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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/29153562/noncontrast-myocardial-t1-mapping-by-cardiac-magnetic-resonance-predicts-outcome-in-patients-with-aortic-stenosis
#1
Heesun Lee, Jun-Bean Park, Yeonyee E Yoon, Eun-Ah Park, Hyung-Kwan Kim, Whal Lee, Yong-Jin Kim, Goo-Yeong Cho, Dae-Won Sohn, Andreas Greiser, Seung-Pyo Lee
OBJECTIVES: The aim of this study was to evaluate whether native T1 value of the myocardium on cardiac magnetic resonance (CMR) could predict clinical events in patients with significant aortic stenosis (AS). BACKGROUND: Although previous studies have demonstrated the prognostic value of focal fibrosis using late gadolinium enhancement (LGE) by CMR in AS patients, the prognostic implication of diffuse myocardial fibrosis by noninvasive imaging remains unknown. METHODS: A prospective observational longitudinal study was performed in 127 consecutive patients with moderate or severe AS (68...
November 10, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29153460/real-world-procedural-and-30-day-outcome-using-the-portico-transcatheter-aortic-valve-prosthesis-a-large-single-center-cohort
#2
Andrea Denegri, Fabian Nietlispach, Jan Kottwitz, Gabor Suetsch, Philipp Haager, Hector Rodriguez, Maurizio Taramasso, Slayman Obeid, Francesco Maisano
BACKGROUND: Published procedural and short-term outcome of the Portico valve for Transcatheter Aortic Valve Implantation (TAVI) is limited. We report a single-center patient series assessing procedural and 30-day outcome of this device. METHODS AND RESULTS: Procedural and 30-day follow-up data were prospectively collected from a consecutive series of 73 patients (80.7±6.9years, 45% male, mean STS score: 4.8±3.9) with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI)...
November 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#3
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29130619/a-feasibility-study-of-transaxillary-tavi-with-the-lotus-valve
#4
Sagar N Doshi, Sudhakar George, Chun Shing Kwok, Anthony Mechery, Mamas Mamas, Peter F Ludman, Jonathan N Townend, Moninder Bhabra
OBJECTIVES: To assess the feasibility of axillary transcatheter aortic valve implantation (TAVI) using the Lotus valve. BACKGROUND: TAVI is used to treat patients with severe aortic stenosis, with transfemoral (TF) access being the safest and most widely used route. In patients unsuitable for this, there are reports that the axillary artery may be safest alternative access route. The Lotus device is a fully retrievable 2nd generation transcatheter heart valve which is licensed for femoral and transaortic access...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#5
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29128473/transfemoral-aortic-valve-implantation-is-more-successful-with-the-edwards-sapien-3-compared-with-the-edwards-xt-for-the-treatment-of-symptomatic-severe-aortic-stenosis
#6
Birgid Gonska, Julia Seeger, Alexander Junker, Christoph Rodewald, Ulrike Trepte, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual aortic regurgitation (AR) after transfemoral aortic valve implantation (TAVI) is associated with increased mortality. The new Edwards Sapien 3 valve (ES3) is designed to reduce paravalvular AR. AIM: To compare a new-generation and a late-generation balloon-expandable transcatheter heart valve. METHODS: In this study, 100 consecutive patients treated with the ES3 for symptomatic native severe aortic stenosis were compared with 100 consecutive patients treated with the Edwards Sapien XT valve (EXT); all valves were implanted via transfemoral access...
November 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#7
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29124471/clinical-outcome-and-functional-characteristics-of-patients-with-asymptomatic-low-flow-low-gradient-severe-aortic-stenosis-with-preserved-ejection-fraction-are-closer-to-high-gradient-severe-than-to-moderate-aortic-stenosis
#8
Mohammad Kavianipour, Amir Farkhooy, Frank A Flachskampf
Asymptomatic "paradoxic" severe low-flow low-gradient aortic stenosis with preserved ejection fraction (PAS) constitutes a challenging condition where the optimal management and follow-up remain elusive. We evaluated the clinical outcome in patients with PAS as compared to asymptomatic patients with moderate (MAS) or classical severe aortic stenosis (CAS). Consecutive asymptomatic moderate or severe aortic stenosis patients without concomitant other heart or lung disease (n = 121) were invited. Participants (n = 74) were assigned to three subgroups with regard to degree of aortic stenosis: MAS (n = 25), CAS (n = 22) and PAS (n = 27)...
November 9, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29122274/frequency-and-significance-of-intravascular-hemolysis-before-and-after-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis
#9
Tsung-Yu Ko, Mao-Shin Lin, Lung-Chun Lin, Ying-Ju Liu, Chih-Fan Yeh, Ching-Chang Huang, Ying-Hsien Chen, Yih-Sharng Chen, Hsien-Li Kao
Intravascular hemolysis (IVH) has been identified in patients with surgical prosthetic valves, but few have been reported after transcatheter aortic valve implantation (TAVI). We conducted a prospective analysis of 64 TAVI patients. The hemolysis profiles were collected at baseline and 6 months after TAVI. The echocardiography was performed at baseline and 6 months after TAVI. There are 14 patients (21.9%) with IVH before and 24(37.5%) after TAVI. The serum haptoglobin values before and 6 months after TAVI are 126...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29105964/simultaneous-transcatheter-transfemoral-aortic-and-transeptal-mitral-valve-replacement-using-edward-sapien-s3
#10
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102579/long-term-health-benefit-of-tavr-in-patients-with-chronic-lung-disease
#11
Juan A Crestanello, Jeffrey J Popma, David H Adams, G Michael Deeb, Mubashir Mumtaz, Barry George, Jian Huang, Michael J Reardon
OBJECTIVES: This study sought to characterize the long-term effect of chronic lung disease (CLD) on mortality, clinical outcomes, quality of life, and health benefits after transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis. BACKGROUND: The long-term effect of CLD after TAVR is unknown. METHODS: Prevalence and severity of CLD was determined at baseline in high- and extreme-risk patients with aortic stenosis from the CoreValve US Pivotal Trial...
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29098879/regulation-of-circulating-chromogranin-b-levels-in-heart-failure
#12
Felix M Heidrich, Carolin Melz, Mimi S Buechau, Christian Pfluecke, Silvio Quick, Uwe Speiser, David M Poitz, Antje Augstein, Tobias Ruf, Nadine K Wäßnig, Akram Youssef, Ruth H Strasser, Stephan Wiedemann
BACKGROUND: Chromogranin B (CGB) regulates B-type natriuretic peptide (BNP) production. Circulating CGB levels are elevated in heart failure (HF) animal models and HF patients, but also increase in healthy individuals in response to physical activity. Therefore, CGB seems to integrate information from myocardial stress and systemic neuro-endocrine activation. Substantial gaps remain in our understanding of CGB regulation in HF. METHODS AND RESULTS: We conducted a retrospective registry study including 372 patients...
November 3, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29082593/a-rare-mechanism-of-aortic-regurgitation-in-a-young-patient
#13
Ahmet Guner, Sabahattin Gunduz, Cagatay Onal, Taylan Akgun, Emrah Bayam, Ozkan Candan, Mehmet Ozkan
A 19-year-old male patient was admitted to our institute with dyspnea. His medical history had no rheumatic fever or infective endocarditis. Physical examination revealed a diastolic murmur over the aortic area, rales of bilateral lungs. Bedside transthoracic echocardiography (TTE) revealed a severe aortic regurgitation (AR) without aortic valve stenosis and a moderately dilated left ventricle accompanied by an ejection fraction of 55%. The aortic valve could not be clearly demonstrated as either bicuspid or tricuspid...
October 29, 2017: Echocardiography
https://www.readbyqxmd.com/read/29066342/bioprosthesis-leaflet-thrombosis-following-self-expanding-valve-in-valve-transcatheter-aortic-valve-replacement-in-patient-taking-factor-xa-inhibitor-and-warfarin-a-case-report
#14
Kyle D Buchanan, M Chadi Alraies, Gaby Weissman, Itsik Ben-Dor, Lowell F Satler, Ron Waksman
An 87-year-old female with symptomatic severe aortic stenosis underwent transcatheter valve replacement (TAVR) via the transfemoral approach with a 29mm self-expanding device. Moderate to severe paravalvular regurgitation led to the development of congestive heart failure and hospital readmission 1 month following TAVR. A second 29mm valve was placed to abolish the paravalvular regurgitation. Routine follow-up computed tomography (CT) imaging demonstrated leaflet thickening and decreased leaflet mobility suggesting valve thrombosis, despite adherence to Factor Xa inhibitor...
May 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29062748/transcatheter-aortic-valve-implantation-economics-a-grisly-reality
#15
Antonis S Manolis
Transcatheter aortic valve implantation (TAVI), an established treatment for inoperable and high-risk operable symptomatic patients with severe aortic stenosis with growing numbers of procedures and expanding indications, is an expensive therapy. Cost-effectiveness analyses rely on the value of the incremental cost-effectiveness ratio (ICER), which is the difference in cost between two possible interventions, divided by the difference in their effect. Several analyses have demonstrated that TAVI is cost-effective with an acceptable ICER for the inoperable patient alone and only via the iliofemoral route, while TAVI is more costly and is either less or equally effective as surgery in high-risk operable patients...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062741/clinical-outcomes-and-prognostic-factors-of-transcatheter-aortic-valve-implantation-in-bicuspid-aortic-valve-patients
#16
Sung-Han Yoon, Rahul Sharma, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, Masaki Miyasaka, Takahiro Nomura, Tomoki Ochiai, Sharjeel Israr, Tanya Rami, Mamoo Nakamura, Wen Chen, Raj R Makkar
BACKGROUND: The purpose of this study was to evaluate the outcomes of transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS). METHODS: From April 2012 and December 2016, 108 patients with bicuspid AS underwent TAVR using the Sapien XT (34 patients) and Sapien 3 (74 patients) valves. Procedural and clinical outcomes were assessed according to VARC-2 criteria and compared between the two devices. RESULTS: In the overall cohort, the majority of patients were male (71...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29054182/clinical-outcome-in-nonagenarians-undergoing-transcatheter-valve-replacement
#17
Oscar Mendiz, Carlos Fava, Fernando Cura, Carla Agatiello, Matias Sztejfman, Anibal Damonte, Hugo Londero, Alfonsina Candiello, Daniel Berrocal
BACKGROUND: Nonagenarians are mostly denied from different therapeutic strategies due to high preoperative risk. We present the results of nonagenarians with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS: Our retrospective analysis include baseline and procedural data along with clinical outcome. Clinical follow-up was performed in all patients after TAVR. RESULTS: Out of 689 patients, 33 nonagenarians with a mean age of 90...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29050627/outcomes-for-the-commercial-use-of%C3%A2-self-expanding-prostheses-in-transcatheter-aortic-valve-replacement-a-report-from-the-sts-acc-tvt-registry
#18
Paul Sorajja, Susheel Kodali, Michael J Reardon, Wilson Y Szeto, Stanley J Chetcuti, James Hermiller, Sharla Chenoweth, David H Adams, Jeffrey J Popma
OBJECTIVES: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry. BACKGROUND: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29045977/-clinical-and-genetic-characteristics-of-williams-beuren-syndrome-2-cases-report
#19
S Q Wang, Z X Yang, H Li
To explore the clinical and genetic characteristics of Williams-Beuren syndrome (WBS) and to raise awareness of the disease. The characteristics of clinical manifestations, personal history, cardiac ultrasound, brain magnetic resonance imaging (MRI), electroencephalogram (EEG) and chromosome detection results of two cases with WBS were analyzed. The two patients were both male and the age was 11 months and 1 day, and 9 months and 9 days, respectively. They both suffered from cardiovascular malformation: case one presented supravalvular aortic stenosis, and case two showed atrial septal defect and patent ductus arteriosus...
October 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29042031/relation-of-the-mitral-annular-plane-systolic-excursion-to-risk-for-intervention-in-initially-asymptomatic-patients-with-aortic-stenosis-and-preserved-systolic-function
#20
Jason D Matos, Joshua E Kiss, Andrew H Locke, Randal I Goldberg, Kenneth Mukamal, Warren J Manning
Aortic valve intervention (AVI) in patients with a severe aortic stenosis (AS) and a preserved left ventricular ejection fraction (LVEF) is controversial. Mitral annular plane systolic excursion (MAPSE) is an easily acquired metric of left ventricular longitudinal shortening. We sought to investigate if an asymptomatic decrease in MAPSE preceded the need for AVI in asymptomatic patients with AS and a preserved LVEF. In this retrospective cohort study, we identified 205 consecutive patients (56% male, 73 ± 11 years) with at least a moderate AS and a normal LVEF who underwent a serial outpatient transthoracic echocardiography (TTE) from 2006 to 2013...
December 1, 2017: American Journal of Cardiology
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