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Moderate aortic stenosis

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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
#1
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
https://www.readbyqxmd.com/read/28633375/final-5-year-clinical-and-echocardiographic-results-for-treatment-of-severe-aortic-stenosis-with-a-self-expanding-bioprosthesis-from-the-advance-study
#2
Ulrich Gerckens, Corrado Tamburino, Sabine Bleiziffer, Johan Bosmans, Peter Wenaweser, Stephen Brecker, Jia Guo, Axel Linke
Aims: The ADVANCE study was designed to evaluate the safety and effectiveness of transcatheter aortic valve implantation (TAVI) with a self-expanding bioprosthesis in real-world patients with symptomatic, severe aortic stenosis at high surgical risk for valve replacement. Methods and results: Study participants were enrolled from 44 experienced centres in 12 countries. Patient eligibility, treatment approach, and choice of anaesthesia were determined by the local Heart Team...
June 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28629660/characterization-and-risk-factors-for-aortic-dilatation-in-pediatric-patients-with-bicuspid-aortic-valve
#3
Anna Sabaté-Rotés, Laura Sabidó Sanchez, Ferran Gran Ipiña, Dimpna Albert Brotons, Raúl F Abella, Ferran Rosés Noguer
INTRODUCTION AND OBJECTIVES: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. METHODS: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17)...
June 16, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#4
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28611119/turbulent-kinetic-energy-assessed-by-multipoint-4-dimensional-flow-magnetic-resonance-imaging-provides-additional-information-relative-to-echocardiography-for-the-determination-of-aortic-stenosis-severity
#5
Christian Binter, Alexander Gotschy, Simon H Sündermann, Michelle Frank, Felix C Tanner, Thomas F Lüscher, Robert Manka, Sebastian Kozerke
BACKGROUND: Turbulent kinetic energy (TKE), assessed by 4-dimensional (4D) flow magnetic resonance imaging, is a measure of energy loss in disturbed flow as it occurs, for instance, in aortic stenosis (AS). This work investigates the additional information provided by quantifying TKE for the assessment of AS severity in comparison to clinical echocardiographic measures. METHODS AND RESULTS: Fifty-one patients with AS (67±15 years, 20 female) and 10 healthy age-matched controls (69±5 years, 5 female) were prospectively enrolled to undergo multipoint 4D flow magnetic resonance imaging...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28611091/inhibition-of-microrna-146a-and-overexpression-of-its-target-dihydrolipoyl-succinyltransferase-protect-against-pressure-overload-induced-cardiac-hypertrophy-and-dysfunction
#6
Ward A Heggermont, Anna-Pia Papageorgiou, Annelies Quaegebeur, Sophie Deckx, Paolo Carai, Wouter Verhesen, Guy Eelen, Sandra Schoors, Rick van Leeuwen, Sergey Alekseev, Ies Elzenaar, Stefan Vinckier, Peter Pokreisz, Ann-Sophie Walravens, Rik Gijsbers, Chris Van Den Haute, Alexander G Nickel, Blanche Schroen, Marc van Bilsen, Stefan Janssens, Christoph Maack, Yigal M Pinto, Peter Carmeliet, Stephane Heymans
Background -Cardiovascular diseases remain the predominant cause of death worldwide, with the prevalence of heart failure continuing to increase. Despite increased knowledge of the metabolic alterations that occur in heart failure, novel therapies to treat the observed metabolic disturbances are still lacking. Methods -Mice were subjected to pressure overload by means of angiotensin-II infusion or transversal aortic constriction (TAC). MicroRNA-146a was either genetically or pharmacologically knocked out, or genetically overexpressed in cardiomyocytes...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28609808/resection-of-subaortic-membrane-for-discrete-subaortic-stenosis
#7
Sachin Talwar, Abhishek Anand, Saurabh Kumar Gupta, Sivasubramanian Ramakrishnan, Shyam Sunder Kothari, Anita Saxena, Rajnish Juneja, Shiv Kumar Choudhary, Balram Airan
BACKGROUND: We reviewed the long-term results of surgery for discrete subaortic membrane (SubAM) from a single institute. METHODS: A retrospective review of medical records of all patients (n = 146) who underwent resection of a SubAM for discrete subaortic stenosis between 1990 and 2015 at the All India Institute of Medical Sciences, New Delhi, India was undertaken. RESULTS: Median age at surgery was 9.0 years (9 months-47 years). There was one early death...
June 13, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#8
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28605423/source-3-1-year-outcomes-post-transcatheter-aortic-valve-implantation-using-the-latest-generation-of-the-balloon-expandable-transcatheter-heart-valve
#9
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Franz-Josef Neumann, Giuseppe Tarantini, José Luis Zamorano, Alec Vahanian
Aims: Transcatheter aortic valve implantation (TAVI) has developed from a procedure for patients with aortic stenosis inoperable or high risk for surgery, into a treatment option even for intermediate risk elderly patients. This development has been facilitated by the clinical learning curve and constant improvements of transcatheter heart valves used. We present total 1-year results of SOURCE 3, the European post-approval multicentre registry of the latest generation balloon expandable SAPIEN 3TM (Edwards Lifesciences, Irvine, CA, USA)...
June 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28599977/fate-of-remnant-sinuses-of-valsalva-in-patients-with-bicuspid-and-trileaflet-valves-undergoing-aortic-valve-ascending-aorta-and-aortic-arch-replacement
#10
Rita Karianna Milewski, Andreas Habertheuer, Joseph E Bavaria, Mary Siki, Wilson Y Szeto, Eric Krause, Varun Korutla, Nimesh D Desai, Prashanth Vallabhajosyula
OBJECTIVE: In patients presenting with aortic valvulopathy with concomitant ascending aortic aneurysm, surgical management of the sinus of Valsalva segment remains undefined, especially for moderately dilated aortic roots. In patients with this pathology undergoing aortic valve replacement with supracoronary ascending aorta replacement, we assessed the fate of the remnant preserved sinus of Valsalva segment stratified by aortic valve morphology and pathology. METHODS: From 2002 to 2015, 428 patients underwent elective aortic valve replacement with supracoronary ascending aorta replacement...
April 28, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28599694/a-multiparous-woman-with-lately-diagnosed-multilevel-left-ventricular-obstruction
#11
Muhammad Nasir Rahman, Ibrahim Gul, Amjad Nabi
A 56-year hypertensive, multiparous woman presented to the cardiology unit with Canadian Cardiovascular Society (CCS) class-III angina and worsening dyspnea for the past few weeks. Her clinical examination showed high blood pressure and mid-systolic crescendo-decrescendo murmur radiating to carotids. However, there was no radio-femoral delay or significant blood pressure difference between her arms. Her transthoracic echocardiography (TTE) revealed moderate aortic stenosis (AS) and mid cavity left ventricular outflow (LVO) obstruction...
May 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28589708/modified-continuity-equation-using-left-ventricular-outflow-tract-three-dimensional-imaging-for-aortic-valve-area-estimation
#12
Pedro Pinto Teixeira, Ruben Ramos, Pedro Rio, Luísa Moura Branco, Guilherme Portugal, Ana Abreu, Ana Galrinho, Hugo Marques, Luísa Figueiredo, Rui Cruz Ferreira
PURPOSE: Aortic valve area (AVA) is usually estimated by the continuity equation (CE) in which the left ventricular outflow tract (LVOT) area is calculated assuming a circular shape. This study aimed to compare measurements of LVOT area using standard 2D transthoracic echocardiography (2DTTE), 3D transesophageal echocardiography (3DTEE), and multidetector computed tomography (MDCT) and assess their relative impact on AVA estimated by the CE. METHODS AND RESULTS: We prospectively enrolled 60 patients with severe aortic stenosis (AS) referred for transcatheter aortic valve replacement (TAVR) who systematically underwent 2DTTE, 3DTEE, and MDCT...
June 7, 2017: Echocardiography
https://www.readbyqxmd.com/read/28582580/transaortic-transcatheter-aortic-valve-implantation-using-sapien-xt-or-sapien-3-valves-in-the-route-registry%C3%A2
#13
Mauro Romano, Derk Frank, Riccardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Cornelia Deutsch, Peter Bramlage, Martin Thoenes, Vinayak Bapat
OBJECTIVES: Transaortic (TAo) access for transcatheter aortic valve implantation (TAVI) is an alternative to the conventional transfemoral or transapical routes. Data comparing the characteristics and outcomes of TAo-TAVI using the SAPIEN XT and SAPIEN 3 heart valves are scarce. The objective of the current analysis was to provide such information. METHODS: ROUTE is an international, prospective, observational registry. Patients with severe calcific aortic stenosis scheduled for TAo-TAVI with an Edwards SAPIEN XT or a SAPIEN 3 heart valve were consecutively enrolled at 22 centres across Europe between February 2013 and February 2015...
June 5, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28582434/asymptomatic-aortic-stenosis-an-assessment-of-patients-and-of-their-general-practitioners-knowledge-after-an-indexed-specialized-assessment-in-community-practice
#14
Raphaëlle-Ashley Guerbaii, Gabriel Fustier, Pierre-Vladimir Ennezat, Anne Ringle, Camille Trouillet, Pierre Graux, André Vincentelli, Christophe Tribouilloy, Sylvestre Maréchaux
BACKGROUND: Clinical and echocardiography follow-up is recommended in patients with aortic stenosis to detect symptom onset, thus a watchful waiting approach has to be safe and effective. For both AS patients and their general practitioners, evaluation of valvular heart disease (VHD) knowledge, after the indexed specialized assessment has never been measured. AIMS: To evaluate the knowledge of clinical symptoms of aortic stenosis by both patients and their general practitioner...
2017: PloS One
https://www.readbyqxmd.com/read/28570236/transcatheter-aortic-valve-replacement-versus-surgical-valve-replacement-in-low-intermediate-surgical-risk-patients-a-systematic-review-and-meta-analysis
#15
Aakash Garg, Sunil V Rao, Gautam Visveswaran, Sahil Agrawal, Abhishek Sharma, Lohit Garg, Indrajeet Mahata, Jalaj Garg, Dinesh Singal, Marc Cohen, John B Kostis
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a viable alternative to surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (SAS) who are at high risk for surgery. We sought to evaluate the outcomes of TAVR vs SAVR in low-intermediate risk patients with SAS. METHODS AND RESULTS: We performed random-effects meta-analysis of randomized controlled trials (RCTs) and propensity-matched observational studies comparing TAVR vs SAVR for low-intermediate risk patients...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28569053/pathology-of-balloon-expandable-transcatheter-aortic-valves
#16
Kazuyuki Yahagi, Elena Ladich, Robert Kutys, Hiroyoshi Mori, Lars G Svensson, Michael J Mack, Howard C Herrmann, Craig R Smith, Martin B Leon, Renu Virmani, Aloke V Finn
BACKGROUND: The Placement of AoRtic TraNscathetER Valves trials (PARTNER) showed favorable safety and efficacy versus medical or surgical therapy in inoperable, high, and intermediate surgical risk patients with severe aortic stenosis. However, the biological responses to transcatheter aortic valves have not been well characterized. OBJECTIVES: The aim of this study was to perform pathologic assessment of Edwards SAPIEN transcatheter aortic valves removed either at autopsy or surgically during the PARTNER I and II clinical trials...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28560501/relationship-of-bone-mineral-density-with-valvular-and-annular-calcification-in-community-dwelling-older-people-the-cardiovascular-health-study
#17
Daniele Massera, Shuo Xu, Traci M Bartz, Anna E Bortnick, Joachim H Ix, Michel Chonchol, David S Owens, Eddy Barasch, Julius M Gardin, John S Gottdiener, John R Robbins, David S Siscovick, Jorge R Kizer
Associations between bone mineral density and aortic valvular, aortic annular, and mitral annular calcification were investigated in a cross-sectional analysis of a population-based cohort of 1497 older adults. Although there was no association between continuous bone mineral density and outcomes, a significant association between osteoporosis and aortic valvular calcification in men was found. INTRODUCTION: The process of cardiac calcification bears a resemblance to skeletal bone metabolism and its regulation...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28555592/repositionable-percutaneous-aortic-valve-implantation-with-the-lotus-valve-30-day-and-1-year-outcomes-in-250-high-risk-surgical-patients
#18
Ian T Meredith, Nicolas Dumonteil, Daniel J Blackman, Didier Tchétché, Darren L Walters, David Hildick-Smith, Ganesh Manoharan, Jan Harnek, Stephen G Worthley, Gilles Rioufol, Thierry Lefèvre, Thomas Modine, Nicolas M Van Mieghem, Ted Feldman, Dominic J Allocco, Keith D Dawkins
AIMS: The REPRISE IIE trial evaluated outcomes following transcatheter aortic valve implantation of the fully repositionable and retrievable Lotus Valve with a unique seal designed to minimize paravalvular leak (PVL). METHODS AND RESULTS: This prospective, multicentre study enrolled 250 patients with severe aortic stenosis considered high-risk for surgery by a multidisciplinary Heart Team. An independent Clinical Events Committee adjudicated events per Valve Academic Research Consortium criteria...
May 30, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28552098/cardiopulmonary-exercise-testing-in-aortic-stenosis
#19
Van Doan Tuyet Le
Patients with moderate to severe aortic stenosis (AVA <1.3 cm(2)) who were judged, by a referring cardiologist, as asymptomatic or equivocal symptomatic from the aortic stenosis were included in the study. Patients with left ventricular ejection fraction <50% were not included. Twenty-nine percent of the referred patients were judged asymptomatic and 71% equivocal symptomatic from their valve disease. The mean age was 72 years and 90% of the patients had an AVA-index <0.6 cm(2)/m(2). By clinical evaluation in the outpatient clinic, 48% were judged as having functional limitation corresponding to NYHA≥II...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28550588/value-of-ct-signs-and-measurements-as-a-predictor-of-pulmonary-hypertension-and-mortality-in-symptomatic-severe-aortic-valve-stenosis
#20
Matthias Eberhard, Monika Mastalerz, Jovana Pavicevic, Thomas Frauenfelder, Fabian Nietlispach, Francesco Maisano, Felix C Tanner, Thi Dan Linh Nguyen-Kim
To assess the value of computed tomography (CT) for non-invasive detection of pulmonary hypertension (PH) in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI) and to correlate CT measurements and signs with mortality after TAVI. 257 TAVI patients (median 84 years; 134 females) with both right heart catheterisation (RHC) and CT within 3 days were retrospectively analyzed. According to guidelines PH was defined as mean pulmonary artery pressure ≥25 mmHg in RHC. CT-signs for PH assessment were evaluated...
May 26, 2017: International Journal of Cardiovascular Imaging
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