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Moderate aortic stenosis

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https://www.readbyqxmd.com/read/28415120/p1088match-and-mismatch-between-opening-area-and-resistance-in-mild-and-moderate-rheumatic-mitral-stenosis
#1
I El-Dosouky
Background: Mitral valve resistance (MVR) is a hemodynamic consequence of mitral stenosis but it has no clear threshold and it has a shortage of data to be reliable. Purpose: is to investigate match and mismatch between opening area and resistance especially in patients with moderate and mild mitral stenosis. Materials: This cross section case control study comprised 88 patients with moderate and mild rheumatic mitral stenosis. Transthorathic echocardiographic study estimated: mitral valve area (MVA) both by planimerty (2D) and pressure half time (PHT), mitral valve score (MVS), mean transmitral pressure gradient (MPG), diastolic filling time(DFT), left ventricular out flow tract diameter (LVOTd) and velocity time integral (LVOT vti) , the MVR was calculated as: MPG/aortic flow ratio [(LVOTd) (LVOTvti)/ DFT] in dynes...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415115/p981lvot-area-measurement-using-gated-ct-data-reclassifies-aortic-stenosis-severity-as-graded-by-echocardiography
#2
L Moderato, A Palumbo, S Coli, D Orlandini, G Russo, N Gaibazzi
Background: Measurement of left ventricular outflow tract (LVOT) diameter and area for estimation of aortic valve area (AVA) using transthoracic echocardiography (TTE) and the continuity equation assumes circular LVOT. The use of direct planimetric measurement of LVOT area by gated-CT can theoretically improve accuracy of AVA calculation. Purpose: We aim to assess reproducibility of LVOT echo measurement and its correlation and agreement with Gated CT measurements...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28415097/p544the-importance-of-contractile-reserve-when-assessing-asymptomatic-patients-with-aortic-stenosis
#3
J J Van Zalen, S Badiani, L Hart, A Marshall, N Patel, G Lloyd
Asymptomatic patients may exhibit symptoms during objective exercise testing, but whether symptoms are due to the obstructively of the valve (typified by the mean gradient) or underlying ventricular function remains unknown. While the mean gradient is an easy parameter to measure no consensus about the measurement of contractile reserve exists. Longitudinal abnormalities may occur in the presence of a normal ejection fraction and the augmentation of these parameters is poorly described. To obtain an objective regarding patients exercise ability is best determined using cardiopulmonary exercise testing...
December 1, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28411747/the-impact-of-carotid-or-intracranial-atherosclerosis-on-perioperative-stroke-in-patients-undergoing-open-aortic-arch-surgery
#4
Ken-Ichi Imasaka, Eiki Tayama, Yukihiro Tomita
OBJECTIVES: This study aimed to clarify the impact of carotid or intracranial atherosclerosis on perioperative stroke in patients undergoing open aortic arch surgery. METHODS: Between 2008 and 2015, 200 consecutive patients underwent elective aortic arch surgery with selective antegrade cerebral perfusion and moderate hypothermic circulatory arrest. Nonselective screening for carotid or intracranial atherosclerosis was performed using carotid ultrasonography or magnetic resonance angiography...
May 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28398671/transcatheter-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-evidence-from-a-meta-analysis
#5
Partha Sardar, Amartya Kundu, Saurav Chatterjee, Dmitriy N Feldman, Theophilus Owan, Nikolaos Kakouros, Ramez Nairooz, Linda A Pape, Ted Feldman, J Dawn Abbott, Sammy Elmariah
OBJECTIVES: We performed a meta-analysis to evaluate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in comparison to surgical aortic valve replacement (SAVR) in intermediate-risk patients. BACKGROUND: TAVR is an established treatment option in high-risk patients with severe aortic valve stenosis (AS). There are fewer data regarding efficacy of TAVR in intermediate-risk patients. METHODS: Databases were searched through April 30, 2016 for studies that compared TAVR with SAVR for the treatment of intermediate-risk patients with severe AS...
April 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28396860/aortic-valve-replacement-for-moderate-aortic-stenosis-with-severe-calcification-and-left-ventricualr-dysfunction-a-case-report-and-review-of-the-literature
#6
Nikhil Narang, Roberto M Lang, Vladimir M Liarski, Valluvan Jeevanandam, Marion A Hofmann Bowman
A 55-year-old man with a history of erosive, seropositive rheumatoid arthritis (RA), and interstitial lung disease presented with shortness of breath. Echocardiography showed new-onset severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 15% and moderately increased mean aortic valve gradient of 20 mmHg in a trileaflet aortic valve with severe sclero-calcific degeneration. Coronary angiography revealed no significant obstructive coronary disease. Invasive hemodynamic studies and dobutamine stress echocardiography were consistent with moderate aortic stenosis...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28395958/relationship-between-exercise-pressure-gradient-and-haemodynamic-progression-of-aortic-stenosis
#7
Anne Ringle, Franck Levy, Pierre-Vladimir Ennezat, Caroline Le Goffic, Anne-Laure Castel, François Delelis, Aymeric Menet, Dorothée Malaquin, Pierre Graux, André Vincentelli, Christophe Tribouilloy, Sylvestre Maréchaux
BACKGROUND AND AIMS: We hypothesized that large exercise-induced increases in aortic mean pressure gradient can predict haemodynamic progression during follow-up in asymptomatic patients with aortic stenosis. METHODS: We retrospectively identified patients with asymptomatic moderate or severe aortic stenosis (aortic valve area<1.5cm(2) or<1cm(2)) and normal ejection fraction, who underwent an exercise stress echocardiography at baseline with a normal exercise test and a resting echocardiography during follow-up...
April 7, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28377231/prevalence-and-impact-of-coexistent-bicuspid-aortic-valve-in-hypertrophic-cardiomyopathy
#8
Ratnasari Padang, Bernard J Gersh, Steve R Ommen, Jeffrey B Geske
BACKGROUND: The association between bicuspid aortic valve (BAV) and hypertrophic cardiomyopathy (HCM) has been reported but its true prevalence is unknown. This study investigated the prevalence and clinical impact of coexistent BAV in a large referral HCM population. METHODS: Retrospective analysis of 3765 echocardiograms between 2004 and 2014 in 2640 consecutive patients with HCM was performed to assess for BAV. Patients with coexistent conditions were studied...
March 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28370410/echocardiographic-assessment-of-pediatric-semilunar-valve-disease
#9
REVIEW
Massimiliano Cantinotti, Raffaele Giordano, Michele Emdin, Nadia Assanta, Maura Crocetti, Marco Marotta, Giorgio Iervasi, Leo Lopez, Shelby Kutty
We reviewed echocardiography literature for the assessment and management of semilunar valve disease in children. A search was performed within the National Library of Medicine using the keywords aortic stenosis (AS), aortic regurgitation, pulmonary stenosis (PS), and pulmonary regurgitation in children. The search was further refined adding the keywords-pediatric, neonates, echocardiographic definition, classification, evaluation. Thirty-eight studies were included. For stenotic lesions, there were sufficient consistencies between Doppler and invasive gradients (especially for PS), while other quantitative parameters used in adults showed significant limitations when applied to children...
March 31, 2017: Echocardiography
https://www.readbyqxmd.com/read/28369281/relation-between-calcium-burden-echocardiographic-stent-frame-eccentricity-and-paravalvular-leakage-after-corevalve-transcatheter-aortic-valve-implantation
#10
Luigi F M Di Martino, Osama I I Soliman, Lennart van Gils, Wim B Vletter, Nicolas M Van Mieghem, Ben Ren, Tjebbe W Galema, Carl Schultz, Peter P T de Jaegere, Matteo Di Biase, Marcel L Geleijnse
Aims: Paravalvular aortic leakage (PVL) after transcatheter aortic valve implantation (TAVI) is a complication with potentially severe consequences. The relation between native aortic root calcium burden, stent frame eccentricity and PVL was not studied before. Methods and results: Two-hundred-and-twenty-three consecutive patients with severe aortic stenosis who underwent TAVI with a Medtronic CoreValve System© and who had available pre-discharge transthoracic echocardiography were studied...
March 27, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28330793/procedural-and-clinical-outcomes-in-transcatheter-aortic-valve-replacement-for-bicuspid-versus-tricuspid-aortic-valve-stenosis
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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