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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/29778342/one-year-outcomes-associated-with-a-novel-stented-bovine-pericardial-aortic-bioprosthesis
#1
Joseph F Sabik, Vivek Rao, Rüdiger Lange, A Pieter Kappetein, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Neil J Weissman, Himanshu J Patel, Michael J Reardon, Federico M Asch, Cathy Zeng, Robert J M Klautz
OBJECTIVES: The study objectives were to evaluate the safety, effectiveness, and hemodynamic performance of a new stented bovine pericardial aortic valve. METHODS: This trial enrolled patients with symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. We assessed death, valve-related adverse events, functional recovery, and hemodynamic performance at discharge, 3 to 6 months, and 1 year, as required by the US Food and Drug Administration for regulatory approval...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29762919/incremental-value-of-transesophageal-echocardiography-integrated-with-transthoracic-echocardiography-in-the-assessment-of-aortic-stenosis-severity
#2
Shmuel Schwartzenberg, Mordehay Vaturi, Shirit Kazum, Daniel Monakier, Alexander Sagie, Ran Kornowski, Yaron Shapira
BACKGROUND: Transthoracic echocardiography (TTE) is the standard method for evaluating the severity of aortic stenosis (AS), while transesophageal echocardiography (TEE) is useful for morphologic characterization. The study aim was to assess the impact of complementary TEE to TTE in refining hemodynamic assessment of AS severity. METHODS: A retrospective analysis was conducted of sequential TTE and TEE studies performed in 100 patients with moderate or severe AS confirmed on prior TTE...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29746546/transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-high-surgical-risk-patients-a-systematic-review-and-meta-analysis
#3
Zulian Liu, Elaine Kidney, Danai Bem, George Bramley, Susan Bayliss, Mark A de Belder, Carole Cummins, Rui Duarte
BACKGROUND: Symptomatic aortic stenosis has a poor prognosis. Many patients are considered inoperable or at high surgical risk for surgical aortic valve replacement (SAVR), reflecting their age, comorbidities and frailty. The clinical effectiveness and safety of TAVI have not been reviewed systematically for these high levels of surgical risk. This systematic review compares mortality and other important clinical outcomes up to 5 years post treatment following TAVI or other treatment in these risk groups...
2018: PloS One
https://www.readbyqxmd.com/read/29741486/computed-tomography-based-oversizing-and-incidence-of-para-valvular-aortic-regurgitation-and-permanent-pacemaker-implantation-with-a-new-generation-self-expanding-transcatheter-heart-valve
#4
Ung Kim, Philipp Blanke, Stephan Windecker, Albert M Kasel, Ulrich Schäfer, Darren Walters, Axel Linke, Herve Le Breton, Gerhard Schymik, Mark S Spence, Lars Sondergaard, Mohammed Abdel-Wahab, Stephen Worthley, Didier Tchetche, Hermann Reichenspurner, Mickael Ohana, Stephanie L Sellers, Jonathon A Leipsic
AIMS: We aimed to evaluate the relationship between CT-based annular perimeter oversizing and the incidence of paravalvular aortic regurgitation (PAR) and permanent pacemaker (PPM) implantation in patients treated with the new self-expanding CENTERA transcatheter heart valve (THV) for severe aortic stenosis. METHODS AND RESULTS: 198 patients in the CENTERA-EU trial were stratified priori into four groups based on the perimeter oversizing (2.5%-10%, 10-15%, 15-20% and >20%)...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29730841/grading-of-aortic-stenosis-severity-a-head-to-head-comparison-between-cardiac-magnetic-resonance-imaging-and-echocardiography
#5
Cesare Mantini, Gabriele Di Giammarco, Jacopo Pizzicannella, Sabina Gallina, Fabrizio Ricci, Emilia D'Ugo, Marziale Marchetti, Antonio Raffaele Cotroneo, Nauman Ahmed, Chiara Bucciarelli-Ducci, Armando Tartaro, Raffaele De Caterina
AIM: To prospectively evaluate the accuracy of cardiac magnetic resonance (cMR) imaging for the assessment of aortic valve effective orifice area (EOA) by continuity equation and anatomical aortic valve area (AVA) by direct planimetry, as compared with transthoracic (TTE) and transesophageal (TEE) two-dimensional (2D) echocardiography, respectively. METHODS AND RESULTS: A total of 31 patients (21 men, 10 women, mean age 69 ± 10 years) with moderate-to-severe aortic stenosis (AS) diagnosed by TTE and scheduled for elective aortic valve replacement, underwent both cMR and TEE...
May 5, 2018: La Radiologia Medica
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/29719036/clinical-context-and-detection-of-the-murmur-of-advanced-aortic-stenosis
#7
Ajoe John Kattoor, Anusha Shanbhag, Annette Abraham, Srikanth Vallurupalli
OBJECTIVES: Auscultation is an important clue to the presence of aortic stenosis (AS). We sought to assess the effect of symptom status, prior knowledge of diagnosis, and other patient factors on murmur detection. METHODS: Patients with moderate-to-severe AS by echocardiography at a single center between June 2015 and June 2016 were included. Five consecutive patient encounters (inpatient and outpatient) within 12 months before the echocardiogram were analyzed. RESULTS: Ninety-five patients (418 different clinician encounters) were studied...
April 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29718178/results-of-aortic-valve-repair-using-decellularized-bovine-pericardium-in-congenital-surgery
#8
Sarah Nordmeyer, Peter Murin, Antonia Schulz, Friederike Danne, Johannes Nordmeyer, Johanna Kretzschmar, Daria Sumbadze, Katharina Rose Luise Schmitt, Oliver Miera, Mi-Young Cho, Nicodeme Sinzobahamvya, Felix Berger, Stanislav Ovroutski, Joachim Photiadis
OBJECTIVES: The search for an optimal patch material for aortic valve reconstruction (AVR) is an ongoing challenge. In this study, we report our experience of AVR using decellularized bovine pericardial patch material in congenital heart surgery. METHODS: Data of 40 consecutive patients who underwent AVR using the CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) between February 2014 and August 2016 were retrospectively reviewed. The median age of the patients at operation was 9 (2-34) years, and 18 patients were younger than 7 years...
April 30, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29708917/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#9
Katarina J Ruscic, Grettel J Zamora-Berridi, Francis J McGovern, Curtis Cetrulo, Jonathan M Winograd, Kyle R Eberlin, Branko Bojovic, Dicken S Ko, T Anthony Anderson
Regional anesthesia has been used to help create local sympathectomy and improve blood flow in plastic surgery procedures involving tissue grafts and flaps. However, anesthetic techniques that reduce systemic vascular resistance must be used with caution in patients with aortic stenosis (AS). Combined neuraxial and general anesthesia with careful titration of the local anesthetic dose can be a safe approach for patients with AS undergoing microvascular procedures. We present the anesthetic management of the first North American penile transplant, on an obese patient with moderate AS...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29680341/pulmonary-hypertension-in-patients-with-severe-aortic-stenosis-prognostic-impact-after-transcatheter-aortic-valve-replacement-pulmonary-hypertension-in-patients-undergoing-tavr
#10
Brunilda Alushi, Frederik Beckhoff, David Leistner, Marcus Franz, Markus Reinthaler, Barbara E Stähli, Andreas Morguet, Hans R Figulla, Torsten Doenst, Francesco Maisano, Volkmar Falk, Ulf Landmesser, Alexander Lauten
OBJECTIVES: The authors investigated the development of pulmonary hypertension (PH), predictors of PH regression, and its prognostic impact on short, mid-, and long-term outcomes in patients undergoing transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). BACKGROUND: PH represents a common finding in patients with AS. Although TAVR is frequently associated with regression of PH, the predictors of reversible PH and its prognostic significance remain uncertain...
April 13, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29671283/trends-and-outcomes-of-transcatheter-aortic-valve-implantation-tavi-in-korea-the-results-of-the-first-cohort-of-korean-tavi-registry
#11
Cheol Woong Yu, Won Jang Kim, Jung Min Ahn, Hyungdon Kook, Se Hun Kang, Jung Kyu Han, Young Guk Ko, Seung Hyuk Choi, Bon Kwon Koo, Kiyuk Chang, Hyo Soo Kim
BACKGROUND AND OBJECTIVES: There has been no nation-wide data on the outcomes of transcatheter aortic valve implantation (TAVI) after commercialization of TAVI in Korea. We report clinical features and outcomes of the first cohort of TAVI performed from Jun 2015 to Jun 2017 in Korea. METHODS: The first cohort of Korean-TAVI (K-TAVI) registry includes 576 consecutive patients with severe symptomatic aortic stenosis who underwent TAVI from 17 Korean hospitals for 2 years...
April 17, 2018: Korean Circulation Journal
https://www.readbyqxmd.com/read/29668501/transcaval-valve-in-valve-in-valve-aortic-valve-replacement-for-bioprosthetic-valve-degeneration
#12
A Claire Watkins, Chandan M Devireddy, Talal Al-Atassi, Amy E Simone, Jessica Forcillo, Vinod H Thourani
A 74-year-old man presented with progressive dyspnea on exertion. History included peripheral arterial disease and coronary artery bypass grafting with aortic valve replacement 12 years ago. Subsequently, the surgical valve developed severe stenosis and moderate insufficiency. He underwent a transapical valve-in-valve transcatheter aortic valve replacement 5 years before presentation. This second valve developed a mean gradient of 66 mm Hg with mild insufficiency. The patient was treated with a third aortic valve using an alternative transcaval approach, significantly alleviating his symptoms...
April 17, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29622987/outcome-of-transcatheter-aortic-valve-implantation-in-high-risk-patients-with-severe-aortic-stenosis
#13
Hamdy Soliman, Khlid Alrabaat, Tarek Aboalaazm, Shaimaa Mostafa, Asaad Samy
Aim: To assess outcome of TAVI in high risk patients with severe symptomatic aortic stenosis. Patients and methods: 40 patients with symptomatic severe aortic stenosis and high risk underwent TAVI with implantation of either Sapien XT valve or Core Valve and followed for 6 months. Device success, cardiovascular mortality, myocardial infarction, stroke, life-threatening bleeding and vascular complications were defined according to Valve Academic Research Consortium definitions...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29617762/pressure-gradient-vs-flow-relationships-to-characterize-the-physiology-of-a-severely-stenotic-aortic-valve-before-and-after-transcatheter-valve-implantation
#14
Nils P Johnson, Jo M Zelis, Pim A L Tonino, Patrick Houthuizen, R Arthur Bouwman, Guus R G Brueren, Daniel T Johnson, Jacques J Koolen, Hendrikus H M Korsten, Inge F Wijnbergen, Frederik M Zimmermann, Richard L Kirkeeide, Nico H J Pijls, K Lance Gould
Aims: Echocardiography and tomographic imaging have documented dynamic changes in aortic stenosis (AS) geometry and severity during both the cardiac cycle and stress-induced increases in cardiac output. However, corresponding pressure gradient vs. flow relationships have not been described. Methods and results: We recruited 16 routine transcatheter aortic valve implantations (TAVI's) for graded dobutamine infusions both before and after implantation; 0.014″ pressure wires in the aorta and left ventricle (LV) continuously measured the transvalvular pressure gradient (ΔP) while a pulmonary artery catheter regularly assessed cardiac output by thermodilution...
April 2, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29607143/early-and-mid-term-follow-up-of-patients-receiving-arterial-switch-operation-a-single-center-experience
#15
Yaqiong Xiao, Ping Zhang, Wei Su, Nianguo Dong
Background: The arterial switch operation (ASO) has become the preferred method for surgical correction of transposition of the great arteries (TGA) and Taussig-Bing anomaly. This study was aimed to analysis the early and mid-term results of patients receiving ASO for TGA and Taussig-Bing anomaly in our institute. Methods: A single-institution retrospective study was conducted to assess cardiovascular outcomes after ASO between January 2007 and December 2013. A total of 119 consecutive patients were included in this study...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29602140/effect-of-simvastatin-and-ezetimibe-on-supar-levels-and-outcomes
#16
Gethin W Hodges, Casper N Bang, Julie L Forman, Michael H Olsen, Kurt Boman, Simon Ray, Y Antero Kesäniemi, Jesper Eugen-Olsen, Anders M Greve, Jørgen L Jeppesen, Kristian Wachtell
BACKGROUND AND AIMS: Soluble urokinase plasminogen activator receptor (suPAR) is an inflammatory marker associated with cardiovascular disease. Statins lower both low-density lipoprotein (LDL)-cholesterol and C-reactive protein (CRP), resulting in improved outcomes. However, whether lipid-lowering therapy also lowers suPAR levels is unknown. METHODS: We investigated whether treatment with Simvastatin 40 mg and Ezetimibe 10 mg lowered plasma suPAR levels in 1838 patients with mild-moderate, asymptomatic aortic stenosis, included in the Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) study, using a pattern mixture model...
March 16, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29579303/impact-of-the-bicuspid-aortic-valve-on-aortic-root-haemodynamics-three-dimensional-computed-fluid-dynamics-simulation
#17
Denis Berdajs, Selim Mosbahi, Friedrich S Eckstein, Dominique Charbonnier, Enrico Ferrari, Ludwig K von Segesser
OBJECTIVES: The aim was to evaluate the impact of a bicuspid aortic valve (BAV) on local shear stress and on the pressure profile on the elements of the aortic root (AoR). METHODS: The experiment setup included a BAV with aortic valve stenosis (n = 5 pigs, 67 ± 3.5 kg) and insufficiency (n = 5 pigs, 66.7 ± 4.4 kg). By implanting 6 high-fidelity microsonometric crystals in each AoR, we determined the 3-dimensional (3D) geometry of the AoR. Experimental and geometric data were used to create a 3D time- and pressure-dependent computed fluid dynamic model of the AoR with the BAV...
March 22, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29572082/correlation-of-tricuspid-regurgitation-and-new-pacemaker-implantation-in-patients-undergoing-transcatheter-aortic-valve-implantation
#18
Dimitry Schewel, Jury Schewel, Michael Schlüter, Felix Kreidel, Tobias Schmidt, Michael Schmoeckel, Albrecht Elsässer, Karl-Heinz Kuck, Christian Frerker
AIMS: Conduction abnormalities (CA), in particular complete atrioventricular block (CAVB), requiring permanent pacemaker (PPM) implantation, are frequent complications after transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis (AS). However, the potential mechanisms are still incompletely understood. The objective of this retrospective study was to determine further predictors of CAVB after TAVI in patients without the known predictors. METHODS AND RESULTS: This study included patients without prior CA/PPM who underwent TAVI of a balloon-expandable valve (Sapien or Sapien XT or Sapien 3)...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29567131/midterm-outcomes-after-aortic-valve-neocuspidization-with-glutaraldehyde-treated-autologous-pericardium
#19
Shigeyuki Ozaki, Isamu Kawase, Hiromasa Yamashita, Shin Uchida, Mikio Takatoh, Nagaki Kiyohara
OBJECTIVE: We had previously reported the short-term results of the aortic valve neocuspidization (AVNeo) procedure. We have now evaluated the midterm results with the longest follow-up of 118 months. METHODS: From April 2007 through December 2015, 850 patients were treated with AVNeo using autologous pericardium. Medical records of these patients were retrospectively reviewed. The procedure was on the basis of independent tricuspid replacement using autologous pericardium...
February 15, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29566814/reduced-left-ventricular-ejection-fraction-in-patients-with-aortic-stenosis
#20
Saki Ito, William R Miranda, Vuyisile T Nkomo, Heidi M Connolly, Sorin V Pislaru, Kevin L Greason, Patricia A Pellikka, Bradley R Lewis, Jae K Oh
BACKGROUND: Left ventricular ejection fraction (LVEF) is reduced in a subset of patients with severe aortic stenosis (AS). OBJECTIVES: The authors sought to determine the temporal course of reduced LVEF, its predictors, and its impact on prognosis in severe AS. METHODS: Serial echocardiograms of 928 consecutive patients with first-time diagnosis of severe AS (aortic valve area [AVA] ≤1 cm2 ) who had at least 1 echocardiogram before the diagnosis were evaluated...
March 27, 2018: Journal of the American College of Cardiology
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