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Valve prosthesis selection

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https://www.readbyqxmd.com/read/28616345/wrapping-of-the-ascending-aorta-revisited-is-there-any-role-left-for-conservative-treatment-of-ascending-aortic-aneurysm
#1
REVIEW
José María González-Santos, María Elena Arnáiz-García
Dilatation of the ascending aorta (AA) is a common finding in patients with aortic valve disease. The clinical practice guidelines recommend replacing the AA whenever the diameter exceeds 45 mm. However, no consensus has been reached regarding the approach when the aorta is only moderately dilated. Although the risk in aorta replacement is generally low, it may be higher when associated with other complex surgical procedures or it is carried out in elderly patients or patients with significant comorbidity. This would justify the use of alternative surgical techniques, which reduce surgical risk and guarantee a durable correction of the aortic pathology...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28530122/low-pacemaker-incidence-with-continuous-sutured-valves-a-retrospective-analysis
#2
Lars Niclauss, Dominique Delay, Raymond Pfister, Sebastien Colombier, Matthias Kirsch, René Prêtre
Background Permanent pacemaker implantation after surgical aortic valve replacement depends on patient selection and risk factors for conduction disorders. We aimed to identify risk criteria and obtain a selected group comparable to patients assigned to transcatheter aortic valve implantation. Methods Isolated sutured aortic valve replacements in 994 patients treated from 2007 to 2015 were reviewed. Demographics, hospital stay, preexisting conduction disorders, surgical technique, and etiology in patients with and without permanent pacemaker implantation were compared...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28486657/minimal-access-surgery-for-mitral-valve-endocarditis
#3
Cristina Barbero, Giovanni Marchetto, Davide Ricci, Samuel Mancuso, Massimo Boffini, Enrico Cecchi, Francesco Giuseppe De Rosa, Mauro Rinaldi
OBJECTIVES: Minimal access mitral valve surgery (MVS) has already proved to be feasible and effective with low perioperative mortality and excellent long-term outcomes. However, experience in more complex valve diseases such as infective endocarditis (IE) still remains limited. The aim of this retrospective study was to evaluate early and long-term results of minimal access MVS for IE. METHODS: Data were entered into a dedicated database. Analysis was performed retrospectively for the 8-year period between January 2007 and April 2015...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28470996/impact-of-small-prosthesis-size-on-transcatheter-or-surgical-aortic-valve-replacement-outcomes
#4
Michael Salna, Omar K Khalique, Codruta Chiuzan, Paul Kurlansky, Michael A Borger, Rebecca T Hahn, Martin B Leon, Craig R Smith, Susheel K Kodali, Isaac George
OBJECTIVES: Determine the comparative impact of small prosthesis size on transcatheter and surgical aortic valve replacement (SAVR) outcomes. BACKGROUND: Patients with small aortic annuli tend to have worse postoperative outcomes and hemodynamics. We sought to describe surgical outcomes in patients with very small aortic annuli and then compare early hemodynamic and clinical outcomes in patients undergoing surgical or transcatheter aortic valve replacement (TAVR) with the smallest available valves to assist in optimal prosthesis selection for this challenging patient population...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28449479/early-results-of-the-sorin-%C3%A2-perceval-s-sutureless-valve-systematic-review-and-meta-analysis
#5
Karan Sian, Sheila Li, Daneish Selvakumar, Ross Mejia
BACKGROUND: Minimally invasive aortic valve replacement (MAVR) has demonstrated a benefit with respect to increased patient satisfaction due to minimised pain and earlier recovery. Sutureless valves may benefit MAVR and conventional aortic valve replacement (AVR) by reducing operative times and blood transfusion requirements. The Perceval valve (Sorin, Salluggia, Italy) is a self-expanding prosthesis made from bovine pericardium mounted in a nitinol stent, designed to simplify the implantation of an aortic valve...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28430909/clinical-trial-principles-and-endpoint-definitions-for-paravalvular-leaks-in-surgical-prosthesis-an-expert-statement
#6
Carlos E Ruiz, Rebecca T Hahn, Alain Berrebi, Jeffrey S Borer, Donald E Cutlip, Greg Fontana, Gino Gerosa, Reda Ibrahim, Vladimir Jelnin, Hasan Jilaihawi, E Marc Jolicoeur, Chad Kliger, Itzhak Kronzon, Jonathon Leipsic, Francesco Maisano, Xavier Millan, Patrick Nataf, Patrick T O'Gara, Philippe Pibarot, Stephen R Ramee, Charanjit S Rihal, Josep Rodes-Cabau, Paul Sorajja, Rakesh Suri, Julie A Swain, Zoltan G Turi, E Murat Tuzcu, Neil J Weissman, Jose L Zamorano, Patrick W Serruys, Martin B Leon
The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28427582/clinical-trial-principles-and-endpoint-definitions-for-paravalvular-leaks-in-surgical-prosthesis-an-expert-statement
#7
REVIEW
Carlos E Ruiz, Rebecca T Hahn, Alain Berrebi, Jeffrey S Borer, Donald E Cutlip, Greg Fontana, Gino Gerosa, Reda Ibrahim, Vladimir Jelnin, Hasan Jilaihawi, E Marc Jolicoeur, Chad Kliger, Itzhak Kronzon, Jonathon Leipsic, Francesco Maisano, Xavier Millan, Patrick Nataf, Patrick T O'Gara, Philippe Pibarot, Stephen R Ramee, Charanjit S Rihal, Josep Rodes-Cabau, Paul Sorajja, Rakesh Suri, Julie A Swain, Zoltan G Turi, E Murat Tuzcu, Neil J Weissman, Jose L Zamorano, Patrick W Serruys, Martin B Leon
The VARC (Valve Academic Research Consortium) for transcatheter aortic valve replacement set the standard for selecting appropriate clinical endpoints reflecting safety and effectiveness of transcatheter devices, and defining single and composite clinical endpoints for clinical trials. No such standardization exists for circumferentially sutured surgical valve paravalvular leak (PVL) closure. This document seeks to provide core principles, appropriate clinical endpoints, and endpoint definitions to be used in clinical trials of PVL closure devices...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28400918/patient-selection-for-transcatheter-aortic-valve-replacement-a-combined-clinical-and-multimodality-imaging-approach
#8
REVIEW
Rosangela Cocchia, Antonello D'Andrea, Marianna Conte, Massimo Cavallaro, Lucia Riegler, Rodolfo Citro, Cesare Sirignano, Massimo Imbriaco, Maurizio Cappelli, Giovanni Gregorio, Raffaele Calabrò, Eduardo Bossone
Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR...
March 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28329135/low-target-inr-anticoagulation-is-safe-in-selected-aortic-valve-patients-with-the-medtronic-open-pivot-mechanical-prosthesis-long-term-results-of-a-propensity-matched-comparison-with-standard-anticoagulation
#9
Thierry Bové, Yves Van Belleghem, Katrien François, Frank Caes, Michel De Pauw, Yves Taeymans, Guido J Van Nooten
OBJECTIVES: To investigate the long-term results of a low international normalized ratio (INR)-anticoagulation program in selected patients after aortic valve replacement (AVR) with the Medtronic Open Pivot mechanical heart valve (OPMHV). METHODS: From January 1993 to December 2012, 909 OPMHV valves were used for single AVR. Patients with preserved sinus rhythm and left ventricular function (Low-INR, n  = 552), were managed to an INR of 1.5-2.5 and compared to patients (Standard-INR, n  = 357) treated with standard anticoagulation (INR 2...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28290174/when-not-to-go-solo-contraindications-based-on-implant-experience
#10
Laurens W Wollersheim, Wilson W Li, Abdullah Kaya, Wim J van Boven, Jan van der Meulen, Bas A de Mol
BACKGROUND: Because of the design and specific implantation technique of the stentless Freedom SOLO bioprosthesis, patient selection is crucial. The aim of the study was to discuss the contraindications to this prosthesis based on the authors' implant experience. METHODS: Between April 2005 and February 2015, one surgeon at the authors' center performed 292 aortic valve replacements using a bioprosthesis, with the initial intention of implanting a SOLO valve in every patient...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290167/simple-interrupted-suturing-for-redo-mitral-valve-replacement
#11
Hiroshi Furukawa, Taishi Tamura, Takeshi Honda, Hiroki Takiuchi, Masahiko Kuinose, Kazuo Tanemoto
BACKGROUND: An evaluation was made of the early clinical outcomes and efficacies of simple interrupted suturing (SIS) for redo mitral valve replacement (MVR). METHODS: Among 336 mitral valve surgery patients at the authors' institution between April 2000 and May 2014, a total of 21 redo MVR using SIS (12 women, nine men; mean age 67±11 years; range 32-80 years) participated in the study. Surgical indications for redo MVR were paravalvular leakage (PVL) in 10 patients, prosthetic valve endocarditis in five, mechanical valve thrombosis in three, and structural valve deterioration (SVD) of the bioprosthesis in three...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28290164/risk-factors-for-permanent-pacemaker-after-implantation-of-surgical-or-percutaneous-self-expanding-aortic-prostheses
#12
Emmanuel Villa, Alberto Clerici, Antonio Messina, Luca Testa, Francesco Bedogni, Andrea Moneta, Francesco Donatelli, Giovanni Troise
BACKGROUND: The use of transcatheter aortic valve implantation (TAVI) following the introduction of Nitinol autoexpandable devices has spread rapidly during recent years. In addition, cardiac surgery has been revolutionized due to the use of Nitinol-based sutureless prostheses for aortic valve replacement (AVR). During the same period, however, permanent pacemaker (PPM) implantation has emerged as a frequent complication. The study aim was to identify the risk factors of PPM following the implantation of a Nitinol self-expanding prosthesis (for AVR or TAVI)...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28240641/transcatheter-mitral-valve-replacement-with-a-novel-self-expandable-prosthesis-single-institutional-experience-procedural-outcomes-and-follow-up
#13
Gian Paolo Ussia, Valeria Cammalleri, Jawahar L Mehta, Kunal Sarkar, Saverio Muscoli, Pasquale de Vico, Giovanni Ruvolo, Francesco Romeo
AIMS: We report our experience with the CardiAQ prosthetic valve using both transapical and transseptal access. Aim of our study was proving the feasibility, safety and effectiveness of a novel transcatheter mitral valve bioprosthesis. METHODS: Four patients with severe mitral regurgitation, not eligible for mitral valve surgery, were treated with the CardiAQ valve. The procedures were performed under general anaesthesia, fluoroscopic and transesophageal echocardiographic guidance...
June 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28131425/evaluation-of-hemodynamic-performance-of%C3%A2-aortic-valve-bioprostheses-in-a-model-of%C3%A2-oversizing
#14
John D Cleveland, Michael E Bowdish, Carol E Eberhardt, Wendy J Mack, James A Crabtree, Thomas A Vassiliades, Alan M Speir, Yogesh A Darekar, Amy E Hackmann, Vaughn A Starnes, Robbin G Cohen
BACKGROUND: The risk of patient-prosthesis mismatch drives most surgeons to select the largest bioprosthesis possible during aortic valve replacement, but interactions between the native aortic annulus and valve prosthesis remain poorly defined. We examined the hemodynamic and functional consequences of oversizing contemporary bioprostheses in an in vitro model. METHODS: Three sizes each (21, 23, and 25 mm) of 5 aortic bioprostheses (Magna, Edwards Lifesciences, Irvine, CA; Trifecta and Epic, St...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28130049/automated-and-manual-measurements-of-the-aortic-annulus-with-ecg-gated-cardiac-ct-angiography-prior-to-transcatheter-aortic-valve-replacement-comparison-with-3d-transesophageal-echocardiography
#15
David Guez, Gilda Boroumand, Nicholas J Ruggiero, Praveen Mehrotra, Ethan Joseph Halpern
RATIONALE AND OBJECTIVES: Multimodality evaluation of the aortic annulus is generally advocated to plan for transcatheter aortic valve replacement (TAVR). We compared aortic annular measurements by cardiac computed tomography angiography (cCTA) to three-dimensional transesophageal echocardiography (3D-TEE), and also evaluated the use of semi-automated software for cCTA annular measurements. MATERIALS AND METHODS: A retrospective cohort of 74 patients underwent 3D-TEE and electrocardiogram-gated cCTA of the heart within 30 days for TAVR planning...
May 2017: Academic Radiology
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#16
EDITORIAL
James M McCabe, Larry S Dean
Increasing annular calcification portends more adverse outcomes and worse hemodynamic results following percutaneous structural heart interventions. Though the Direct Flow prosthesis did not appear to have significantly different post-procedural gradients based on aortic valve calcium burden in a selected group of patients, the average residual gradients were relatively high in all cases and the presence of a paravalvular leak was more common with increasing valvular calcification. It is unclear how the Direct Flow prosthesis fits into the armamentarium of TAVR prostheses...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28092726/pathophysiology-incidence-and-predictors-of-conduction-disturbances-during-transcatheter-aortic-valve-implantation
#17
REVIEW
Marco Barbanti, Simona Gulino, Giuliano Costa, Corrado Tamburino
Over the past decade, transcatheter aortic valve implantation (TAVI) has evolved rapidly toward an extremely reproducible, safe and effective procedure, with a marked reduction of its related complications. However, the occurrence of conduction disturbances and the need for permanent pacemaker implantation (PPI) after TAVI remains a concern. Areas covered: In this article review, we will go through the mechanisms involved in conduction disturbances after TAVI, and we will discuss the key aspects of pathophysiology, incidence and predictors of conduction disturbances following Transcatheter Aortic Valve Implantation...
February 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28078734/coronary-procedures-after-tavi-with-the-self-expanding-aortic-bioprosthesis-medtronic-corevalve%C3%A2-not-an-easy-matter
#18
Madjid Boukantar, Romain Gallet, Gauthier Mouillet, Abdelkaoui Belarbi, Vladimir Rubimbura, Julien Ternacle, Jean-Luc Dubois-Rande, Emmanuel Teiger
OBJECTIVES: To evaluate the feasibility of coronary procedures after transcatheter aortic valve implantation (TAVI) with the CoreValve™ device. BACKGROUND: Due to its design, CoreValve™ prosthesis may interfere with coronary procedures. Data on this issue are sparse. METHODS: Between 2007 and 2015, 550 patients underwent CoreValve™ TAVI in our hospital. Among them, 16 underwent coronary angiogram after TAVI and were included in our retrospective study...
February 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28077510/mitral-implant-of-the-inovare-transcatheter-heart-valve-in-failed-surgical-bioprostheses-a-novel-alternative-for-valve-in-valve-procedures
#19
Diego Felipe Gaia, Ademir Massarico Braz, Matheus Simonato, Danny Dvir, João Roberto Breda, Gustavo Calado Ribeiro, Carolina Baeta Ferreira, José Augusto Marcondes Souza, Enio Buffolo, José Honório Palma
OBJECTIVES: Reoperative procedure for the treatment of a failed mitral bioprosthesis is associated with considerable risk. In some cases, mortality is high and might contraindicate the benefit of the procedure. The minimally invasive valve-in-valve (ViV) transcatheter mitral valve implant offers an alternative less-invasive approach, reducing morbidity and mortality. The objective of this paper was to evaluate the mitral ViV approach using the Braile Inovare prosthesis. METHODS: : The transcatheter balloon-expandable Braile Inovare prosthesis was used in 12 cases...
April 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28067715/incidence-risk-factors-clinical-impact-and-management-of-bioprosthesis-structural-valve-degeneration
#20
Nancy Côté, Philippe Pibarot, Marie-Annick Clavel
PURPOSE OF REVIEW: Structural valve deterioration is the major cause of bioprosthesis failure and is increasing over time. We present an overview of incidence, mechanisms, predictors, clinical impact, and management of bioprosthetic valve structural degeneration. RECENT FINDINGS: Early degeneration caused by calcification and destruction of connective tissue of the prosthesis is controlled by multiple mechanisms, from mechanical stress to infiltration of lipids and inflammatory cells, and activation of the immune system...
March 2017: Current Opinion in Cardiology
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