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Valve prosthesis selection

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
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
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
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
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
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
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
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
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...
November 20, 2017: Minerva Cardioangiologica
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...
November 13, 2017: General Thoracic and Cardiovascular Surgery
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
Haran Burri, Hajo Müller, Richard Kobza, Christian Sticherling, Peter Ammann, Heiko Zerlik, Carine Stettler, Catherine Klersy, Frits Prinzen, Angelo Auricchio
AIMS: To compare cardiac function when pacing from the right or left ventricular apex in patients with preserved left ventricular systolic function, at 1-year follow-up. METHODS: Prospective, multicentre centre randomizing conventional right ventricular apical (RVA) versus left ventricular apical (LVA) pacing using a coronary sinus lead in patients requiring ventricular pacing for bradycardia. Follow-up was performed using 3D-echocardiography at 6 and 12 months...
October 27, 2017: Indian Pacing and Electrophysiology Journal
João G Almeida, Sara M Ferreira, Paulo Fonseca, Tiago Dias, Cláudio Guerreiro, Ana Barbosa, Pedro Teixeira, Mónica Carvalho, Wilson Ferreira, Nuno D Ferreira, Pedro Braga, José Ribeiro, Vasco G Ribeiro
OBJECTIVES: Compare final morphology of self-expanding and balloon-expandable prosthesis and association with paravalvular regurgitation (PVR). BACKGROUND: PVR after transcatheter aortic valve replacement (TAVR) remains a frequent complication. A better understanding of the prosthesis geometry may be important to improve selection of the best device for each case and possibly reduce the rates of PVR. METHODS: Retrospective study including patients consecutively submitted to transcatheter aortic valve replacement: August/2007-October/2016...
November 6, 2017: Catheterization and Cardiovascular Interventions
Tomaz Podlesnikar, Edgard A Prihadi, Philippe J van Rosendael, E Mara Vollema, Frank van der Kley, Arend de Weger, Nina Ajmone Marsan, Franjo Naji, Zlatko Fras, Jeroen J Bax, Victoria Delgado
Accurate aortic annulus sizing is key for selection of appropriate transcatheter aortic valve implantation (TAVI) prosthesis size. The present study compared novel automated 3-dimensional (3D) transesophageal echocardiography (TEE) software and multidetector row computed tomography (MDCT) for aortic annulus sizing and investigated the influence of the quantity of aortic valve calcium (AVC) on the selection of TAVI prosthesis size. A total of 83 patients with severe aortic stenosis undergoing TAVI were evaluated...
January 1, 2018: American Journal of Cardiology
William K F Kong, Madelien V Regeer, Kian K Poh, James W Yip, Philippe J van Rosendael, Tiong C Yeo, Edgar Tay, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Background: Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR...
October 6, 2017: European Heart Journal
Mackram F Eleid, Brian K Whisenant, Allison K Cabalka, Mathew R Williams, Mohammed Nejjari, David Attias, Neil Fam, Nicholas Amoroso, Thomas A Foley, Peter M Pollak, Oluseun O Alli, Sorin V Pislaru, Sameh M Said, Joseph A Dearani, Charanjit S Rihal
OBJECTIVES: The aim of this study was to examine 1-year outcomes of transseptal balloon-expandable transcatheter heart valve implantation in failed mitral bioprosthesis, ring annuloplasty, and mitral annular calcification (MAC). BACKGROUND: Immediate outcomes following transseptal mitral valve implantation in failed bioprostheses are favorable, but data on subsequent outcomes are lacking. METHODS: Percutaneous transseptal implantation of balloon-expandable transcatheter heart valves was performed in 87 patients with degenerated mitral bioprostheses (valve in valve [VIV]) (n = 60), previous ring annuloplasty (valve in ring) (n = 15), and severe MAC (valve in MAC) (n = 12)...
October 9, 2017: JACC. Cardiovascular Interventions
David Gonzalez-Lopez, Gloria Faerber, Mahmoud Diab, Paulo Amorim, Natig Zeynalov, Torsten Doenst
OBJECTIVES: Current sizing strategies suggest valve selection based on annulus diameter despite supra-annular placement of biological prostheses potentially allowing placement of a larger size. We assessed the frequency of selecting a larger prosthesis if prosthesis size was selected using a replica (upsizing) and evaluated its impact on haemodynamics. METHODS: We analysed all discharge echocardiograms between June 2012 and June 2014, where a replica sizer was used for isolated aortic valve replacement (Epic Supra: 266 patients, Trifecta: 49 patients)...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
Victor Mauri, Won K Kim, Mohammad Abumayyaleh, Thomas Walther, Helge Moellmann, Ulrich Schaefer, Lenard Conradi, Christian Hengstenberg, Michael Hilker, Thorsten Wahlers, Stephan Baldus, Volker Rudolph, Navid Madershahian, Tanja K Rudolph
BACKGROUND: Surgical aortic valve replacement in patients with small annular dimensions is challenging because they are at increased risk for prosthesis-patient mismatch and impaired outcomes. Transcatheter aortic valve replacement might be a good alternative; however, comparative data on different transcatheter heart valves are missing. METHODS AND RESULTS: This multicenter, propensity score-matched study compared hemodynamics and early clinical outcomes in 246 patients with an aortic annulus area <400 mm2 undergoing transcatheter aortic valve replacement with either a self-expanding transcatheter heart valve (Symetis ACURATE neo, n=129) or a balloon-expandable transcatheter heart valve (Edwards SAPIEN 3, n=117)...
October 2017: Circulation. Cardiovascular Interventions
Francesco Nappi, Cristiano Spadaccio, Jean-Louis Sablayrolles
A case of delayed malposition of a CoreValve device causing obstruction of coronary ostia is described. Nine months after the original implant, the patient developed an acute coronary syndrome and was readmitted to hospital. Angiogram demonstrated an ostial stenosis of both the left main stem and the right coronary ostia, which were filled by a paravalvular leakage of the bioprosthesis. Gated computed tomography scan with 3D reconstruction showed valve malposition with cusps situated 14 mm above the ostium of the right coronary and the presence of fibrous and calcific agglomerations associated to one of the cusp causing a tight stenosis of the left ostium...
December 1, 2017: European Journal of Cardio-thoracic Surgery
Stefan Toggweiler, Henrik Nissen, Brynjolfur Mogensen, Florim Cuculi, Christian Fallesen, Karsten Tange Veien, Miriam Brinkert, Richard Kobza, Andreas Rück
AIMS: Investigate if minimizing trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and need for permanent pacemakers. METHODS AND RESULTS: A total of 175 patients (58% women, mean age 83 ± 6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centers in Europe. Prosthesis size selection was based on perimeter derived annular diameter. Predilatation was performed in all with a balloon 1...
September 5, 2017: EuroIntervention
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