupont, Cedric Delhaye, Basile Verdier, Emmanuel Robin, Peter J Lenting, Sophie Susen, Eric Van Belle
Significant paravalvular regurgitation (PVR) remains a relatively frequent (4% to 9%) and deleterious complication of transcatheter aortic valve replacement (TAVR), even with the latest generation of bioprosthesis. Although mini-invasive TAVR without general anesthesia or transesophageal echocardiography (TEE) is progressively becoming the predominant approach, identification and grading of PVR in the catheterization laboratory remain an important and challenging clinical issue. The authors discuss how a recently reported blood biomarker reflecting the von Willebrand factor activity, that is, the closure time with adenosine diphosphate, can be successfully applied during the TAVR procedure to detect and monitor PVR in real time, with an excellent negative predictive value...
September 10, 2018: JACC. Cardiovascular Interventions
Renato C de Souza, Leonardo Paim, Guilherme Viotto, Joaquim Aprigio, Lucas L Araújo, Henrique Ribeiro, Roney O Sampaio, Flavio Tarasoutchi, Pablo M A Pomerantzeff, José Honório Palma, Fabio B Jatene
OBJECTIVE: To analyze the behavior of platelets after transcatheter valve-in-valve implantation for the treatment of degenerated bioprosthesis and how they correlate with adverse events upon follow-up. METHODS: Retrospective analysis of 28 patients who received a valve-in-valve implant, 5 in aortic, 18 in mitral and 5 in tricuspid positions. Data were compared with 74 patients submitted to conventional redo valvular replacements during the same period, and both groups' platelet curves were analyzed...
July 2018: Brazilian Journal of Cardiovascular Surgery
Angelo Buscaglia, Giacomo Tini, Gian Paolo Bezante, Claudio Brunelli, Manrico Balbi
BACKGROUND: Valve-in-valve transcatheter aortic valve implantation for degenerated aortic bioprostheses is an effective option for patients at high risk for redo surgery, even if it may be burdened by complications more common in specific settings, such as, coronary artery obstruction. CASE PRESENTATION: We present the case of a Caucasic 84-year-old woman with degeneration of a previously implanted aortic Mitroflow bioprosthesis. She underwent a valve-in-valve transcatheter aortic valve implantation with a CoreValve® bioprosthesis...
September 5, 2018: Journal of Medical Case Reports
Tuomas Kiviniemi, Joonas Lehto, Maunu Nissinen, Tuomo Nieminen, Juha Hartikainen, Markus Malmberg, Fredrik Yannopoulos, Jyri Savolainen, Pasi Karjalainen, K E Juhani Airaksinen, Stefano Rosato, Fausto Biancari
OBJECTIVE: Stroke is a frequent complication occurring early and late after surgical aortic valve replacement. There is an unmet clinical need for simple tools to assess postoperative stroke risk. We sought to assess the predictive performance of Congestive heart failure; Hypertension; Age ≥75 (doubled); Diabetes mellitus; prior Stroke, transient ischemic attack or thromboembolism (doubled); Vascular disease; Age 65 to 74; Sex category (female) (CHA2 DS2 -VASc) score in patients undergoing surgical aortic valve replacement with a bioprosthesis...
July 29, 2018: Journal of Thoracic and Cardiovascular Surgery
Martin Andreas, Iuliana Coti, Raphael Rosenhek, Shiva Shabanian, Stephane Mahr, Keziban Uyanik-Uenal, Dominik Wiedemann, Thomas Binder, Alfred Kocher, Guenther Laufer
OBJECTIVES: The Edwards INTUITY Valve System is a balloon-expandable bioprosthesis, inspired from the Edwards Magna valve and transcatheter technology, with a subvalvular stent frame to enable rapid deployment. We report a single-centre experience of aortic valve replacement with this novel bioprosthesis. METHODS: Five hundred consecutive patients, of whom 45.6% were female with a mean age of 73.5 [standard deviation (SD) 7.9 years], with severe aortic stenosis who received a rapid deployment aortic valve between May 2010 and July 2017 were included in a prospective and ongoing database...
August 20, 2018: European Journal of Cardio-thoracic Surgery
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