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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/28741721/left-ventricular-septal-hypertrophy-in-elderly-patients-with-aortic-stenosis
#1
Minako Katayama, Prasad M Panse, Christopher B Kendall, John R Daniels, Stephen S Cha, F David Fortuin, John P Sweeney, Patrick A DeValeria, Louis A Lanza, Marek Belohlavek, Hari P Chaliki
OBJECTIVES: Left ventricular (LV) septal hypertrophy in aortic stenosis raises diagnostic and therapeutic questions. However, the etiology and clinical consequences of this finding have not been well studied. The aim of this study was to perform a morphologic evaluation of the LV in aortic stenosis and to investigate the contributing factors and consequences of septal hypertrophy. METHODS: Patients with moderate or severe aortic stenosis were prospectively enrolled...
July 25, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#2
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28704465/lipoprotein-a-in-patients-with-aortic-stenosis-insights-from-cardiovascular-magnetic-resonance
#3
Vassilios S Vassiliou, Paul D Flynn, Claire E Raphael, Simon Newsome, Tina Khan, Aamir Ali, Brian Halliday, Annina Studer Bruengger, Tamir Malley, Pranev Sharma, Subothini Selvendran, Nikhil Aggarwal, Anita Sri, Helen Berry, Jackie Donovan, Willis Lam, Dominique Auger, Stuart A Cook, Dudley J Pennell, Sanjay K Prasad
BACKGROUND: Aortic stenosis is the most common age-related valvular pathology. Patients with aortic stenosis and myocardial fibrosis have worse outcome but the underlying mechanism is unclear. Lipoprotein(a) is associated with adverse cardiovascular risk and is elevated in patients with aortic stenosis. Although mechanistic pathways could link Lipoprotein(a) with myocardial fibrosis, whether the two are related has not been previously explored. In this study, we investigated whether elevated Lipoprotein(a) was associated with the presence of myocardial replacement fibrosis...
2017: PloS One
https://www.readbyqxmd.com/read/28701592/risk-factors-of-postcardiotomy-ventricular-dysfunction-in-moderate-to-high-risk-patients-undergoing-open-heart-surgery
#4
Christoph Ellenberger, Tornike Sologashvili, Mustafa Cikirikcioglu, Gabriel Verdon, John Diaper, Tiziano Cassina, Marc Licker
INTRODUCTION: Ventricular dysfunction requiring inotropic support frequently occurs after cardiac surgery, and the associated low cardiac output syndrome largely contributes to postoperative death. We aimed to study the incidence and potential risk factors of postcardiotomy ventricular dysfunction (PCVD) in moderate-to-high risk patients scheduled for open-heart surgery. METHODS: Over a 5-year period, we prospectively enrolled 295 consecutive patients undergoing valve replacement for severe aortic stenosis or coronary artery bypass surgery who presented with Bernstein-Parsonnet scores >7...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28700016/primary-mitral-valve-regurgitation-outcome-in-patients-with-severe-aortic-stenosis-1-year-after-transcatheter-aortic-valve-implantation-echocardiographic-evaluation
#5
Thiago Marinho Florentino, David Le Bihan, Alexandre Antonio Cunha Abizaid, Alexandre Vianna Cedro, Amably Pessoa Corrêa, Alexandre Roginski Mendes Dos Santos, Alexandre Costa Souza, Tiago Costa Bignoto, José Eduardo Moraes Rego Sousa, Amanda Guerra de Moraes Rego Sousa
Background: Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature. Objective: To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors...
July 10, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28698585/effects-of-aortic-valve-replacement-on-severe-aortic-stenosis-and-preserved-systolic-function-systematic-review-and-network-meta-analysis
#6
Qishi Zheng, Andie H Djohan, Enghow Lim, Zee Pin Ding, Lieng H Ling, Luming Shi, Edwin Shih-Yen Chan, Calvin Woon Loong Chin
The survival benefits of aortic valve replacement (AVR) in the different flow-gradient states of severe aortic stenosis (AS) is not known. A comprehensive search in PubMed/MEDLINE, Embase, Cochrane Library, CNKI and OpenGrey were conducted to identify studies that investigated the prognosis of severe AS (effective orifice area ≤1.0 cm(2)) and left ventricular ejection fraction ≥50%. Severe AS was stratified by mean pressure gradient [threshold of 40 mmHg; high-gradient (HG) and low-gradient (LG)] and stroke volume index [threshold of 35 ml/m(2); normal-flow (NL) and low-flow (LF)]...
July 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28698175/echocardiographic-aortic-valve-calcification-and-outcomes-in-women-and-men-with-aortic-stenosis
#7
Henrik K Thomassen, Giovanni Cioffi, Eva Gerdts, Eigir Einarsen, Helga Bergljot Midtbø, Constantino Mancusi, Dana Cramariuc
OBJECTIVE: Sex differences in risk factors of aortic valve calcification (AVC) by echocardiography have not been reported from a large prospective study in aortic stenosis (AS). METHODS: AVC was assessed using a prognostically validated visual score and grouped into none/mild or moderate/severe AVC in 1725 men and women with asymptomatic AS in the Simvastatin Ezetimibe in Aortic Stenosis study. The severity of AS was assessed by the energy loss index (ELI) taking pressure recovery in the aortic root into account...
July 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28691910/transcatheter-aortic-valve-implantation-for-mixed-versus-pure-stenotic-aortic-valve-disease
#8
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Jan G Tijssen, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
AIMS: In addition to patients with pure/predominant aortic stenosis (PAS), real-world transcatheter aortic valve implantation (TAVI) referrals include patients with mixed aortic valve disease (MAVD; severe stenosis + moderate-severe regurgitation). We sought to compare TAVI outcomes in patients with MAVD vs. PAS. METHODS AND RESULTS: Out of 793 consecutive patients undergoing TAVI, 106 (13.4%) had MAVD. Patients with MAVD were younger and had a higher operative risk, a severer adverse cardiac remodeling, and a worse functional status than patients with PAS...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#9
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28684441/structural-valve-deterioration-after-transcatheter-aortic-valve-implantation
#10
Farid Foroutan, Gordon H Guyatt, Catherine M Otto, Reed A Siemieniuk, Stefan Schandelmaier, Thomas Agoritsas, Per O Vandvik, Sai Bhagra, Rodrigo Bagur
BACKGROUND: Transcatheter aortic valve implantation (TAVI), widely used to treat high-risk patients with severe symptomatic aortic stenosis, has recently been extended to younger patients at lower operative risk in whom long-term durability of TAVI devices is an important concern. Therefore, we conducted a systematic review and meta-analysis of observational studies addressing the frequency of structural valve deterioration (SVD) after TAVI. METHODS: We searched Medline, Embase, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL from 2002 to September 2016...
July 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28683542/feasibility-and-applicability-of-static-vascular-outline-roadmapping-during-tavi
#11
Navid Madershahian, Carolyn Weber, Payman Majd, Tanja Rudolph, Elmar Kuhn, Maximilian Scherner, Yeong-Hoon Choi, Kaveh Eghbalzadeh, Volker Rudolph, Cherif Sahyoun, Thorsten Wahlers
BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips "Vascular Outlining" prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two- dimensional vessel margins as a roadmap on live fluoroscopy...
July 5, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28681443/evaluation-of-the-congenital-supravalvular-aortic-stenosis-by-different-imaging-modalities
#12
Ahmet Guner, Nuri Havan, Sabahattin Gunduz, Taylan Akgun, Busra Guvendi, Gokhan Kahveci
A 36-year-old female was admitted to hospital exhibiting chest pain, dyspnea, and a heart murmur on the right upper sternal border, radiating to both carotid arteries. The blood pressure of the patient's right arm exceeded the pressure in the left by 25 mm Hg (Coanda effect). In spite of laboratory results that did not fall outside the expected range, the left ventricle was revealed to be hypertrophic following electrocardiography. Transthoracic echocardiography revealed a severe supravalvular aortic stenosis (SVAS) with a peak Doppler velocity of 6...
July 6, 2017: Echocardiography
https://www.readbyqxmd.com/read/28676179/transaortic-edge-to-edge-mitral-valve-repair-for-moderate-secondary-functional-mitral-regurgitation-in-patients-undergoing-aortic-root-valve-intervention
#13
Shiv Kumar Choudhary, Atul Abraham, Amol Bhoje, Parag Gharde, Manoj Sahu, Sachin Talwar, Balram Airan
OBJECTIVE: The present study evaluates the feasibility, safety, and efficacy of edge-to-edge repair for moderate secondary/functional mitral regurgitation in patients undergoing aortic valve/root interventions. METHODS: Sixteen patients underwent transaortic edge-to-edge mitral valve repair. Mitral regurgitation was 2+ in 8 patients and 3+ in 6 patients. Two patients in whom cardiac arrest developed preoperatively had severe (4+) mitral regurgitation. Patients underwent operation for severe aortic regurgitation ± aortic root lesions...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28674629/morbidity-outcomes-after-surgical-aortic-valve-replacement
#14
Andreas Auensen, Amjad Iqbal Hussain, Bjørn Bendz, Lars Aaberge, Ragnhild Sørum Falk, Marte Meyer Walle-Hansen, Jorun Bye, Johanna Andreassen, Jan Otto Beitnes, Kjell Arne Rein, Kjell Ingar Pettersen, Lars Gullestad
OBJECTIVE: In patients with mild to moderate operative risk, surgical aortic valve replacement (SAVR) is still the preferred treatment for patients with severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of postsurgical outcomes, this study reports a broad set of morbidity outcomes following surgical intervention. METHODS: Our cohort comprised 442 patients referred for severe AS; 351 had undergone SAVR, with the remainder (91) not operated on...
2017: Open Heart
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#15
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#16
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28655164/role-of-diastolic-function-indices-in-the-risk-stratification-of-patients-with-mixed-aortic-valve-disease
#17
Alexander C Egbe, Arooj R Khan, Amber Boler, Sameh M Said, Jeffrey B Geske, William R Miranda, Emmanuel Akintoye, Heidi M Connolly, Carole A Warnes, Jae K Oh
Aims: Determine the role of diastolic function indices in pre-operative and post-operative risk stratification in patients with moderate mixed aortic valve disease (MAVD). Methods and results: A retrospective study was conducted of asymptomatic patients with moderate MAVD (a combination of moderate aortic stenosis and moderate aortic regurgitation) and an ejection fraction of 50% or more who were followed up at Mayo Clinic from 1 January 2004, to 31 December 2013...
June 23, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28651336/safety-and-efficacy-of-a-repositionable-and-fully-retrievable-aortic-valve-used-in-routine-clinical-practice-the-respond-study
#18
Volkmar Falk, Jochen Wöhrle, David Hildick-Smith, Sabine Bleiziffer, Daniel J Blackman, Mohamed Abdel-Wahab, Ulrich Gerckens, Axel Linke, Hüseyin Ince, Peter Wenaweser, Dominic J Allocco, Keith D Dawkins, Nicolas M Van Mieghem
Aims: RESPOND is a prospective, open-label, single-arm study evaluating the outcomes following transcatheter aortic valve implantation (TAVI) with the repositionable and fully retrievable Lotus Valve used in routine clinical practice for the treatment of patients with aortic valve stenosis. Methods and results: RESPOND enrolled 1014 patients at sites across Europe, New Zealand, and Latin America; 996 patients received a Lotus Valve (mean age: 80.8 years; 50.8% female; Society of Thoracic Surgeons score: 6...
June 22, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28651163/ex-vivo-assessment-of-valve-thickness-calcification-of-patients-with-calcific-aortic-stenosis-in-relation-to-in-vivo-clinical-outcomes
#19
Ching-Li Cheng, Hsiao-Huang Chang, Pei-Jung Huang, Wei-Chen Wang, Shan-Yang Lin
Calcific aortic stenosis (AS) plays a critical role in the risk of cardiovascular disease. This preliminary study examined the relationship between the ex vivo valve thickness/calcification and in vivo clinical outcomes of Chinese patients with calcific AS. Six Chinese patients (3 patients with tricuspid aortic valves (TAV)) and 3 patients with. bicuspid aortic valves (BAV) with calcific AS undergoing heart valve replacement were initially chosen for this study. In vivo medical imaging of these calcific AS patients was evaluated using computed tomography and echocardiography...
June 22, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#20
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
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