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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/28521921/1-year-results-in-patients-undergoing-transcatheter-aortic-valve-replacement-with-failed-surgical-bioprostheses
#1
G Michael Deeb, Stanley J Chetcuti, Michael J Reardon, Himanshu J Patel, P Michael Grossman, Theodore Schreiber, John K Forrest, Tanvir K Bajwa, Daniel P O'Hair, George Petrossian, Newell Robinson, Stanley Katz, Alan Hartman, Harold L Dauerman, Joseph Schmoker, Kamal Khabbaz, Daniel R Watson, Steven J Yakubov, Jae K Oh, Shuzhen Li, Neal S Kleiman, David H Adams, Jeffrey J Popma
OBJECTIVES: This study evaluated the safety and effectiveness of self-expanding transcatheter aortic valve replacement (TAVR) in patients with surgical valve failure (SVF). BACKGROUND: Self-expanding TAVR is superior to medical therapy for patients with severe native aortic valve stenosis at increased surgical risk. METHODS: The CoreValve U.S. Expanded Use Study was a prospective, nonrandomized study that enrolled 233 patients with symptomatic SVF who were deemed unsuitable for reoperation...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28511326/-comparison-of-aortic-annular-diameter-defined-by-different-measurement-mordalities-before-transcatheter-aortic-valve-implantation
#2
R X Qi, X D You, Z X Pu, Q Yang, Z X Huang, L M Zhou, P T Huang
Objective: To compare aortic annular diameter measured by transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and multislice computed tomography (MSCT) in patients with severe aortic stenosis, and to evaluate the impact on selection of prosthetic valve type in transcatheter aortic valve implantation (TAVI). Methods: Clinical data of 138 patients with severe aortic stenosis referred for TAVI between January 2014 and June 2016 in our hospital were retrospectively analyzed.The difference of aortic annular diameter measured by TTE, TEE, and MSCT were compared...
May 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28510739/comparison-of-preoperative-and-intraoperative-assessment-of-aortic-stenosis-severity-by-echocardiography
#3
Y Uda, B Cowie, R Kluger
Background: General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Methods: Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28500739/feasibility-and-safety-of-transfemoral-sheathless-portico-aortic-valve-implantation-preliminary-results-in-a-single-center-experience
#4
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28499670/feasibility-and-relevance-of-right-parasternal-view-for-assessing-severity-and-rate-of-progression-of-aortic-valve-stenosis-in-primary-care
#5
Giovanni Benfari, Anna Maria Gori, Andrea Rossi, Barbara Papesso, Corrado Vassanelli, Giovanni Battista Zito, Stefano Nistri
BACKGROUND: Right parasternal view (RPV) is important in assessing the severity of aortic stenosis (AS). However, the feasibility and relevance of RPV in primary care is unresolved. Moreover, information regarding the role of RPV in the evaluation of the hemodynamic progression of AS is lacking. METHODS: Consecutive patients with peak aortic valve velocity (Vmax) ≥2.5m/s were prospectively enrolled in a primary care echocardiographic laboratory. Aortic Doppler parameters were evaluated from apical view and RPV...
May 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28495455/increased-left-ventricular-diastolic-stiffness-is-associated-with-heart-failure-symptoms-in-aortic-stenosis-patients-with-preserved-ejection-fraction
#6
Daisuke Kamimura, Takeki Suzuki, Ervin R Fox, Thomas N Skelton, Michael D Winniford, Michael E Hall
BACKGROUND: Clinical risk factors associated with heart failure (HF) symptoms in aortic stenosis (AS) patients with preserved ejection fraction (EF) have not been fully identified. We hypothesized that left ventricular (LV) diastolic stiffness is associated with HF symptoms in patients with AS. METHODS AND RESULTS: We retrospectively evaluated 275 patients with at least moderate AS (aortic valve area < 1.5cm(2)) and preserved EF (EF ≥50%). LV diastolic stiffness was evaluated using echocardiographic parameters, diastolic wall strain (DWS, a measure of LV wall stiffness) and KLV (a marker of LV chamber stiffness)...
May 8, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28494977/aortic-stenosis-is-still-very-tricky-especially-when-it-is-moderate
#7
EDITORIAL
William J Stewart
No abstract text is available yet for this article.
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28494976/prognostic-implications-of-moderate-aortic%C3%A2-stenosis-in-patients-with-left%C3%A2-ventricular-systolic%C3%A2-dysfunction
#8
Lennart van Gils, Marie-Annick Clavel, E Mara Vollema, Rebecca T Hahn, Ernest Spitzer, Victoria Delgado, Tamim Nazif, Peter P De Jaegere, Marcel L Geleijnse, Ori Ben-Yehuda, Jeroen J Bax, Martin B Leon, Philippe Pibarot, Nicolas M Van Mieghem
BACKGROUND: Left ventricular (LV) systolic dysfunction and moderate aortic stenosis (AS) are more frequent with advancing age and often coexist. Afterload reduction is the mainstay of pharmacological treatment of heart failure (HF). Aortic valve replacement (AVR) is only formally indicated for symptomatic severe AS. OBJECTIVES: This study sought to determine the clinical outcome of patients with concomitant moderate AS and LV systolic dysfunction. METHODS: Echocardiographic and clinical data of patients with moderate AS and LV systolic dysfunction between 2010 and 2015 from 4 large academic institutions were retrospectively analyzed...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28490615/contemporary-natural-history-of-bicuspid-aortic-valve-disease-a-systematic-review
#9
REVIEW
Ahmad Masri, Lars G Svensson, Brian P Griffin, Milind Y Desai
We performed a systematic review of the current state of the literature regarding the natural history and outcomes of bicuspid aortic valve (BAV). PubMed and the reference lists of the included articles were searched for relevant studies reporting on longitudinal follow-up of BAV cohorts (mean follow-up ≥2 years). Studies limited to patients undergoing surgical interventions were excluded. 13 studies (11 502 patients with 2-16 years of follow-up) met the inclusion criteria. There was a bimodal age distribution (30-40 vs ≥50 years), with a 3:1 male to female ratio...
May 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28484830/insights-on-mid-term-tavr-performance-3-year-clinical-and-echocardiographic-results-from-the-corevalve-advance-study
#10
Sabine Bleiziffer, Johan Bosmans, Stephen Brecker, Ulrich Gerckens, Peter Wenaweser, Corrado Tamburino, Axel Linke
BACKGROUND: Extensive evidence relating to transcatheter aortic valve replacement (TAVR) has accumulated in recent years, but mid-term outcomes are less reported. We investigated 996 patients after implantation of the CoreValve prosthesis for severe aortic stenosis in a real-world setting. OBJECTIVE: To report clinical and echocardiographic 3-year results from the ADVANCE study. METHODS: ADVANCE is a prospective, multicenter, fully monitored, nonrandomized clinical study...
May 8, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28475690/safety-effectiveness-and-haemodynamic-performance-of-a-new-stented-aortic-valve-bioprosthesis%C3%A2
#11
Robert J M Klautz, A Pieter Kappetein, Rüdiger Lange, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Martin Misfeld, Cathy Zeng, Joseph F Sabik Iii
OBJECTIVES: We assessed the safety, effectiveness and haemodynamic performance of a new bovine stented aortic valve bioprosthesis (Avalus™). METHODS: The PERIGON Pivotal Trial is a prospective, non-randomized, multicentre study. Subjects had symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. Death, valve-related adverse events (AEs), functional recovery and haemodynamic performance were assessed at discharge, 3-6 months and 1 year...
May 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28473338/appropriate-minimal-dose-of-gadobutrol-for-3d-time-resolved-mra-of-the-supra-aortic-arteries-comparison-with-conventional-single-phase-high-resolution-3d-contrast-enhanced-mra
#12
S H Bak, H G Roh, W-J Moon, J W Choi, H S An
BACKGROUND AND PURPOSE: The development of nephrogenic systemic fibrosis and neural tissue deposition is gadolinium dose-dependent. The purpose of this study was to determine the appropriate minimal dose of gadobutrol with time-resolved MRA to assess supra-aortic arterial stenosis with contrast-enhanced MRA as a reference standard. MATERIALS AND METHODS: Four hundred sixty-two consecutive patients underwent both standard-dose contrast-enhanced MRA and low-dose time-resolved MRA and were classified into 3 groups; group A (a constant dose of 1 mL for time-resolved MRA), group B (2 mL), or group C (3 mL)...
May 4, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28473216/transcatheter-aortic-valve-implantation-in-intermediate-surgical-risk-patients-with-severe-aortic-stenosis-a-systematic-review-and-meta-analysis
#13
Kuljit Singh, Kristin Carson, Mohammed K Rashid, Rohan Jayasinghe, Abdulrahman AlQahtani, Alexander Dick, Christopher Glover, Marino Labinaz
BACKGROUND: Recent data from randomised and observational studies have reported non-inferior outcomes for transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement (SAVR) in intermediate-risk patients. We performed a systematic review to evaluate the mortality of TAVI compared to SAVR in intermediate-risk patients. METHODS: A comprehensive search of four major databases (EMBASE, Ovid MEDLINE, PubMed, and Google Scholar) was performed from their inception to 29 April 2016...
April 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28460759/utility-of-physical-examination-and-comparison-to-echocardiography-for-cardiac-diagnosis
#14
Ashish Patel, Nitin Singh Tomar, Anil Bharani
OBJECTIVE: To find out the accuracy of cardiac auscultation using non-digital stethoscope in physical diagnosis of cardiac diseases. METHODS: We enrolled 104 consecutive patients with abnormal cardiac auscultatory findings attending cardiology clinic and not previously evaluated by echocardiography. One time detailed cardiac physical examination followed by echocardiography within 1 month was undertaken. Agreement between two methods was calculated using mean pair percentage agreement, kappa statistics (κ) and calculation of 95% confidence interval (CI) for kappa statistics...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28455294/stroke-volume-index-in-mild-moderate-aortic-stenosis-more-than-a-barometer-of-systolic-function
#15
EDITORIAL
Anvesha Singh, Gerry P McCann
No abstract text is available yet for this article.
April 28, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28415120/p1088match-and-mismatch-between-opening-area-and-resistance-in-mild-and-moderate-rheumatic-mitral-stenosis
#16
I El-Dosouky
Background: Mitral valve resistance (MVR) is a hemodynamic consequence of mitral stenosis but it has no clear threshold and it has a shortage of data to be reliable. Purpose: is to investigate match and mismatch between opening area and resistance especially in patients with moderate and mild mitral stenosis. Materials: This cross section case control study comprised 88 patients with moderate and mild rheumatic mitral stenosis. Transthorathic echocardiographic study estimated: mitral valve area (MVA) both by planimerty (2D) and pressure half time (PHT), mitral valve score (MVS), mean transmitral pressure gradient (MPG), diastolic filling time(DFT), left ventricular out flow tract diameter (LVOTd) and velocity time integral (LVOT vti) , the MVR was calculated as: MPG/aortic flow ratio [(LVOTd) (LVOTvti)/ DFT] in dynes...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415115/p981lvot-area-measurement-using-gated-ct-data-reclassifies-aortic-stenosis-severity-as-graded-by-echocardiography
#17
L Moderato, A Palumbo, S Coli, D Orlandini, G Russo, N Gaibazzi
Background: Measurement of left ventricular outflow tract (LVOT) diameter and area for estimation of aortic valve area (AVA) using transthoracic echocardiography (TTE) and the continuity equation assumes circular LVOT. The use of direct planimetric measurement of LVOT area by gated-CT can theoretically improve accuracy of AVA calculation. Purpose: We aim to assess reproducibility of LVOT echo measurement and its correlation and agreement with Gated CT measurements...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415097/p544the-importance-of-contractile-reserve-when-assessing-asymptomatic-patients-with-aortic-stenosis
#18
J J Van Zalen, S Badiani, L Hart, A Marshall, N Patel, G Lloyd
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#19
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28398671/transcatheter-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-evidence-from-a-meta-analysis
#20
Partha Sardar, Amartya Kundu, Saurav Chatterjee, Dmitriy N Feldman, Theophilus Owan, Nikolaos Kakouros, Ramez Nairooz, Linda A Pape, Ted Feldman, J Dawn Abbott, Sammy Elmariah
OBJECTIVES: We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. BACKGROUND: TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer data regarding efficacy of TAVR in intermediate-risk patients. METHODS: Databases were searched through April 30, 2016 for studies that compared TAVR with SAVR for the treatment of intermediate-risk patients with severe AS...
April 11, 2017: Catheterization and Cardiovascular Interventions
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