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Moderate aortic stenosis

Lorenzo Conte, Iacopo Fabiani, Nicola R Pugliese, Cristina Giannini, Salvatore La Carruba, Marco Angelillis, Paolo Spontoni, Marco De Carlo, Anna Sonia Petronio, Vitantonio Di Bello
OBJECTIVES: Assessment of the prognostic role of left ventricular stiffness (LVS) in patients with aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS: We performed a complete two-dimensional transthoracic echocardiographic study before and after TAVI in patients with severe AS at high surgical risk. In order to assess LVS, we measured LV end-diastolic pressure (EDP) invasively during TAVI and LV end-diastolic volume (EDV) by means of echocardiography...
October 25, 2016: Echocardiography
Jan-Malte Sinning, Anna Sonia Petronio, Nicolas Van Mieghem, Giulio Zucchelli, Georg Nickenig, Raffi Bekeredjian, Johan Bosmans, Francesco Bedogni, Marian Branny, Karl Stangl, Jan Kovac, Anna Nordell, Molly Schiltgen, Nicolo Piazza, Peter de Jaegere
Best practices for transcatheter aortic valve implantation with CoreValve include patient screening and valve size selection using multislice computed tomography, adherence to manufacturer recommendations for oversizing, control of implant depth to 6 mm or less, and management of conduction disturbances according to international guidelines. The ADVANCE II study implemented these strategies and demonstrated their relation to clinical outcomes. From October 2011 to April 2013, 200 patients with severe aortic stenosis were enrolled, and 194 were implanted...
September 30, 2016: American Journal of Cardiology
Neeraj Awasthy, Ria Garg, S Radhakrishnan, Savitri Shrivastava
: Balloon aortic valvuloplasty (BAV) is a well accepted modality of treatment in congenital aortic stenosis in all age groups. Although in infants and children it is the modality of choice, in adolescents and young adults, it is of debatable efficacy. AIM: To evaluate long-term results of aortic valvuloplasty particularly in adolescent and adults (>12 years) and compare the outcome in other age groups that are <1 year and between 1 are 11 years. SETTING: Tertiary referral center...
September 2016: Indian Heart Journal
Ahmad Masri, Vidyasagar Kalahasti, Lars G Svensson, Eric E Roselli, Douglas Johnston, Donald Hammer, Paul Schoenhagen, Brian P Griffin, Milind Y Desai
BACKGROUND: -In patients with a dilated proximal ascending aorta and trileaflet aortic valve (TAV), we sought to assess a) factors independently associated with increased long-term mortality and b) the incremental prognostic utility of indexing aortic root to patient height. METHODS: -We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003-2007...
October 21, 2016: Circulation
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Pingjin Gao, Dingliang Zhu
OBJECTIVE: Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). We hereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population...
September 2016: Journal of Hypertension
J J Jiang, H K Qing, X M Zhang, X M Zhang, W Li, C Y Shen, Q L Li, Y Jiao
OBJECTIVE: To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. METHODS: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People's Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Lorin Arie Schwartz, Zach Rozenbaum, Ehab Ghantous, Judith Kramarz, Simon Biner, Michael Ghermezi, Jason Shimiaie, Ariel Finkelstein, Shmuel Banai, Galit Aviram, Meirav Ingbir, Gad Keren, Yan Topilsky
BACKGROUND: Right ventricular (RV) dysfunction and tricuspid regurgitation (TR) may coexist with aortic stenosis. The aim of this study was to assess the association between RV dysfunction, TR, associated comorbidities, and outcomes following transcatheter aortic valve replacement (TAVR). METHODS: A retrospective analysis was conducted of baseline and 6-month clinical and echocardiographic parameters, including TR grade, RV size (grade, end-diastolic and end-systolic areas, annular diameter), and function (grade, tricuspid annular plane systolic excursion [TAPSE], fractional area change, Tei index), in 519 consecutive TAVR patients...
October 11, 2016: Journal of the American Society of Echocardiography
Moshe Bronshtein, Zeev Blumenfeld, Asaad Choury, Ayala Gover
OBJECTIVES: To assess the natural history and outcome of fetal pulmonary stenosis [PS] detected at 14 to 16 weeks gestation. METHODS: This is a retrospective study, in the years 2004-2015, with serial follow up during pregnancy. Patients referred for complete early fetal ultrasound including all fetal systems and a fetal echocardiogram. Ninety seven percent of the women were low risk, and 3% had risk factors such as maternal type 1 diabetes mellitus, exposure to teratogenic drugs or anomalies in previous pregnancies or in other family members...
October 14, 2016: Ultrasound in Obstetrics & Gynecology
Stephan Kische, Giuseppe D'Ancona, Hüseyin U Agma, Gihan El-Achkar, Martin Dißmann, Jasmin Ortak, Hüseyin Ince
OBJECTIVES: To analyze our single center experience with the Direct Flow Medical (DFM). BACKGROUND: The DFM has been recently introduced to the market and large real world experiences are lacking. METHODS: A total of 126 patients with severe aortic valve stenosis (AVS) were treated by the same team from March 2013 to May 2015. Device success and procedural safety were classified, according to valve academic research consortium (VARC) criteria, for the entire cohort, including patients treated in the early phases of our learning curve...
October 14, 2016: Catheterization and Cardiovascular Interventions
Stefan Orwat, Gerhard-Paul Diller, Iris M van Hagen, Renate Schmidt, Daniel Tobler, Matthias Greutmann, Regina Jonkaitiene, Amro Elnagar, Mark R Johnson, Roger Hall, Jolien W Roos-Hesselink, Helmut Baumgartner
BACKGROUND: Controversial results on maternal risk and fetal outcome have been reported in women with aortic stenosis (AS). OBJECTIVES: The authors sought to investigate maternal and fetal outcomes in patients with AS in a large cohort. METHODS: The Registry on Pregnancy and Cardiac Disease (ROPAC) is a global, prospective observational registry of women with structural heart disease, providing a uniquely large study population. Data of women with moderate (peak gradient 36 to 63 mm Hg) and severe AS (peak gradient ≥64 mm Hg) were analyzed...
October 18, 2016: Journal of the American College of Cardiology
Yigal Abramowitz, Hasan Jilaihawi, Tarun Chakravarty, Yoshio Maeno, Hiroyuki Kawamori, Yoshio Kazuno, Geeteshwar Mangat, Tanya Rami, Zev Allison, David Anderson, Larry Chan, Wen Cheng, Raj R Makkar
OBJECTIVES: Aortic valve preparation with balloon aortic valvuloplasty (BAV) has been previously considered mandatory during transcatheter aortic valve implantation (TAVI) procedures. BAV-inherent risks including stroke, conduction abnormalities, and reduced device profile size established the rationale for safe valve deployment without the need for aggressive valve preparation. We investigate the feasibility and safety of performing Sapien 3 (S3; Edwards Lifesciences) balloon-expandable TAVI with moderate or without predilation (PD)...
October 2016: Journal of Invasive Cardiology
Tolga Han Efe, Kadriye Gayretli Yayla, Cagri Yayla, Ahmet Goktug Ertem, Tolga Cimen, Hilal Erken Pamukcu, Murat Bilgin, Mehmet Erat, Mehmet Dogan, Ekrem Yeter
INTRODUCTION: Calcific aortic valve disease, a chronic progressive disorder, is the leading cause of valve replacement among elderly patients. The lymphocyte/monocyte ratio has been recently put forward as an inflammatory marker of relevance in several cancers as well as in cardiovascular disease. This study aims to assess the correlation between severity of calcific aortic stenosis and the lymphocyte/monocyte ratio. METHODS: The study retrospectively included 178 patients with a diagnosis of calcific aortic stenosis and 139 age- and gender-matched controls...
September 30, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Reed A Siemieniuk, Thomas Agoritsas, Veena Manja, Tahira Devji, Yaping Chang, Malgorzata M Bala, Lehana Thabane, Gordon H Guyatt
OBJECTIVE:  To examine the effect of transcatheter aortic valve implantation (TAVI) versus surgical replacement of an aortic valve (SAVR) in patients with severe aortic stenosis at low and intermediate risk of perioperative death. DESIGN:  Systematic review and meta-analysis DATA SOURCES:  Medline, Embase, and Cochrane CENTRAL. STUDY SELECTION:  Randomized trials of TAVI compared with SAVR in patients with a mean perioperative risk of death <8%...
September 28, 2016: BMJ: British Medical Journal
Inger Njølstad, Ellisiv B Mathiesen, Henrik Schirmer, Dag Steinar Thelle
The rapid increase of coronary heart disease mortality in Northern Norway during 1951-1970 was why the newly established University of Tromsø decided to start a study to identify major operating cardiovascular risk factors. The first Tromsø survey in 1974 suggested that the relatively high cardiovascular mortality was associated with elevated cholesterol levels and high prevalence of smoking, while high-density-lipoprotein-cholesterol (HDL-C) was identified as a preventive factor. After 1974, six more surveys including both genders (aged 20 to 89 years) were undertaken...
September 21, 2016: Scandinavian Cardiovascular Journal: SCJ
Patrick M Sullivan, Agustin E Rubio, Troy A Johnston, Thomas K Jones
OBJECTIVES: To describe long-term risk of mortality, aortic insufficiency (AI), and re-intervention following balloon aortic valvuloplasty (BAV) in pediatric patients and to identify risk factors for re-intervention. BACKGROUND: Few studies report long-term outcomes following BAV in infants and children. METHODS: Kaplan-Meier estimates and proportional hazards regression were used in a retrospective study of 154 patients undergoing BAV from 1993 to 2013...
September 21, 2016: Catheterization and Cardiovascular Interventions
Mustafa Zungur, Ilker Gul, Ahmet Tastan, Ertan Damar, Talat Tavli
BACKGROUND/AIMS: The Mehran risk score (MS) was adopted to predict the development of contrast-induced nephropathy (CIN) and includes clinical and procedural variables. In this study, we aimed to evaluate the value of MS in the prediction of CIN development after transcatheter aortic valve implantation (TAVI). METHODS: Ninety-three patients (47 females; mean age, 77.2 ± 7.6 years) who underwent aortic valve replacement with TAVI for severe aortic stenosis in our center between June 2013 and November 2014 were included in the study...
August 2016: Cardiorenal Medicine
Yan Wang, Jin Zhang, Yuesheng Qian, Xiaofeng Tang, Huawei Ling, Kemin Chen, Pingjin Gao, Dingliang Zhu
OBJECTIVE: Intracranial arterial stenosis (ICAS) is a common cause of ischemic stroke in Asians, whereas whites tend to have more extracranial lesions. Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been associated with ischemic stroke by a large amount of work. However, there are few studies focusing on the relationship of Lp-PLA2 and asymptomatic ICAS or extracranial arterial stenosis (ECAS). We hereby sought to explore the relationship of Lp-PLA2 and ICAS, ECAS and concurrent stenosis in stroke-free hypertensive patients in Chinese population...
September 2016: Journal of Hypertension
Tetsuo Yamanaka, Toru Fukatsu, Yoshimaro Ichinohe, Hirotaka Komatsu, Masahiro Seki, Kenichi Sasaki, Hideaki Takai, Takashi Kunihara, Yasunobu Hirata
We herein report an adult case of unicommissural unicuspid aortic valve (UAV). A 59-year-old man, who was noted to have a cardiac murmur at 31 years of age, was admitted to our hospital due to acute heart failure. Severe calcification in the aortic valve with severe low-flow/low-gradient aortic stenosis and moderate aortic regurgitation was observed and thought to be the cause of heart failure, however, the etiology of aortic valve dysfunction was not clear. Aortic valve replacement was subsequently performed, and unicommissural UAV was diagnosed according to the intraoperative findings...
2016: Internal Medicine
Chance M Witt, Gang Wu, Dachun Yang, David O Hodge, Veronique L Roger, Yong-Mei Cha
OBJECTIVES: This study aimed to define the prognosis for patients with left bundle branch block (LBBB) and a mildly to moderately reduced left ventricular ejection fraction (LVEF) (36% to 50%) as well as to clarify whether LBBB remained a negative prognostic marker in this group. BACKGROUND: LBBB is associated with worse outcomes in patients with heart failure in the setting of severely reduced LVEF. The level of morbidity and mortality associated with LBBB in the setting of a mildly to moderately reduced LVEF (36% to 50%) has not been clearly characterized...
August 28, 2016: JACC. Heart Failure
Birgid Gonska, Julia Seeger, Justus Baarts, Christoph Rodewald, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual paravalvular moderate or severe aortic regurgitation (AR) has been an independent risk factor for mortality after transcatheter aortic valve implantation (TAVI). The design of the third generation Edwards Sapien 3 (ES3; Edwards Lifesciences, Irvine, CA, USA) valve was optimized with an outer skirt to address the issue of paravalvular AR. METHODS AND RESULTS: We compared 100 consecutive patients treated with the ES3 for severe aortic stenosis with 100 patients treated with the Medtronic CoreValve (CV; Medtronic, Minneapolis, MN, USA) (Clinical Trial Registration: NCT02162069)...
September 7, 2016: Journal of Cardiology
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