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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/28330793/procedural-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-for-bicuspid-versus-tricuspid-aortic-valve-stenosis
#1
Sung-Han Yoon, Sabine Bleiziffer, Ole De Backer, Victoria Delgado, Takahide Arai, Johannes Ziegelmueller, Marco Barbanti, Rahul Sharma, Gidon Y Perlman, Omar K Khalique, Erik W Holy, Smriti Saraf, Florian Deuschl, Buntaro Fujita, Philipp Ruile, Franz-Josef Neumann, Gregor Pache, Masao Takahashi, Hidehiro Kaneko, Tobias Schmidt, Yohei Ohno, Niklas Schofer, William K F Kong, Edgar Tay, Daisuke Sugiyama, Hiroyuki Kawamori, Yoshio Maeno, Yigal Abramowitz, Tarun Chakravarty, Mamoo Nakamura, Shingo Kuwata, Gerald Yong, Hsien-Li Kao, Michael Lee, Hyo-Soo Kim, Thomas Modine, S Chiu Wong, Francesco Bedgoni, Luca Testa, Emmanuel Teiger, Christian Butter, Stephan M Ensminger, Ulrich Schaefer, Danny Dvir, Philipp Blanke, Jonathon Leipsic, Fabian Nietlispach, Mohamed Abdel-Wahab, Bernard Chevalier, Corrado Tamburino, David Hildick-Smith, Brian K Whisenant, Seung-Jung Park, Antonio Colombo, Azeem Latib, Susheel K Kodali, Jeroen J Bax, Lars Søndergaard, John G Webb, Thierry Lefèvre, Martin B Leon, Raj Makkar
BACKGROUND: Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valve stenosis (AS) is being increasingly performed. OBJECTIVES: From the Bicuspid AS TAVR multicenter registry, the procedural and clinical outcomes in patients with bicuspid versus tricuspid AS were compared. METHODS: Outcomes of 561 patients with bicuspid AS and 4,546 patients with tricuspid AS were compared after propensity-score matching assembling 546 pairs of patients with similar baseline characteristics...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28330445/cardiac-amyloidosis-mimicking-severe-aortic-valve-stenosis-a-case-report-demonstrating-diagnostic-pitfalls-and-role-of-dobutamine-stress-echocardiography
#2
Tim Salinger, Kai Hu, Dan Liu, Sebastian Herrmann, Kristina Lorenz, Georg Ertl, Peter Nordbeck
BACKGROUND: Aortic valve stenosis is a common finding diagnosed with high sensitivity in transthoracic echocardiography, but the examiner often finds himself confronted with uncertain results in patients with moderate pressure gradients and concomitant systolic heart failure. While patients with true-severe low-gradient aortic valve stenosis with either reduced or preserved left ventricular systolic function are primarily candidates for valve replacement, there is a relevant proportion of patients with pseudo-severe aortic valve stenosis anticipated not to benefit but actually rather deteriorate by interventional therapy or surgery...
March 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28329333/pre-and-postoperative-tricuspid-regurgitation-in-patients-with-severe-symptomatic-aortic-stenosis-importance-of-pre-operative-tricuspid-annulus-diameter
#3
Claire Dumont, Elena Galli, Emmanuel Oger, Maxime Fournet, Erwan Flecher, Christophe Leclercq, Jean-Philippe Verhoye, Erwan Donal
Aims: Secondary tricuspid regurgitation (STR) is commonly found in patients with aortic stenosis and is associated with increased morbidity. The study sought to evaluate the prevalence of pre-operative STR and its progression after surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Also, it sought to analyse the predictors of post-operative changes in STR. Methods and results: We prospectively evaluated 116 patients (aged 75...
March 7, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329317/patient-prosthesis-mismatch-in-new-generation-trans-catheter-heart-valves-a-propensity-score-analysis
#4
Alexis Theron, Johan Pinto, Dominique Grisoli, Karolina Griffiths, Erwan Salaun, Nicolas Jaussaud, Eléonore Ravis, Marc Lambert, Lyna Messous, Cecile Amanatiou, Thomas Cuisset, Vlad Gariboldi, Roch Giorgi, Gilbert Habib, Frederic Collart
Aims: When compared with the former Sapien XT (XT-THV), the Sapien 3 trans-catheter heart valve (S3-THV) embeds an outer annular sealing cuff to prevent para-valvular regurgitation (PVR). The consequences of this new feature on valve haemodynamics have never been evaluated. We aimed to compare both types of prostheses regarding patient-prosthesis mismatch (PPM). Methods and results: Patients who underwent a TAVR for aortic stenosis were retrospectively included...
February 27, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28329177/can-perceval-sutureless-valve-reduce-the-rate-of-patient-prosthesis-mismatch-%C3%A2
#5
Igor Belluschi, Stefano Moriggia, Andrea Giacomini, Benedetto Del Forno, Stefania Di Sanzo, Andrea Blasio, Antonio Scafuri, Ottavio Alfieri
OBJECTIVES: The aim of this study is to compare the theoretical incidence of patient-prosthesis mismatch (PPM) in patients undergoing a sutureless or a sutured aortic valve replacement using an exact statistical matching. METHODS: Between May 2012 and March 2016, 65 patients with severe symptomatic aortic stenosis underwent a sutureless aortic valve replacement with the Perceval bioprosthesis in 2 centres. Moreover, 177 aortic valve replacements with conventional sutured bioprosthesis were performed between August 2003 and September 2015...
February 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28321003/midterm-outcomes-with-a-self-expandable-transcatheter-heart-valve-in-japanese-patients-with-symptomatic-severe-aortic-stenosis
#6
Yoshiki Sawa, Kei Torikai, Junjiro Kobayashi, Hiroshi Niinami, Toru Kuratani, Koichi Maeda, Hideaki Kanzaki, Nobuyuki Komiyama, Yutaka Tanaka, Angie Zhang, Shigeru Saito
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is a viable alternative to surgical aortic valve replacement in high-risk or inoperable patients with aortic stenosis (AS). Here we report the midterm outcomes of high-risk Japanese patients with severe AS who underwent TAVI with a self-expandable TAV.Methods and Results:The CoreValve Japan Trial was a prospective, multicenter trial of the CoreValve System. A group of 55 patients (mean age 82.5±5.5 years, 30.9% male, 100% NYHA class III/IV, STS 8...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28319871/autoantibodies-and-immune-complexes-to-oxidation-specific-epitopes-and-progression-of-aortic-stenosis-results-from-the-astronomer-trial
#7
Romain Capoulade, Kwan L Chan, Patrick Mathieu, Yohan Bossé, Jean G Dumesnil, James W Tam, Koon K Teo, Xiaohong Yang, Joseph L Witztum, Benoit J Arsenault, Jean-Pierre Després, Philippe Pibarot, Sotirios Tsimikas
BACKGROUND AND AIMS: Elevated levels of lipoprotein(a) [Lp(a)] and oxidized phospholipids on apolipoprotein B-100 (OxPL-apoB) predict the progression of pre-existing mild-to-moderate calcific aortic valve stenosis (CAVS). Whether indirect markers of oxidation-specific epitopes (OSE) are also predictive is not known. The association between IgG and IgM autoantibodies and malondialdehyde-modified low density lipoprotein (MDA-LDL) and IgG and IgM apolipoprotein B immune complexes (apoB-IC), and the hemodynamic progression rate of CAVS was determined in the ASTRONOMER (Aortic Stenosis Progression Observation: Measuring Effects of Rosuvastatin, NCT00800800) trial...
March 9, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28316038/the-impact-of-the-aortic-valve-impairment-on-the-distant-coronary-arteries-hemodynamics-a-fluid-structure-interaction-study
#8
Hossein Mohammadi, Raymond Cartier, Rosaire Mongrain
Atherosclerosis is still the leading cause of death in the developed world. Although its initiation and progression is a complex multifactorial process, it is well known that blood flow-induced wall shear stress (WSS) is an important factor involved in early atherosclerotic plaque initiation. In recent clinical studies, it was established that the regional pathologies of the aortic valve can be involved in the formation of atherosclerotic plaques. However, the impact of hemodynamic effects is not yet fully elucidated for disease initiation and progression...
March 18, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28302288/valvular-heart-disease-patients-on-edoxaban-or-warfarin-in-the-engage%C3%A2-af-timi-48-trial
#9
Raffaele De Caterina, Giulia Renda, Anthony P Carnicelli, Francesco Nordio, Marco Trevisan, Michele F Mercuri, Christian T Ruff, Elliott M Antman, Eugene Braunwald, Robert P Giugliano
BACKGROUND: The use of non-vitamin K antagonist oral anticoagulants (NOACs) instead of vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) and coexisting valvular heart disease (VHD) is of substantial interest. OBJECTIVES: This study explored outcomes in patients with AF with and without VHD in the ENGAGE AF-TIMI 48 (Effective Anticoagulation with factor Xa Next Generation in Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial, comparing edoxaban with warfarin...
March 21, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28296065/direct-percutaneous-transaxillary-implantation-of-a-novel-self-expandable-transcatheter-heart-valve-for-aortic-stenosis
#10
Florian Deuschl, Niklas Schofer, Moritz Seiffert, Samer Hakmi, Isamu Mizote, Andreas Schaefer, Johannes Schirmer, Hermann Reichenspurner, Stefan Blankenberg, Lenard Conradi, Ulrich Schäfer
OBJECTIVES: The aim of this study was to evaluate safety, feasibility, and efficacy of transaxillary TAVI using a novel self-expandable transcatheter heart valve (THV) via a direct percutaneous technique. METHODS: The analysis comprises 12 consecutive patients with severe aortic stenosis treated with the ACURATE Neo™ THV (Symetis) by direct percutaneous transaxillary access. RESULTS: Patients presented with a mean age of 79.9 ± 6.2 years and high calculated surgical risk (logEuroSCORE I: 19...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28292302/impact-of-left-ventricular-outflow-tract-ellipticity-on-the-grading-of-aortic-stenosis-in-patients-with-normal-ejection-fraction
#11
Frédéric Maes, Sophie Pierard, Christophe de Meester, Jamila Boulif, Mihaela Amzulescu, David Vancraeynest, Anne-Catherine Pouleur, Agnès Pasquet, Bernhard Gerber, Jean-Louis Vanoverschelde
BACKGROUND: The pathophysiology of paradoxical low-gradient (LG) severe aortic stenosis (SAS) remains controversial. As low transvalvular flow has been implicated, we sought to investigate the impact of left ventricular outflow tract (LVOT) ellipticity on the estimation of the LV stroke volume, the calculation of the aortic valve area (AVA) by use of the continuity equation and on AS severity grading. METHODS: We studied 190 consecutive patients (mean age: 72 ± 13 years; male: 57%) with SAS (indexed AVA < 0...
March 15, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28291817/specific-changes-in-circulating-cytokines-and-growth-factors-induced-by-exercise-stress-testing-in-asymptomatic-aortic-valve-stenosis
#12
Renata Kolasa-Trela, Malgorzata Konieczynska, Marta Bazanek, Anetta Undas
BACKGROUND: We evaluated exercise-induced changes in the profile of circulating cytokines and growth factors in patients with AS. METHODS: We studied 32 consecutive asymptomatic moderate-to-severe AS patients and 32 age and sex-matched controls. Plasma levels of interleukin (IL)-6, IL-10, hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), and transforming growth factor (TGF)-β were measured at 4 time points, i.e. at rest, at peak bicycle exercise, one hour and 24 hours after a symptom-limited exercise...
2017: PloS One
https://www.readbyqxmd.com/read/28290165/clinical-outcomes-in-different-types-of-aortic-stenosis-as-assessed-by-doppler-echocardiography
#13
R Brandon Stacey, Meng Meng, Graham V Byrum Iii, Olivia N Gilbert, Bharathi Upadhya, Carlos Rodriguez, David Zhao, Min Pu
BACKGROUND: Cardiologists continue to struggle with the prognosis and significance of low-gradient, severe aortic stenosis (AS) with preserved ejection fraction (EF). Conflicting data makes more substantive decisions challenging. The study aim was to determine the prognosis and significance of severe AS by reviewing index cases from the authors' echocardiography laboratory. METHODS: The study included 302 patients with AS and with aortic valve area (AVA) ≤1.0 cm2 who were identified from the echocardiography database between 2010 and 2011...
November 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28259370/sequential-transcatheter-aortic-valve-implantation-due-to-valve-dislodgement-a-portico-valve-implanted-over-a-corevalve-bioprosthesis
#14
Rui Campante Teles, Cátia Costa, Manuel Almeida, João Brito, Lars Sondergaard, José P Neves, João Abecasis, Henrique M Gabriel
Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve(®), which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28254817/deficient-circumferential-growth-is-the-primary-determinant-of-aortic-obstruction-attributable-to-partial-elastin-deficiency
#15
Yang Jiao, Guangxin Li, Arina Korneva, Alexander W Caulk, Lingfeng Qin, Matthew R Bersi, Qingle Li, Wei Li, Robert P Mecham, Jay D Humphrey, George Tellides
OBJECTIVE: Williams syndrome is characterized by obstructive aortopathy attributable to heterozygous loss of ELN, the gene encoding elastin. Lesions are thought to result primarily from excessive smooth muscle cell (SMC) proliferation and consequent medial expansion, although an initially smaller caliber and increased stiffness of the aorta may contribute to luminal narrowing. The relative contributions of such abnormalities to the obstructive phenotype had not been defined. APPROACH AND RESULTS: We quantified determinants of luminal stenosis in thoracic aortas of Eln(-/-) mice incompletely rescued by human ELN...
March 2, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28251911/sex-differences-in-phenotypes-of-bicuspid-aortic-valve-and-aortopathy-insights-from-a-large-multicenter-international-registry
#16
William K F Kong, Madelien V Regeer, Arnold C T Ng, Louise McCormack, Kian Keong Poh, Tiong Cheng Yeo, Miriam Shanks, Sarah Parent, Roxana Enache, Bogdan A Popescu, James W Yip, Lawrence Ma, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
BACKGROUND: This large multicenter, international bicuspid aortic valve (BAV) registry aimed to define the sex differences in prevalence, valve morphology, dysfunction (aortic stenosis/regurgitation), aortopathy, and complications (endocarditis and aortic dissection). METHODS AND RESULTS: Demographic, clinical, and echocardiographic data at first presentation of 1992 patients with BAV (71.5% men) were retrospectively analyzed. BAV morphology and valve function were assessed; aortopathy configuration was defined as isolated dilatation of the sinus of Valsalva or sinotubular junction, isolated dilatation of the ascending aorta distal to the sinotubular junction, or diffuse dilatation of the aortic root and ascending aorta...
March 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28242079/long-term-follow-up-after-the-ross-procedure-a-single-center-22-year-experience
#17
Adriaan W Schneider, Hein Putter, Robert J M Klautz, Eline F Bruggemans, Eduard R Holman, Regina Bökenkamp, Mark G Hazekamp
BACKGROUND: The aim of this study was to analyze long-term outcomes after the Ross procedure, focusing on autograft function and risk of reoperation in time. METHODS: Between February 1994 and February 2016, 154 patients underwent the Ross (n = 105) and Ross-Konno (n = 49) procedure at our institution and were included in this study. Data were collected retrospectively from patients' medical records or through telephone contact. Competing risks analyses were performed to determine incidences of death and reoperation...
February 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28239757/predictive-factor-of-secondary-tricuspid-regurgitation-after-aortic-valve-replacement-for-aortic-stenosis-the-importance-of-myocardial-hypertrophy-and-diastolic-dysfunction
#18
Takashi Igarashi, Masahiro Tanji, Koki Takahashi, Keiichi Ishida, Satomi Sasaki, Hitoshi Yokoyama
OBJECTIVES: The aim of this study is to determine the predictors of secondary tricuspid regurgitation after aortic valve replacement for aortic stenosis. METHODS: Seventy-one patients, who underwent aortic valve replacement for aortic stenosis at our institute from January 2006 to July 2011, were divided into two groups: an STR group, which included 15 patients with moderate or greater than moderate secondary tricuspid regurgitation at a follow-up visit and a control group...
February 26, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28238233/cardiac-fibrosis-in-aortic-stenosis-and-hypertensive-heart-disease-assessed-by-magnetic-resonance-t1-mapping
#19
Florian von Knobelsdorff-Brenkenhoff, Anna-Katharina Mueller, Marcel Prothmann, Pierre Hennig, Matthias A Dieringer, Luisa Schmacht, Andreas Greiser, Jeanette Schulz-Menger
BACKGROUND: Continuous pressure overload may lead to subclinical myocardial tissue changes in patients with hypertensive heart disease (HHD) and aortic stenosis (AS). The study aim was to detect interstitial fibrosis using quantitative cardiovascular magnetic resonance. METHODS: Fifteen patients with HHD (arterial hypertension + septal wall thickness ≥13 mm), 33 with AS (eight mild, 15 moderate, 10 severe), and 60 healthy controls were enrolled. Native T1 maps (modified Look-Locker inversion recovery) were obtained in a basal, mid-ventricular, and apical shortaxis slice of the left ventricle to assess cardiac fibrosis...
September 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28224928/impact-of-right-ventricular-function-on-outcome-of-severe-aortic-stenosis-patients-undergoing-transcatheter-aortic-valve-replacement
#20
Edward Koifman, Romain Didier, Nirav Patel, Zack Jerusalem, Sarkis Kiramijyan, Itsik Ben-Dor, Smita I Negi, Zuyue Wang, Steven A Goldstein, Michael J Lipinski, Rebecca Torguson, Jiaxiang Gai, Augusto D Pichard, Lowell F Satler, Ron Waksman, Federico M Asch
BACKGROUND: Right ventricular (RV) dysfunction was shown to be associated with adverse outcomes in a variety of cardiac patients and is considered a risk factor for adverse outcome according to the updated Valve Academic Research Consortium criteria. OBJECTIVE: Our goal was to assess the impact of RV function at baseline on 1-year mortality among patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). METHODS: All patients with severe AS treated with TAVR from May 2007 to March 2015 at our center were included in the present study, and baseline and procedural characteristics were recorded for each patient...
February 2017: American Heart Journal
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