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Aortic insufficiency

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https://www.readbyqxmd.com/read/29464441/left-heart-pressures-can-be-the-key-to-know-the-limitation-of-left-ventricular-assist-device-support-against-progression-of-aortic-insufficiency
#1
Kei Iizuka, Tomohiro Nishinaka, Noritsugu Naito, Daichi Akiyama, Yoshiaki Takewa, Kenji Yamazaki, Eisuke Tatsumi
Aortic insufficiency (AI) is a worrisome complication under left ventricular assist device (LVAD) support. AI progression causes LVAD-left ventricular (LV) recirculation and can require surgical intervention to the aortic valve. However, the limitations of LVAD support are not well known. Using an animal model of LVAD with AI, the effect of AI progression on hemodynamics and myocardial oxygen metabolism were investigated. Five goats (Saanen 48 ± 2 kg) underwent centrifugal type LVAD, EVAHEART, implantation...
February 20, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29461305/transcatheter-aortic-valve-replacement-as-a-bridge-to-left-ventricular-assist-device-implantation
#2
Adham Elmously, Berhane Worku, Evelyn M Horn, Shing-Chiu Wong, Arash Salemi
We describe a case of the pre-emptive use of transcatheter aortic valve replacement in a patient with end-stage ischemic cardiomyopathy and native aortic stenosis/aortic insufficiency as a bridge to left ventricular assist device implantation. The use of this strategy can not only medically optimize patients before left ventricular assist device implantation but also provide a minimally invasive bridge to left ventricular assist device support, avoiding concomitant surgical aortic valve replacement or closure...
February 14, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29461278/home-inotropes-in-patients-supported-with-left-ventricular-assist-devices
#3
Emeka C Anyanwu, Viktoriya Kagan, Ankit Bhatia, David M Tehrani, Sirtaz Adatya, Gene Kim, Nitasha Sarswat, Valluvan Jeevanandam, Gabriel Sayer, Nir Uriel
There is little data outlining the use of outpatient inotropic medications in patients with existing left ventricular assist devices (LVADs). This case series explores this patient population and seeks to define the indications, complications, and safety of dual support. A retrospective chart review was conducted for all patients on LVAD and then subsequently started on home inotropes post device implant. Eight patients met inclusion criteria. The indications for inotropes were right ventricular failure, aortic insufficiency with biventricular failure, LVAD thrombosis with contraindication to device exchange, and cannula malposition with elevated pulmonary vascular resistance...
February 15, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29460874/-robot-assisted-atrial-septal-defect-closure-in-adults-first-experience-in-russia
#4
A N Arkhipov, A V Bogachev-Prokofiev, A V Zubritskiy, T S Khapaev, Yu N Gorbatykh, P M Pavlushin, A M Karaskov
AIM: To analyze immediate results of minimally invasive robot-assisted atrial septal defect (ASD) closure in adults. MATERIAL AND METHODS: For the period from March 2012 to November 2016 sixty patients with contraindications to endovascular procedure have undergone robot-assisted atrial septal defect closure at Meshalkin Siberian Federal Biomedical Research Center. Mean age was 34.5±11.3 years, body mass index - 24.6±4.0 kg/m2 . 48 (80%) patients had NYHA class II before surgery...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29458883/maternal-and-fetal-outcomes-in-pregnancies-with-pulmonary-hypertension-experience-of-a-tertiary-center
#5
Zehra Nihal Dolgun, Cihan Inan, N Cenk Sayin
OBJECTIVE: Pregnancies complicated with PHT are serious debates for obstetricians due to high maternal and fetal complication potentials. The aim of the study was to present our maternofetal outcomes in pregnant women with pulmonary hypertension. MATERIALS AND METHODS: This study was performed using data extracted from the medical files of 23 pregnancies of 18 patients with PHT who were followed-up in the obstetrics and gynecology department. RESULTS: The average age was 27...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29455964/polytetrafluoroethylene-conduits-versus-homografts-for-right-ventricular-outflow-tract-reconstruction-in-infants-and-young-children-an-institutional-experience
#6
Christopher W Mercer, Shawn C West, Mahesh S Sharma, Masahiro Yoshida, Victor O Morell
OBJECTIVE: Our institution uses a valved polytetrafluoroethylene conduit as an alternative to homografts. The objective of this study was to investigate the performance of bicuspid valved polytetrafluoroethylene conduits used for right ventricular outflow tract reconstruction in children aged less than 2 years and to evaluate risk factors for earlier conduit explant. METHODS: We performed an Institutional Review Board-approved retrospective chart review of all patients aged less than 2 years who underwent surgical right ventricular outflow tract reconstruction with a bicuspid valved polytetrafluoroethylene conduit or homograft conduit from July 2004 to December 2014...
January 31, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29432524/reimplantation-versus-remodelling-with-ring-annuloplasty-comparison-of-mid-term-outcomes-after-valve-sparing-aortic-root-replacement
#7
Marien Lenoir, Bart Maesen, Louis-Mathieu Stevens, Raymond Cartier, Philippe Demers, Nancy Poirier, Michaël Tousch, Ismail El-Hamamsy
OBJECTIVES: Remodelling with extra-aortic ring annuloplasty has emerged as an alternative approach to root reimplantation. However, no studies have yet compared outcomes between procedures. The aim of this study was to compare mid-term outcomes in patients undergoing reimplantation versus remodelling with extra-aortic annuloplasty. METHODS: From 2001 to 2017, 142 patients underwent root remodelling with extra-aortic annuloplasty (n = 83, 48 ± 13 years) or a reimplantation technique (n = 59, 48 ± 12 years) at the Montreal Heart Institute...
February 8, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29431029/oversized-biodegradable-arterial-grafts-promote-enhanced-neointimal-tissue-formation
#8
Cameron A Best, Takuma Fukunishi, Joseph Drews, Ramak Khosravi, Kan Hor, Nathan Mahler, Tai Yi, Jay D Humphrey, Jed Johnson, Christopher K Breuer, Narutoshi Hibino
Most tissue-engineered arterial grafts are complicated by aneurysmal dilation secondary to insufficient neotissue formation after scaffold degradation. The optimal graft would form an organized multi-layered structure with a robust extracellular matrix that could withstand arterial pressure. The purpose of the current study was to determine how oversizing a biodegradable arterial scaffold affects long-term neotissue formation. Size-matched (1.0 mm, n=11) and oversized (1.6 mm, n=9) electrospun polycaprolactone/chitosan scaffolds were implanted as abdominal aortic interposition grafts in Lewis rats...
February 12, 2018: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/29427619/the-association-of-aortic-valve-pathology-with-renal-resistive-index-as-a-kidney-injury-biomarker
#9
Benjamin Y Andrew, Anne D Cherry, Jennifer N Hauck, Alina Nicoara, Cory D Maxwell, Ryan M Konoske, Annemarie Thompson, Lakshmi D Kartha, Madhav Swaminathan, Mark Stafford-Smith
BACKGROUND: Acute kidney injury (AKI) is a common serious complication following cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology. METHODS: In a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29420709/rapid-deployment-aortic-valve-replacement-in-a-minimal-access-setting-intermediate-clinical-and-echocardiographic-outcomes
#10
Markus Schlömicher, Zulfugar Taghiyev, Yazan AlJabery, Peter Lukas Haldenwang, Michael Zumholz, Magdalena Sikole, Dritan Useini, Hamid Naraghi, Vadim Moustafine, Matthias Bechtel, Justus Thomas Strauch
OBJECTIVES: Transcatheter procedures have overtaken conventional operations in Germany. Considering that this is a highly competitive field, a rate of 25% for minimal access aortic valve replacement seems to be disappointingly low. One way to promote minimal access techniques is through the systematic use of rapid deployment valves. METHODS: A total of 143 patients underwent rapid deployment aortic valve replacement via upper right hemisternotomy between March 2012 and September 2015...
February 6, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29416251/aortic-dissection-masquerading-as-a-bicuspid-aortic-valve
#11
Harendra Arora, Priya Ajit Kumar
A 37-year-old male presented to the Emergency Department with acute worsening of back pain and new onset dyspnea. Transthoracic echocardiography revealed moderate left ventricular dysfunction and a bicuspid aortic valve (BAV). In addition, he was noted to have a dilated thoracic aorta concerning for a dissection, severe aortic insufficiency (AI), and both a pericardial and pleural effusion. Magnetic resonance imaging revealed a Type A ascending aortic dissection. He was taken emergently to the operating room for repair...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29416208/gigantic-thrombus-of-the-left-atrium-in-mitral-stenosis
#12
Enisa Hodzic, Nermir Granov
Introduction: Excess dilatation of the left atrium >65 mm is known in the literature as gigantic atrium. This dilation is most commonly encountered in the mitral insufficiency of rheumatic etiology, but also in severe prolapses of the mitral valve, permanent atrial fibrillation, and at the left right shunt with cardiac insufficiency. Case report: In this paper is presented a case study of echocardiographically verified giant thrombus in left atrium in a 50 years old female patient aged 50 hospitalized because of tiredness, choking, heartburn and urinary tract symptoms...
December 2017: Medical Archives
https://www.readbyqxmd.com/read/29408404/initial-experience-with-a-new-mitral-ring-designed-to-simplify-length-determination-of-neochords
#13
Anatol Prinzing, Sabine Bleiziffer, Markus Krane, Ruediger Lange
BACKGROUND: Artificial chord implantation has become one of the most applied techniques for mitral valve repair (MVR). Many techniques have been described with the goal of optimizing neochord implantation. A new annuloplasty device designed to simplify the determination of appropriate neochord length has been recently introduced. We will describe our initial experience with this new device. METHODS: The semirigid device is equipped with removable loops on the posterior aspect of the ring...
February 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29397472/gastrointestinal-bleeding-in-native-and-prosthetic-valve-disease
#14
REVIEW
Joseph L Blackshear
Gastrointestinal bleeding with severe aortic stenosis was originally described in the 1950s by Heyde, although for years, the association was debated. Further discovery of mechanisms and the ubiquity and severity of acquired von Willebrand syndrome in the left ventricular assist device therapy have removed any doubts. At this time, gastrointestinal bleeding from intestinal angiodysplasia in patients with turbulence-related proteolysis of the highest molecular weight multimers of von Willebrand factor is now known to occur in patients with aortic stenosis, and also subaortic obstruction and associated mitral insufficiency in hypertrophic cardiomyopathy, isolated mitral and aortic insufficiency, endocarditis, and in patients with prosthetic valve dysfunction, either from stenosis or insufficiency...
February 3, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29391147/aortic-valve-repair-of-a-stenotic-unicuspid-aortic-valve-in-young-patients
#15
Adrian Kolesar, Tomas Toporcer, Milan Bajmoczi, Jan Luczy, Peter Candik, Frantisek Sabol
BACKGROUND: The unicuspid aortic valve (UAV) is a well-described pediatric congenital abnormality, with incidence of 0.02% in the general population. Bicuspidization has been described as a potential surgical option to repair this defect. METHODS: Seventeen symptomatic young patients with a unicuspid valve combined with either valve insufficiency or valve stenosis underwent aortic valve bicuspidization procedure using either an equine pericardium. In addition to bicuspidization, eight patients underwent aortic ring implantation and five patients underwent supracoronary replacement of the aorta...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29385426/outcomes-of-valve-sparing-root-replacement-in-acute-type-a-aortic-dissection
#16
Hiroshi Tanaka, Yuki Ikeno, Noriyuki Abe, Hiroaki Takahashi, Takeshi Inoue, Yutaka Okita
OBJECTIVES: To investigate the long-term durability of aortic valves, we reviewed the outcomes of patients who underwent valve-sparing root replacement with acute Type A aortic dissection. METHODS: We included patients who underwent emergent aortic repair for acute Type A aortic dissection at our university hospital between 2000 and 2016. We identified patients who underwent valve-sparing root replacement from the included cohort and assessed their survival and long-term valve durability...
January 29, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29380420/bicuspidization-of-the-morphological-tricuspid-aortic-valve-with-ascending-aorta-replacement-in-a-5-year-old-child
#17
Rahul K Bhukar, Deepak Gowda, Jinaga N Rao, Neelam Desai
Ascending aortic aneurysms are rare in children and may lead to aortic insufficiency, dissection, and/or rupture. We present a 5-year-old child diagnosed with an ascending aortic aneurysm and severe aortic insufficiency, successfully treated with ascending aortic replacement with an aortic valve repair using a bicuspidation technique.
January 30, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29374512/replacement-of-a-stenotic-quadricuspid-aortic-valve-with-a-sutureless-prosthesis
#18
Kathrin Freystaetter, Faruk Özalp
Quadricuspid aortic valve (QAV) is a rare occurrence, usually presenting with insufficiency rather than stenosis. We report a case of aortic valve replacement in a septuagenarian with a stenotic QAV, achieving a good result with a Sorin Perceval sutureless bioprosthesis. We emphasize the particular technique of implantation and possible pitfalls. Sutureless bioprosthetic valves present a feasible option for aortic valve replacement in patients with uncommon valve morphologies, aiming to reduce operative time...
January 24, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29351595/propensity-matched-comparison-between-minimally-invasive-and-conventional-sternotomy-in-aortic-valve-resuspension
#19
Nadejda Monsefi, Petar Risteski, Aleksandra Miskovic, Andreas Zierer, Anton Moritz
OBJECTIVES: The aim of the study was to compare the results of David procedure through conventional or minimally invasive approach. METHODS: A propensity-matched comparison in patients undergoing a minimally invasive (partial upper sternotomy, n = 103) or complete sternotomy (n = 103) David procedure from 1991 to 2016 was performed. Patients were 57 ± 14 years old on average in both groups. The David technique was modified by generating a neosinus (P < 0...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29342427/reconstructive-aortic-valve-surgery-in-the-elderly-techniques-and-outcomes
#20
Paul P Urbanski, Atanas Jankulovski, Kiril Doldurov, Xiaochun Zhan, Ayman Sodah, Michael Zacher, Anno Diegeler
OBJECTIVES: The aim of the study was to evaluate operative techniques and long-term results after aortic valve or root repair in patients aged 75 years or more. METHODS: Between November 2002 and January 2016, a total of 815 patients underwent aortic valve or root repair. Among them were 100 patients aged 75 years or more (mean, 78 ± 3; range, 75-88 years), including 17 patients operated on an emergency basis because of acute aortic dissection. None/trivial, mild, moderate, and severe insufficiency grades were presented in 9, 23, 27, and 41 patients, respectively...
December 19, 2017: Journal of Thoracic and Cardiovascular Surgery
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