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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/29327146/mid-term-outcome-of-100-consecutive-ross-procedures-excellent-survival-but-yet-to-be-a-cure
#1
Corina Zimmermann, Christine Attenhofer Jost, René Prêtre, Christoph Mueller, Matthias Greutmann, Burkhardt Seifert, Emanuela Valsangiacomo Büchel, Oliver Kretschmar, Hitendu Hasmukhlal Dave, Roland Weber
The Ross procedure offers excellent short-term outcome but the long-term durability is under debate. Reinterventions and follow-up of 100 consecutive patients undergoing Ross Procedure at our centre (1993-2011) were analysed. Follow-up was available for 96 patients (97%) with a median duration of 5.3 (0.1-17.1) years. Median age of the patient cohort was 15.2 (0.04-58.4) years with 76 males. 93% had underlying congenital aortic stenosis. Root replacement technique was applied in all. The most common valved conduits used for reconstruction of the right ventricular outflow tract were homografts (66 patients) and bovine jugular vein (ContegraR) graft (31 patients)...
January 12, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29315371/computed-tomography-characteristics-of-the-aortic-valve-and-the-geometry-of-sapien-3-transcatheter-heart-valve-in-patients-with-bicuspid-aortic-valve-disease
#2
Hiroyuki Kawamori, Sung-Han Yoon, Tarun Chakravarty, Yoshio Maeno, Mohammad Kashif, Sharjeel Israr, Yigal Abramowitz, Geeteshwar Mangat, Masaki Miyasaka, Tanya Rami, Yoshio Kazuno, Nobuyuki Takahashi, Hasan Jilaihawi, Mamoo Nakamura, Wen Cheng, John Friedman, Daniel Berman, Rahul Sharma, Raj R Makkar
Aims: We assessed the geometry of transcatheter heart valve (THV) and valve function associated with SAPIEN 3 implantation in patients with bicuspid aortic valve (BAV) stenosis. Methods and results: We included 280 consecutive patients who had a contrast computed tomography (CT) before and after transcatheter aortic valve implantation (TAVI) in our institution. Each THV was assessed by CT at five cross-sectional levels: inflow, annulus, mid, sinus, and outflow. The geometry of THV was assessed for eccentricity (1 - minimum diameter/maximum diameter) and expansion (CT derived external valve area/nominal external valve area)...
January 5, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29311499/transcatheter-aortic-valve-implantation-tavi-for-native-aortic-valve-regurgitation%C3%A3-a-systematic-review
#3
Altayyeb Yousef, Zachary MacDonald, Trevor Simard, Juan J Russo, Joshua Feder, Michael V Froeschl, Alexander Dick, Christopher Glover, Ian G Burwash, Azeem Latib, Josep Rodés-Cabau, Marino Labinaz, Benjamin Hibbert
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has become the standard of care for management of high-risk patients with aortic stenosis. Limited data is available regarding the performance of TAVI in patients with native aortic valve regurgitation (NAVR).Methods and Results:We performed a systematic review from 2002 to 2016. The primary outcome was device success as per VARC-2 criteria. Secondary endpoints included procedural complications, and 30-day and 1-year mortality rates...
December 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29307159/calculation-of-mitral-valve-area-in-mitral-stenosis-comparison-of-continuity-equation-and-pressure-half-time-with-two-dimensional-planimetry-in-patients-with-and-without-associated-aortic-or-mitral-regurgitation-or-atrial-fibrillation
#4
Roya Sattarzadeh, Anahita Tavoosi, Mohammad Saadat, Leila Derakhshan, Bakhtyar Khosravi, Babak Geraiely
Accurate measurement of Mitral Valve Area (MVA) is essential to determining the Mitral Stenosis (MS) severity and to achieving the best management strategies for this disease. The goal of the present study is to compare mitral valve area (MVA) measurement by Continuity Equation (CE) and Pressure Half-Time (PHT) methods with that of 2D-Planimetry (PL) in patients with moderate to severe mitral stenosis (MS). This comparison also was performed in subgroups of patients with significant Aortic Insufficiency (AI), Mitral Regurgitation (MR) and Atrial Fibrillation (AF)...
November 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29301644/sex-specific-outcomes-of-transcatheter%C3%A2-aortic-valve-replacement-with-the-sapien-3-valve-insights-from-the-partner-ii-s3-high-risk-and-intermediate-risk-cohorts
#5
Molly Szerlip, Sarah Gualano, Elizabeth Holper, John J Squiers, Jonathon M White, Darshan Doshi, Mathew R Williams, Rebecca T Hahn, John G Webb, Lars G Svensson, Ajay J Kirtane, David J Cohen, Pamela S Douglas, Maria C Alu, Aaron Crowley, E Murat Tuzcu, Raj R Makkar, Howard C Herrmann, Vasilis Babaliaros, Vinod H Thourani, Martin B Leon, Susheel K Kodali, Michael J Mack
OBJECTIVES: The purpose of this study was to identify sex-specific outcomes of intermediate risk patients undergoing transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: A survival difference has been observed in women as compared with men in inoperable and high-risk patients receiving early-generation balloon-expandable valves for transcatheter aortic valve replacement (TAVR). Whether a sex-specific outcome difference persists with newer-generation valves and in lower-risk patients is unknown...
January 8, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#6
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29288661/wall-stress-and-geometry-of-the-thoracic-aorta-in-patients-with-aortic-valve-disease
#7
Barry J Doyle, Paul E Norman, Peter R Hoskins, David E Newby, Marc R Dweck
BACKGROUND: Aortic valve disease increases velocity and changes the way blood enters the aorta. Over time, the biomechanical environment can cause aortic remodelling. We hypothesised that aortic geometry and wall stress would be different in patients with aortic valve disease compared to controls. METHODS: We examined 40 patients with aortic sclerosis (n=10), mild (n=10), moderate (n=10) and severe (n=10) aortic stenosis, and also 10 control cases. The thoracic aorta of each case was reconstructed into a three-dimensional model from computed tomography...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29279525/planimetry-of-the-orifice-area-in-aortic-valve-stenosis-using-phase-contrast-cardiac-magnetic-resonance-imaging
#8
Hajime Abe, Nobuo Iguchi, Yuko Utanohara, Kaori Takada, Yasuki Hen, Haruhiko Machida, Norihiko Takeda, Tetsuya Sumiyoshi
Manual planimetry is a well-established method using transesophageal echocardiography (TEE) to assess the severity of aortic stenosis (AS). TEE, however, is a less than optimal approach in patients with calcified valves. Even when using cine-cardiac magnetic resonance (CMR), it is often difficult to evaluate the true border of the aortic orifice because of jet turbulence. With phase-contrast sequences of CMR, high flow signals at the aortic orifice can be clearly visualized, even in cases with severe calcification and jet turbulence...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#9
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29248646/symptom-onset-in-aortic-stenosis-relation-to-sex-differences-in-left-ventricular-remodeling
#10
Anvesha Singh, Daniel C S Chan, John P Greenwood, Dana K Dawson, Piotr Sonecki, Kai Hogrefe, Damian J Kelly, Vijay Dhakshinamurthy, Chim C Lang, Jeffery P Khoo, David Sprigings, Richard P Steeds, Ruiqi Zhang, Ian Ford, Michael Jerosch-Herold, Jing Yang, Zhuyin Li, Leong L Ng, Gerry P McCann
OBJECTIVES: The aim of this study was to establish sex differences in remodeling and outcome in aortic stenosis (AS) and their associations with biomarkers of myocardial fibrosis. BACKGROUND: The remodeling response and timing of symptoms is highly variable in AS, and sex plays an important role. METHODS: A total of 174 patients (133 men, mean age 66.2 ± 13.3 years) with asymptomatic moderate to severe AS underwent comprehensive stress cardiac magnetic resonance imaging, transthoracic echocardiography, and biomarker analysis (matrix metalloproteinase [MMP]-2, -3, -7, -8, and -9; tissue inhibitor matrix metalloproteinases-1 and -4; syndecan-1 and -4; and N-terminal pro-B-type natriuretic peptide), and were followed up at 6-month intervals...
December 8, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29238013/definitive-determinant-of-late-significant-tricuspid-regurgitation-after-aortic-valve-replacement
#11
Shin Yajima, Daisuke Yoshioka, Koichi Toda, Satsuki Fukushima, Shigeru Miyagawa, Yasushi Yoshikawa, Shunsuke Saito, Keitaro Domae, Takayoshi Ueno, Toru Kuratani, Yoshiki Sawa
BACKGROUND: Uncertainties remain regarding the course of existing tricuspid regurgitation (TR) after aortic valve replacement (AVR), and its long-term impact on outcome. We investigated changes in existing TR after isolated AVR for severe aortic stenosis (AS), the impact of preoperative TR on long-term outcome, and predictors of late significant TR.Methods and Results:After excluding mild mitral regurgitation and severe TR, 226 consecutive patients undergoing isolated AVR for severe AS between 2002 and 2015 were reviewed...
December 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29212513/cardiac-amyloidosis-is-prevalent-in-older-patients-with-aortic-stenosis-and-carries-worse-prognosis
#12
João L Cavalcante, Shasank Rijal, Islam Abdelkarim, Andrew D Althouse, Michael S Sharbaugh, Yaron Fridman, Prem Soman, Daniel E Forman, John T Schindler, Thomas G Gleason, Joon S Lee, Erik B Schelbert
BACKGROUND: Non-invasive cardiac imaging allows detection of cardiac amyloidosis (CA) in patients with aortic stenosis (AS). Our objective was to estimate the prevalence of clinically suspected CA in patients with moderate and severe AS referred for cardiovascular magnetic resonance (CMR) in age and gender categories, and assess associations between AS-CA and all-cause mortality. METHODS: We retrospectively identified consecutive AS patients defined by echocardiography referred for further CMR assessment of valvular, myocardial, and aortic disease...
December 7, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/29191731/characteristic-morphologies-of-the-bicuspid-aortic-valve-in-patients-with-genetic-syndromes
#13
Talha Niaz, Joseph T Poterucha, Timothy M Olson, Jonathan N Johnson, Cecilia Craviari, Thomas Nienaber, Jared Palfreeman, Frank Cetta, Donald J Hagler
BACKGROUND: In patients with bicuspid aortic valve (BAV), complications including progressive aortic stenosis and aortic dilatation develop over time. The morphology of cusp fusion is one of the determinants of the type and severity of these complications. We present the association of morphology of cusp fusion in BAV patients with distinctive genetic syndromes. METHODS: The Mayo Clinic echocardiography database was retrospectively reviewed to identify patients (age ≤ 22 years) diagnosed with BAV from 1990 to 2016...
November 28, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29189286/epidural-anesthesia-to-facilitate-organ-blood-flow-during-the-first-penile-transplantation-in-the-united-states-a-case-report
#14
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...
November 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29180457/antihypertensive-treatment-with-%C3%AE-blockade-in-patients-with-asymptomatic-aortic-stenosis-and-association-with-cardiovascular-events
#15
Casper N Bang, Anders M Greve, Anne B Rossebø, Simon Ray, Kenneth Egstrup, Kurt Boman, Christoph Nienaber, Peter M Okin, Richard B Devereux, Kristian Wachtell
BACKGROUND: Patients with aortic stenosis (AS) often have concomitant hypertension. Antihypertensive treatment with a β-blocker (Bbl) is frequently avoided because of fear of depression of left ventricular function. However, it remains unclear whether antihypertensive treatment with a Bbl is associated with increased risk of cardiovascular events in patients with asymptomatic mild to moderate AS. METHODS AND RESULTS: We did a post hoc analysis of 1873 asymptomatic patients with mild to moderate AS and preserved left ventricular ejection fraction in the SEAS (Simvastatin and Ezetimibe in Aortic Stenosis) study...
November 27, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29177882/effect-of-the-natural-cytokine-complex-on-the-structure-and-metabolism-of-contractile-myocardium-normally-and-under-increased-hemodynamic-load
#16
M S Tverskaya, L V Gankovskaya, V V Sukhoparova, A O Virganskii
Effect of natural complex of cytokines with activity of IL-1, IL-2, IL-6, TNF, MIF, GTFβ on the structure and metabolism of contractile ventricular cardiomyocytes was assessed in the control and under conditions of acute experimental aortic stenosis. Systemic administration of the complex in the control had no significant effect on myocardial morphology with low number of damaged cardiomyocytes and low degree of structural damage. Administration of the cytokine complex against the background of aortic stenosis did not exert any additional alterative effect on cardiomyocytes, structural damage of contractual nature was moderate...
November 27, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/29174824/intraprocedural-invasive-hemodynamic-parameters-as-predictors-of-short-and-long-term-outcomes-in-patients-undergoing-transcatheter-aortic-valve-replacement
#17
Sarkis Kiramijyan, Edward Koifman, Marco A Magalhaes, Itsik Ben-Dor, Romain Didier, Zachary D Jerusalem, Sandeep Kumar, Arpi Tavil-Shatelyan, Toby Rogers, Arie Steinvil, Jiaxiang Gai, Rebecca Torguson, Lowell F Satler, Augusto D Pichard, Ron Waksman
OBJECTIVE: Evaluation of invasive hemodynamic parameters as prognostic markers of mortality in patients undergoing TAVR. BACKGROUND: The value of invasive intraprocedural hemodynamic evaluation of patients undergoing transcatheter aortic valve replacement is unclear. METHODS: Consecutive patients who underwent transfemoral TAVR and had complete prospectively collected intraprocedural invasive hemodynamic parameters were retrospectively analyzed...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29167215/mid-aortic-syndrome-secondary-to-takayasu-s-disease
#18
Kai Chun Andrew Cheng, Yan-Lin Li
A 24-year-old young woman with good past health presented with hypertension during body check. Blood erythrocyte sedimentary rate level was elevated. CT and MR angiography revealed moderate stenosis of abdominal aorta and bilaterally renal arteries. She was diagnosed with mid-aortic syndrome caused by Takayasu arteritis based on clinical, radiological and pathological findings. She was treated with abdominal aorta resection, graft replacement and aorta-renal bypass. Pathology was compatible with Takayasu arteritis...
November 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29158019/impact-of-significant-mitral-regurgitation-on-assessing-the-severity-of-aortic-stenosis
#19
Pil Hyung Lee, Jung Ae Hong, Byung Joo Sun, Seungbong Han, Sangwoo Park, Jeong Yoon Jang, Dae-Hee Kim, Duk-Hyun Kang, Jae-Kwan Song, Jong-Min Song
BACKGROUND: Significant mitral regurgitation (MR) may reduce a pressure gradient of aortic stenosis (AS) by decreasing forward stroke volume. The study objective was to evaluate whether significant MR can cause inconsistency when assessing the severity of AS. METHODS: Among 5,355 patients diagnosed with AS from 2000 to 2015, 68 were retrospectively found to have concomitant significant (moderate or greater) MR and normal left ventricular ejection fractions in normal sinus rhythm (AS with MR)...
November 17, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/29153562/noncontrast-myocardial-t1-mapping-by-cardiac-magnetic-resonance-predicts-outcome-in-patients-with-aortic-stenosis
#20
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
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