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Aortic insufficiency

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https://www.readbyqxmd.com/read/28097187/intraoperative-epiaortic-ultrasound-for-traumatic-pseudoaneurysm-of-the-ascending-aorta
#1
Michelle Eddins, Marco Aguirre, Jonathan Price, Michael Wait, Pietro Bajona
Epiaortic ultrasound is an imaging modality that is commonly used to evaluate the ascending aorta for atheroma and other mural lesions during elective cardiac surgery. Its use in contained aortic rupture has not been established. We present a case of thoracic trauma with contained pseudoaneurysm of the ascending aorta. At operation, the precise location of the aortic tear could not be identified by visual inspection, manual palpation, or transesophageal echocardiography. Epiaortic ultrasound was employed and the aortic defect was identified and successfully repaired...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28097185/immediate-improvement-in-severe-mitral-regurgitation-after-aortic-valve-replacement-for-severe-aortic-insufficiency
#2
Ahmad Zeeshan, Mojun Zhu, John A Elefteriades
A 57-year-old male with ascending aortic aneurysm, severe aortic regurgitation, and severe mitral regurgitation (MR) underwent ascending aortic replacement and aortic valve replacement. MR in this patient with normal mitral valve morphology was considered secondary to aortic valve incompetency. Consequently, a surgical approach to restore aortic valve function was adopted with successful MR resolution. This case report demonstrates the possibility of reversing early functional mitral regurgitation without surgically approaching the mitral valve...
June 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28091867/arterial-aortic-stiffness-in-patients-with-resistant-hypertension-from-assessment-to-treatment
#3
REVIEW
James E Sharman, Pierre Boutouyrie, Stéphane Laurent
PURPOSE OF REVIEW: The purpose of the review is to examine whether measurement of aortic stiffness could be especially value-adding for risk stratification and treatment among patients with resistant hypertension (RH). RECENT FINDINGS: Adverse arterial remodeling and increased aortic stiffness is associated with RH, and it may be of additional clinical benefit to measure aortic stiffness in these patients. However, there is insufficient evidence to determine whether aortic stiffness is excessively high relative to the level of blood pressure (BP) among people with RH...
January 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28086805/the-safety-of-introducing-a-new-generation-tavr-device-one-departments-experience-from-introducing-a-second-generation-repositionable-tavr
#4
Henrik Bjursten, Shahab Nozohoor, Malin Johansson, Igor Zindovic, Carl-Fredrik Appel, Johan Sjögren, Magnus Dencker, Göran Olivecrona, Jan Harnek, Sasha Koul, Ted Feldman, Michael J Reardon, Matthias Götberg
BACKGROUND: In the evolving field of transcatheter aortic valve replacements a new generation of valves have been introduced to clinical practice. With the complexity of the TAVR procedure and the unique aspects of each TAVR device, there is a perceived risk that changing or adding a new valve in a department could lead to a worse outcome for patients, especially during the learning phase. The objective was to study the safety aspect of introducing a second generation repositionable transcatheter valve (Boston Scientific Lotus valve besides Edwards Sapien valve) in a department...
January 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28079254/pharmacological-treatment-of-vascular-risk-factors-for-reducing-mortality-and-cardiovascular-events-in-patients-with-abdominal-aortic-aneurysm
#5
REVIEW
Lindsay Robertson, Edmond Atallah, Gerard Stansby
BACKGROUND: Pharmacological prophylaxis has been proven to reduce the risk of cardiovascular events in individuals with atherosclerotic occlusive arterial disease. However, the role of prophylaxis in individuals with abdominal aortic aneurysm (AAA) remains unclear. Several studies have shown that despite successful repair, those people with AAA have a poorer rate of survival than healthy controls. People with AAA have an increased prevalence of coronary heart disease and risk of cardiovascular events...
January 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074828/three-dimensional-transesophageal-echocardiography-guided-transcathetar-closure-of-ruptured-noncoronary-sinus-of-valsalva-aneurysm
#6
G Anil Kumar, P S Parimala, M Jayaranganath, A M Jagadeesh
Sinus of Valsalva aneurysm accounts for only 1% of congenital cardiac anomalies. Sinus of Valsalva aneurysm can cause aortic insufficiency, coronary artery flow compromise, cardiac arrhythmia, or aneurysm rupture. Three-dimensional transesophageal echocardiography (3DTEE) represents an adjunctive tool to demonstrate the ruptured sinus of Valsalva with better delineation. We present an adult patient with rupture of noncoronary sinus of Valsalva aneurysm into the right atrium (RA). 3DTEE accurately delineated the site of rupture into the RA and showed the exact size and shape of the defect, which helped in the successful transcatheter closure of the defect with a duct occluder device...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073571/early-clinical-outcomes-of-a-novel-self-expanding-transapical-transcatheter-aortic-valve-bioprosthesis
#7
Michael W A Chu, Rodrigo Bagur, Katie L Losenno, Philip M Jones, Pantelis Diamantouros, Patrick Teefy, Jill J Gelinas, Bob Kiaii
OBJECTIVE: Coronary obstruction remains a challenging complication of transcatheter aortic valve replacement; however, a new self-expanding transapical prosthesis may reduce this risk. The purpose of this study was to evaluate the early 1-year outcomes of patients with low coronary heights who received the Acurate TA bioprosthesis (Symetis, Ecublens, Switzerland). METHODS: Between May 2014 and April 2015, 30 consecutive patients (aged 85 ± 6 years, 63% were female, Society of Thoracic Surgeons score 8...
December 15, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28069701/loss-of-axin2-results-in-impaired-heart-valve-maturation-and-subsequent-myxomatous-valve-disease
#8
Alexia Hulin, Vicky Moore, Jeanne M James, Katherine E Yutzey
AIMS: Myxomatous valve disease (MVD) is the most common aetiology of primary mitral regurgitation. Recent studies suggest that defects in heart valve development can lead to heart valve disease in adults. Wnt/β-catenin signalling is active during heart valve development and has been reported in human MVD. The consequences of increased Wnt/β-catenin signalling due to Axin2 deficiency in postnatal valve remodelling and pathogenesis of MVD were determined. METHODS AND RESULTS: To investigate the role of Wnt/β-catenin signalling, we analysed heart valves from mice deficient in Axin2 (KO), a negative regulator of Wnt/β-catenin signalling...
January 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28043991/partial-root-remodelling-for-treatment-of-a-giant-isolated-right-sinus-of-valsalva-aneurysm
#9
Makoto Hashimoto, Hirosato Doi, Ryuji Koshima, Satoshi Sumino
Sinus of Valsalva aneurysms are rare cardiac abnormalities that may be congenital or acquired. Patch closure or direct closure of the aneurysm orifice is a frequently performed surgical repair strategy. In this report, we present a rare case of an isolated giant right sinus of Valsalva aneurysm with aortic insufficiency and right coronary artery obstruction. We treated this patient by a valve-sparing aortic root remodelling procedure with partial preservation of the intact Valsalva sinuses and coronary artery bypass grafting with a favourable outcome...
January 2, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28043471/relationship-of-normal-aortic-valve-cusp-dimensions-a-tool-to-optimize-cusp-reconstruction-valvuloplasty
#10
Sujata Subramanian, Vsevolod Tikhomirov, Saroja Bharati, Chawki ElZein, David Roberson, Michel N Ilbawi
Outcomes of surgical aortic valvuloplasty hinge primarily on optimal leaflet design. Imprecise valve reconstruction can result in insufficiency or stenosis. Predicting postrepair leaflet parameters from pre- or intraoperative readily measurable valve dimensions could result in improved reconstruction. This study analyzes the relationships between different parameters of the normal aortic valve to establish a method of deriving the optimal dimensions of the reconstructed leaflet following valvuloplasty. Morphologic analysis of the normal aortic valve was performed on 50 autopsy specimens...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28043434/aortic-root-surgery-does-high-surgical-volume-and-a-consistent-perioperative-approach-improve-outcome
#11
Rajdeep Bilkhu, Pouya Youssefi, Gopal Soppa, Rajan Sharma, Anne Child, Mark Edsell, Jean-Pierre van Besouw, Marjan Jahangiri
There is evidence that high surgical volume and team consistency improve outcomes. Mortality of 4%-12% for aortic root surgery has been reported in the United States and UK. We aim to assess outcomes of patients undergoing aortic root surgery by a consistent, high-volume team. Data on patients undergoing elective or urgent aortic root replacement (ARR) were collected prospectively. Patients undergoing emergency surgery were excluded. A standardized perioperative approach was maintained and was achieved by delivering training to team members, including surgical trainees, anesthetic, nursing, and perfusion staff, whenever there was a change of team...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28033700/brucellosis-with-multi-organ-involvement-in-a-patient-with-history-of-composite-aortic-graft-and-hepatitis-b
#12
Seyed Ali Dehghan Manshadi, Omid Rezahosseini, Zahra Abdi Liaei
The brucellosis with multi-organ involvement in a patient with a history of the composite aortic graft (Bentall procedure) and Hepatitis B infection is rare. A 35-year-old man presented to us with fever and loss of consciousness. Four years ago, he was IDU and underwent cardiac surgery because of endocarditis. Recently lumbar spondylodiscitis was diagnosed. The Wright (1/320) and Coombs Wright tests (1/640) were positive. After CNS imaging, lumbar puncture was done. The CSF pleocytosis was lymphocyte dominant...
November 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/28033184/effect-of-outflow-graft-size-on-flow-in-the-aortic-arch-and-cerebral-blood-flow-in-continuous-flow-pumps-possible-relevance-to-strokes
#13
Sindhoor Bhat, Jayakala Mathews, Komrakshi R Balakrishnan, Ramarathnam Krishna Kumar
One of the most devastating complications of continuous flow left ventricular devices (CFLVADS) is a stroke, with a higher incidence in Heartware HVAD as compared to HEARTMATE II. The reason for the observed difference in stroke rates is unclear. Since outflow graft diameters are different, we hypothesized that this could contribute to the difference in stroke rates.A Computational fluid structure interaction model was created from the CT scan of a patient. Pressures were used as the boundary condition and the flow through the cerebral vessels was derived as outputs...
December 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28033075/short-term-results-of-sinus-of-valsalva-aneurysm-repair
#14
Khakimjon Abralov, Amonjon Alimov
BACKGROUND: We retrospectively analyzed 65 patients who underwent surgical repair of sinus of Valsalva aneurysm over the last 27 years. METHODS: From January 1, 1988, to October 1, 2015, a total of 65 patients with sinus of Valsalva aneurysm underwent surgical repair in our hospital. There were 41 males (63%) and 24 females (37%), and their age ranged from 5 to 50 years (mean 23 ± 10 years, median 21 years). Out of the 65 patients, 45 (69%) had ruptured sinus of Valsalva aneurysm, 46 (70%) had a ventricular septal defect, and 22 (34%) had aortic valve insufficiency...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28025312/performance-of-the-labcor-dokimos-plus-pericardial-aortic-prosthesis-a-single-centre-experience
#15
Rashad Zayat, Jessica Arias-Pinilla, Ali Aljalloud, Giulia Musetti, Andreas Goetzenich, Rüdiger Autschbach, Thomas van Gemmeren, Andreas Niedeggen, Nima Hatam
OBJECTIVES: In patients with a small aortic annulus, aortic valve replacement (AVR) is frequently associated with high residual pressure gradients. Supra-annular pericardial aortic prostheses are gaining popularity due to the increased effective orifice areas (EOA) and resulting lower gradients. This study reports the clinical and echocardiographic results following implantation of the new supra-annular pericardial aortic prosthesis Dokimos Plus (Labcor, Belo Horizonte, Brazil). METHODS: Between October 2013 and July 2015, 137 patients (41% women, mean age: 74 years) underwent supra-annular AVR with or without concomitant procedures using the Dokimos Plus prosthesis in our department...
December 26, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28017933/20-years-experience-with-the-ross-operation-in-middle-aged-patients-the-autologous-principle-is-still-alive
#16
Francisco Diniz Affonso da Costa, Daniele Fornazari Colatusso, Eduardo Mendel Balbi Filho, Rafael Marchetti, Andreia Dumsch de Aragon Ferreira, Marise Brenner Affonso da Costa, Joao Gabriel Roderjan, Claudinei Colatusso
OBJECTIVES: Review our long-term results with the Ross operation in middle-aged patients. METHODS: Between 1995 and 2016, 129 consecutive patients (106 males); mean age (47.2 ± 5.2 years) underwent a Ross operation. Right ventricular outflow tract (RVOT) reconstruction was performed with cryopreserved (n = 45) or decellularized allografts (n = 84). Mean follow-up was 8.4 ± 5.3 years (0.1 -: 20.5 years). We analyzed early and late mortality, as well as valve related events and the need for reoperations...
December 25, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28017584/feasibility-of-three-dimensional-magnetic-resonance-angiography-fluoroscopy-image-fusion-technique-in-guiding-complex-endovascular-aortic-procedures-in-patients-with-renal-insufficiency
#17
Adeline Schwein, Ponraj Chinnadurai, Dipan J Shah, Alan B Lumsden, Carlos F Bechara, Jean Bismuth
OBJECTIVE: Three-dimensional image fusion of preoperative computed tomography (CT) angiography with fluoroscopy using intraoperative noncontrast cone-beam CT (CBCT) has been shown to improve endovascular procedures by reducing procedure length, radiation dose, and contrast media volume. However, patients with a contraindication to CT angiography (renal insufficiency, iodinated contrast allergy) may not benefit from this image fusion technique. The primary objective of this study was to evaluate the feasibility of magnetic resonance angiography (MRA) and fluoroscopy image fusion using noncontrast CBCT as a guidance tool during complex endovascular aortic procedures, especially in patients with renal insufficiency...
December 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28009957/implantation-of-a-sapien-3-valve-in-a-patient-with-pure-aortic-regurgitation
#18
Jan-Philipp Minol, Verena Veulemans, Tobias Zeus, Alexander Blehm
Transcatheter aortic valve implantation (TAVI) is an emerging treatment for high-risk patients with aortic stenosis. Aortic regurgitation is considered to be a relative contraindication for transcatheter procedures, as a non-calcified aortic annulus poses the risk of an insufficient anchoring of the transcatheter aortic valve prosthesis. Herein is described the case of a patient who suffered from recurrent aortic valve regurgitation after valve-sparing repair, and which was successfully treated by the transcatheter implantation of an Edwards SAPIEN 3™ prosthesis...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28008357/bicuspid-aortic-valve-disease-systematic-review-and-meta-analysis-of-surgical-aortic-valve-repair
#19
Maximilian Salcher, Huseyin Naci, Sarah Pender, Titus Kuehne, Marcus Kelm
Aortic valve repair is still emerging, and its role in the treatment of bicuspid aortic valve disease (BAVD) is not yet fully understood. Our objective is to synthesise available evidence on outcomes after surgical aortic valve repair in patients with BAVD. We conducted a systematic review of clinical studies using prespecified methods for searching, identifying and selecting eligible studies in 4 databases, and synthesising results (PROSPERO 2014:CRD42014014415). 2 researchers independently reviewed full-text articles and extracted data...
2016: Open Heart
https://www.readbyqxmd.com/read/28007277/random-finding-of-a-ruptured-kommerell-aneurysm-after%C3%A2-stroke
#20
Iannis Ben Abdallah, Salma El Batti, Pierre Julia, Jean-Marc Alsac
The random finding of a ruptured Kommerell aneurysm (rKA) is exceptional. We report the case of a 74-year-old man who received an incidental diagnosis of a contained rKA involving an aberrant right subclavian artery after a stroke. He underwent successful hybrid repair with the use of thoracic endovascular aortic repair associated with cervical debranching of the left subclavian artery and vascular plug occlusion of both subclavian artery origins. Whereas no early adverse event was reported, the patient experienced a vertebrobasilar insufficiency once he had recovered, requiring an additional right carotid-to-subclavian bypass...
January 2017: Annals of Thoracic Surgery
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