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Valve prosthesis selection

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https://www.readbyqxmd.com/read/29789105/oral-anticoagulation-in-chronic-kidney-disease-and-atrial-fibrillation
#1
Gunnar H Heine, Vincent Brandenburg, Stephan H Schirmer
BACKGROUND: Cardiological societies recommend, in their guidelines, that patients with atrial fibrillation and an intermediate (or higher) risk of stroke and systemic embolization should be treated with oral anticoagulant drugs. For patients who do not have mitral valve stenosis or a mechanical valve prosthesis, non-vitamin-K dependent oral anticoagulants (NOAC) are preferred over vitamin K antagonists (VKA) for this purpose. It is unclear, however, whether patients with chronic kidney disease and atrial fibrillation benefit from oral anticoagulation to the same extent as those with normal kidney function...
April 27, 2018: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29762921/long-term-up-to-21-years-follow-up-after-biological-and-mechanical-aortic-valve-replacement-in-younger-patients
#2
Stanislav Tsvelodub, Barbara Pieper, Sina Stock, Hans-Hinrich Sievers, Doreen Richardt
BACKGROUND: Despite the limited durability of biological aortic valves, increasing numbers of younger patients are choosing to receive them, due mainly to the lack of a need for permanent anticoagulation. Few data exist, however, regarding the outcomes of valve replacement in patients aged <55 years, and additional data are required in this patient population. METHODS: Between 1993 and 2014, at the authors' institution, a total of 448 patients (237 males, 101 females; mean age 45...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762920/outcomes-of-a-new-generation-stentless-aortic-valve-a-single-center-experience-with-251-consecutive-implants
#3
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
https://www.readbyqxmd.com/read/29759854/a-meta-analysis-of-reduced-leaflet-motion-for-surgical-and-transcatheter-aortic-valves-relationship-to-cerebrovascular-events-and-valve-degeneration
#4
Nader Makki, Satya Shreenivas, Dean Kereiakes, Scott Lilly
BACKGROUND: Reduced leaflet motion (RLM) of transcatheter aortic valves (TAV) is observed in up to 4% of cases with similar frequency in surgical valves, with an overall incidence that differs based on prosthesis type and size. This phenomenon likely represents subclinical leaflet thrombosis. Herein we sought to analyze the existing reported literature to assess whether or not RLM is associated with subsequent valve degeneration or cerebrovascular events. METHODS AND RESULTS: We searched PubMed, and EMBASE (2008-2017) to identify relevant studies...
April 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29742534/sutureless-prosthesis-implantation-and-ascending-aorta-replacement-through-a-ministernotomy-approach
#5
Antonio Lio, Matteo Ferrarini, Antonio Miceli, Mattia Glauber
A significant proportion of patients undergoing aortic valve replacement have a dilated ascending aorta; presence of an ascending aorta aneurysm is viewed as a contraindication for sutureless valve implantation for the potential risk of prosthesis dislodgment. We describe our technique of sutureless prosthesis implantation and concomitant ascending aorta replacement through an upper ministernotomy. Seven patients underwent aortic valve replacement with a sutureless prosthesis and concomitant ascending aorta replacement between November 2014 and October 2016...
May 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29721704/workup-and-management-of-patients-with-paradoxical-low-flow-low-gradient-aortic-stenosis
#6
REVIEW
Mohamed-Salah Annabi, Marine Clisson, Marie-Annick Clavel, Philippe Pibarot
About 60% of patients with paradoxical low-flow, low-gradient (PLF-LG) aortic stenosis (AS) have a severe disease that justifies aortic valve replacement (AVR). The first step in patients with symptomatic PLF AS should be to rule out measurement errors and treat hypertension. The second step is to distinguish pseudo-severe from true severe AS (TSAS). The third step is to select the optimal treatment modality at the right time. Regarding the second step, projected aortic valve area calculated using stress echocardiography is superior to traditional severity criteria (AVA < 1...
May 2, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29622989/echocardiographic-predictors-of-atrial-fibrillation-after-mitral-valve-replacement
#7
REVIEW
Al-Shimaa Mohamed Sabry, Heba Abd El-Kader Mansour, Tarek Helmy Abo El-Azm, Shimaa Ahmed Mostafa, Basant Samy Zahid
Objectives: Detection of the echocardiographic predictors of post-operative atrial fibrillation in patients with rheumatic mitral valve disease undergoing mitral valve replacement. Methods: The study included 50 patients with rheumatic mitral valve disease undergoing mitral valve replacement. Preoperative assessment included standard two-dimensional echocardiography to assess LA diameter, volume, and emptying fraction, LV volume and ejection fraction. TDI derived velocity, strain of the left atrium and speckle tracking to assess left ventricular function then postoperative follow up for 1 month for occurrence of atrial fibrillation...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29622986/clinical-utility-of-a-predictive-model-for-paravalvular-aortic-regurgitation-after-transcatheter-aortic-valve-implantation-with-a-self-expandable-prosthesis
#8
Ahmad E Mostafa, Gert Richardt, Mohamed Abdel-Wahab
Background: A predictive model for Paravalvular aortic regurgitation (PAR) integrating the left ventricular outflow tract-to-ascending aorta angle (LVOT-AO) and depth to the non-coronary cusp (NCC) after TAVI with CoreValve prosthesis (MCP) was retrospectively identified (2 × ∠LVOT-AO + [depth to NCC-10]2; cutoff = 50). However, the validity and clinical utility of this model remain unknown. Methods: A total of 100 patients (79.6 ± 7 years, mean EuroScore 24...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29590420/on-pump-transapical-cardioscopic-mitral-valve-replacement-with-cardiac-arrest-short-term-results-in-a-porcine-survival-model
#9
Thang Duc Vu, Duc-Viet Nguyen, Min Zin Oo, Mohamed Alaa, Ervin Marquez Ocampo, Suganya Cheyyatraivendran Arularasu, Phyo Wai Win, Nurdiyana Ja'afar, Goh Si-Guim, Patsy Ong, Lian Kah Ti, Arthur Mark Richards, Theo Kofidis
OBJECTIVES: Favourable outcomes with mitral annuloplasty have been achieved with transapical cardioscopic (TAC) surgery in a survival animal model. In addition, experimental TAC on a non-survival animal model also showed adequate access to remove the native mitral valve and implant a prosthetic valve, but the surgical procedure took a long time and lacked follow-up data. The goal of this study was to develop a clinically translatable TAC mitral valve replacement (MVR) procedure using technical and instrumental refinements to reduce the surgical time and to evaluate functional recovery and short-term durability using a survival porcine model...
March 26, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29481667/can-bioprosthetic-valve-thrombosis-be-promoted-by-aortic-root-morphology-an-in-vitro-study
#10
Silje Ekroll Jahren, Paul Philipp Heinisch, David Hasler, Bernhard Michael Winkler, Stefan Stortecky, Thomas Pilgrim, Martina Correa Londono, Thierry Carrel, Hendrik von Tengg-Kobligk, Dominik Obrist
OBJECTIVES: Bioprosthetic valve thrombosis has been considered uncommon, but recent studies have shown that it is more frequent than previously thought. Insufficient washout of the aortic sinus is believed to be a risk factor for bioprosthetic valve thrombosis. The objective of this in vitro experiment was to investigate the impact of aortic root morphology on blood flow in the aortic sinus and to relate these results to in vivo data obtained in patients with a transcatheter aortic valve implant...
February 21, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29468106/a-case-of-acute-left-main-coronary-obstruction-following-transcatheter-aortic-valve-implantation
#11
Iva N Dimitrova, Diana Trendafilova, Peyo Simeonov
Transcatheter aortic valve implantation (TAVI) is a highly effective procedure in selected patients with severe degenerative aortic valve stenosis at high risk for conventional surgery. Coronary occlusion is a periprocedural life-threatening complication that despite its low frequency (˂1%) is poorly predictable and requires immediate diagnosis and treatment. Herein, we report a coronary obstruction after transcatheter implantation of valve prosthesis, followed by coronary intervention with successful recanalization...
December 14, 2017: Curēus
https://www.readbyqxmd.com/read/29452115/bioprosthetic-versus-mechanical-valve-replacement-for-infective-endocarditis-focus-on-recurrence-rates
#12
Nana Toyoda, Shinobu Itagaki, Henry Tannous, Natalia N Egorova, Joanna Chikwe
BACKGROUND: Consensus guidelines for prosthesis selection in infective endocarditis recommend bioprosthetic or mechanical valve replacement based on life expectancy and comorbidity. However, contemporary outcome data are limited to institution series. METHODS: The outcomes of 3,447 patients identified from mandatory discharge databases in California and New York states who had either primary isolated mitral (n=1603) or aortic (n=1,844) valve replacement for active endocarditis between 1998 and 2010, were compared according to whether they received bioprosthetic (n=1,673, 48...
February 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29420710/accuracy-and-reproducibility-of-aortic-annular-measurements-obtained-from-echocardiographic-3d-manual-and-semi-automated-software-analyses-in-patients-referred-for-transcatheter-aortic-valve-implantation-implication-for-prosthesis-size-selection
#13
Stefano Stella, Leonardo Italia, Giulia Geremia, Isabella Rosa, Francesco Ancona, Claudia Marini, Cristina Capogrosso, Manuela Giglio, Matteo Montorfano, Azeem Latib, Alberto Margonato, Antonio Colombo, Eustachio Agricola
Aims: A 3D transoesophageal echocardiography (3D-TOE) reconstruction tool has recently been introduced. The system automatically configures a geometric model of the aortic root and performs quantitative analysis of these structures. We compared the measurements of the aortic annulus (AA) obtained by semi-automated 3D-TOE quantitative software and manual analysis vs. multislice computed tomography (MSCT) ones. Methods and results: One hundred and seventy-five patients (mean age 81...
February 6, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29307461/multidetector-computed-tomography-sizing-of-aortic-annulus-prior-to-transcatheter-aortic-valve-replacement-tavr-variability-and-impact-of-observer-experience
#14
S Le Couteulx, J Caudron, B Dubourg, G Cauchois, M Dupré, P Michelin, E Durand, H Eltchaninoff, J-N Dacher
PURPOSE: To evaluate intra- and inter-observer variability of multidetector computed tomography (MDCT) sizing of the aortic annulus before transcatheter aortic valve replacement (TAVR) and the effect of observer experience, aortic valve calcification and image quality. METHODS: MDCT examinations of 52 consecutive patients with tricuspid aortic valve (30 women, 22 men) with a mean age of 83±7 (SD) years (range: 64-93 years) were evaluated retrospectively. The maximum and minimum diameters, area and circumference of the aortic annulus were measured twice at diastole and systole with a standardized approach by three independent observers with different levels of experience (expert [observer 1]; resident with intensive 6 months practice [observer 2]; trained resident with starting experience [observer 3])...
January 4, 2018: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/29286413/standardized-technique-of-aortic-valve-re-implantation-for-valve-sparing-aortic-root-replacement
#15
Reza Tavakoli, Guillaume Lebreton, Max Gassmann, Peiman Jamshidi, Pascal Leprince
Despite the obvious advantages of the preservation of a normal aortic valve during aortic root replacement, the complexity of valve sparing procedures prevents a number of cardiac surgeons from incorporating them into their practice. The aim of this protocol is to describe a simplified and user-friendly technique of an aortic valve-sparing root replacement (VSRR) procedure by re-implantation of the aortic valve. Proper selection of patients and limitations of the technique are discussed. In 54 consecutive patients, normal appearing aortic valves were re-implanted in a commercially available polyester prosthesis with pre-shaped sinuses by a simplified and standardized technique...
December 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29234617/transcatheter-mitral-valve-implantation-in-open-heart-surgery-an-off-label-technique
#16
Jacopo Alfonsi, Giacomo Murana, Anna Corsini, Carlo Savini, Roberto Di Bartolomeo, Davide Pacini
Extensive mitral annulus calcifications are considered a contraindication for valve surgery. We describe the case of a 76-year-old female with severe mitral and aortic stenosis associated with extensive calcifications of the heart. The patient underwent an open mitroaortic valve replacement using transcatheter aortic valve implantation with an Edwards SAPIEN XT valve (Edwards Lifesciences Corp., Irvine, CA, USA) in the mitral position. The aortic valve was replaced using a stentless valve prosthesis (LivaNova SOLO; LivaNova PLC, London, UK)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29224637/valve-hemodynamic-deterioration-and-cardiovascular-outcomes-in-tavr-a-report-from-the-sts-acc-tvt-registry
#17
MULTICENTER STUDY
Sreekanth Vemulapalli, David R Holmes, David Dai, Roland Matsouaka, Michael J Mack, Fred L Grover, Raj R Makkar, Vinod H Thourani, Pamela S Douglas
BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) and its association with cardiovascular outcomes. METHODS AND RESULTS: Consecutive cases with paired postimplant and follow-up echocardiograms from November 2011 to March 2015 in the STS/ACC TVT Registry were allocated into 2 overlapping cohorts: early (paired echocardiograms at 0 and 30 days) and late (paired echocardiograms at 30 days and 1 year)...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29160045/stentless-sutureless-and-transcatheter-valves-a-comparison-of-the-hemodynamic-performance-of-different-prostheses-concept
#18
Alberto Repossini, Theodor Fischlein, Marco Solinas, Lorenzo DI Bacco, Bruno Passaretti, Herko Grubitzsch, Thierry Folliguet, Giuseppe Santarpino, Roberto DI Bartolomeo, François Laborde, Claudio Muneretto
BACKGROUND: Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. A new concept of surgical sutureless (SU) bioprosthesis has been developed in the last decade. In this multi-institutional study we sought to compare hemodynamics of different bioprosthesis concept as transcatheter (TAVR), Livanova Perceval S sutureless valve and Freedom Solo Stentless (FS) valve in patients undergoing aortic valve replacement (sAVR). METHODS: From 2010 to 2016, 478 patients underwent sAVR with FS, 518 Perceval S and 367 patients underwent TAVR...
April 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29134537/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-4-valvular-heart-surgery
#19
Kiyoharu Nakano, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
Data from the Japan cardiovascular surgery database from 2013 to 2014 were analyzed to demonstrate the mortality rate and choice of surgical procedures, especially concerning the selection of valve prosthesis for each valve position and patient age group, and the effects of preoperative complications on mortality and prosthetic valve selection. The proportion of each surgical procedure was compared for each patient age in the aortic, mitral, and tricuspid positions. The proportion of mechanical valve prostheses was 23...
January 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29111398/multi-slice-ct-msct-imaging-in-pre-trans-catheter-aortic-valve-implantation-tavi-screening-how-to-perform-and-how-to-interpret
#20
REVIEW
George Latsios, Themistoklis N Spyridopoulos, Konstantinos Toutouzas, Andreas Synetos, George Trantalis, Konstantinos Stathogiannis, Vassiliki Penesopoulou, George Oikonomou, Elias Brountzos, Dimitrios Tousoulis
Aortic valve stenosis (AS) is the commonest valvular heart disease among elderly. Trans-catheter aortic valve implantation (TAVI) has become an established and effective alternative therapeutical procedure for inoperable and high risk patients with symptomatic AS. The procedural success is greatly dependent on a thorough pre- TAVI imaging screening. This requires a comprehensive and multi-modality approach, in which multi-slice computed tomography (MSCT) is the cornerstone in the selection of eligible patients, in choosing the appropriate prosthesis and its size, as well as in mapping the safest access route for the intervention...
October 27, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
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