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Aortic regurgitation

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https://www.readbyqxmd.com/read/28345251/complication-of-hybrid-treatment-in-type-b-aortic-dissection-diagnosed-by-echocardiography
#1
Thaís Rossoni Weber, Viviane Tiemi Hotta, Carlos Eduardo Rochitte, Kamila Fernanda Staszko, Ricardo Ribeiro Dias, Charles Mady
This case illustrates an unusual and fatal complication after endovascular treatment of type B aortic dissection and highlights the role of echocardiography in the early diagnosis of complications. In this case, a patient with previous diagnosis of chronic type B aortic dissection and moderate aortic regurgitation underwent endovascular repair of the proximal descending aorta and conservative surgical correction of the aortic valve. On early postoperative, a transesophageal echocardiogram and aortic angiotomography demonstrated proximal endoleak by contrast extravasation around the proximal graft attachment site, causing compression of the stent in its middle portion, resulting in narrowing with reduced cross-sectional area...
March 27, 2017: Echocardiography
https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#2
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342542/determinants-of-late-tricuspid-regurgitation-after-aortic-mitral-double-valve-replacement
#3
Dong Seop Jeong, Pyo Won Park, Kiick Sung, Wook Sung Kim, Young Tak Lee
The aims of this study are to evaluate the long-term outcomes of double valve replacement (aortic and mitral valves) and to investigate the determinants of late tricuspid regurgitation (TR). A total of 239 consecutive patients who underwent double valve replacement were enrolled. Valve pathology was rheumatic in 86.6% (207/239) and degenerative in 13.4% (32/239) of patients. Among these patients, 116 patients underwent concomitant tricuspid annuloplasty, and follow-up was completed for all 239 patients (mean = 7...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28341764/transesophageal-echocardiographic-guidance-of-transcatheter-closure-of-the-aortic-valve-in-a-patient-with-left-ventricular-assist-device-related-severe-aortic-regurgitation
#4
Preetham Muskala, Taiyeb M Khumri, Michael L Main
A 68 year-old man with a severe ischemic cardiomyopathy underwent left ventricular assist device (LVAD) implantation (Heart Mate II device) for destination therapy. He presented 49 months following LVAD implant with worsening heart failure symptoms and new severe aortic regurgitation. Given high risk for both surgical and transcatheter aortic valve replacement, he was admitted for transcatheter closure of the aortic valve under transesophageal echocardiographic (TEE) guidance. TEE imaging revealed severe aortic regurgitation (see Figure 1A and 1B, and multimedia files 1 and 2)...
March 24, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#5
Samir R Kapadia, Amar Krishnaswamy, E Murat Tuzcu
Functional tricuspid regurgitation (FTR) is common, whether in association with mitral or aortic valve disease or presenting as an isolated valvular disease. Several studies have shown that TR is associated with poor patient outcomes, though a cause-and-effect relationship of TR to mortality has not been proven. Similarly the impact of surgical treatment of TR on outcomes needs well-controlled randomized trials that are under planning. The current professional society guidelines for treatment of TR are based on expert opinions with a level of evidence C for all indications...
March 23, 2017: Circulation
https://www.readbyqxmd.com/read/28331219/intragenic-multi-exon-deletion-in-the-fbn1-gene-in-a-child-with-mildly-dilated-aortic-sinus-a-retrotransposal-event
#6
Maggie Brett, George Korovesis, Angeline H M Lai, Eileen C P Lim, Ene-Choo Tan
Marfan syndrome is an autosomal dominant disorder affecting mainly the skeletal, ocular and cardiovascular systems. Most cases are caused by mutations in the fibrillin-1 gene (FBN1), although there are some reports on deletions involving FBN1 and other additional genes. We report a male patient who was first evaluated at 4 years of age. Echocardiogram showed a mildly dilated aortic sinus. He also had a history of muscular ventral septal defect which was closed spontaneously and trivial mitral regurgitation...
March 23, 2017: Journal of Human Genetics
https://www.readbyqxmd.com/read/28329360/early-surgery-versus-conventional-treatment-for-asymptomatic-severe-aortic-regurgitation-with-normal-ejection-fraction-and-left-ventricular-dilatation
#7
Yin Wang, Weiwei Jiang, Junwei Liu, Geng Li, Yi Liu, Xingjian Hu, Nianguo Dong
OBJECTIVES: The management of patients with asymptomatic severe aortic regurgitation (AR) remains controversial. The aim of the present study was to assess and compare the clinical results between early surgery and conventional treatment for asymptomatic severe AR in patients with normal left ventricular (LV) systolic function and LV dilatation. METHODS: This retrospective cohort study included 230 consecutive patients with severe AR with left ventricular ejection function (LVEF ≥50%) and left ventricular end-diastolic dimension (LVEDD >70 mm) from 2003 to 2014...
February 17, 2017: European Journal of Cardio-thoracic Surgery
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
#8
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/28329331/natural-history-of-moderately-dilated-tubular-ascending-aorta-implications-for-determining-the-optimal-imaging-interval%C3%A2
#9
Kay-Hyun Park, Suryeun Chung, Dong Jung Kim, Jun Sung Kim, Cheong Lim
OBJECTIVES: For a moderately dilated ascending aorta (diameter 35-54 mm), current guidelines recommend continuous annual or semi-annual examinations with computed tomography or magnetic resonance imaging. However, few data have shown the yield and benefit of such a protocol. This study aimed to investigate the fate of a moderately dilated ascending aorta and thereby determine the adequate imaging interval. METHODS: In our institutional database, we identified adult patients having an ascending aortic diameter ≥40 mm in contrast-enhanced computed tomography and follow-up imaging(s) after ≥1 year...
February 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28329317/patient-prosthesis-mismatch-in-new-generation-trans-catheter-heart-valves-a-propensity-score-analysis
#10
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/28328570/concomitant-valve-in-valve-transcatheter-aortic-valve-replacement-and-left-ventricular-assist-device-implantation
#11
Takashi Murashita, David L Joyce, Alberto Pochettino, John M Stulak, Lyle D Joyce
Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28325571/frequency-of-development-of-aortic-valve-disease-in-unrepaired-perimembranous-ventricular-septal-defects
#12
Asif Padiyath, Elizabeth S Makil, Katherine T Braley, Elijah H Bolin, Xinyu Tang, Jeffery M Gossett, R Thomas Collins
We sought to determine the natural history of aortic valve disease in patients with unrepaired perimembranous ventricular septal defects (pVSDs) and to identify echocardiographic parameters predictive of increased risk of surgical repair of pVSD because of aortic valve disease. We retrospectively analyzed all echocardiograms of patients with a diagnosis of pVSD at our institution from January 1999 to January 2015. All available echocardiographic data were collected. Patients were excluded if there was another structural cardiac anomaly other than bicuspid aortic valve, small patent foramen ovale, or ductus arteriosus...
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28321917/post-dilation-in-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#13
Nelson Wang, Sean Lal
OBJECTIVES: The aim of this study was to perform a meta-analysis to compare the outcomes of patients undergoing TAVR with and without balloon post-dilation (PD). BACKGROUND: PD is a commonly used technique in TAVR to minimize paravalvular regurgitation (PVR), albeit supported by little evidence. METHODS: Systematic review and meta-analysis of 6 studies comparing 889 patients who had PD compared to 4118 patients without PD. RESULTS: Patients undergoing PD were more likely male (OR 1...
March 21, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28321026/left-ventricular-outflow-tract-migration-of-a-balloon-expandable-prosthesis-during-transcatheter-aortic-valve-implantation
#14
Daisuke Hachinohe, Ken Kobayashi, Azusa Furugen, Ryuji Koshima
Valve migration into the left ventricular outflow tract (LVOT) during transcatheter aortic valve implantation (TAVI) is a life-threatening complication. An 89-year-old female patient was admitted for TAVI due to severe symptomatic aortic stenosis. After deployment of a balloon-expandable prosthesis, the prosthesis had migrated into the LVOT. The prosthesis was reimpacted to the aortic annulus by a balloon-assisted recapture procedure. Immediately after recapturing the prosthesis with an oversized balloon, the patient's vital signs deteriorated due to acute aortic regurgitation (AR), and a prompt valve-in-valve (V-in-V) procedure allowed us to stabilize the patient's condition...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28321003/midterm-outcomes-with-a-self-expandable-transcatheter-heart-valve-in-japanese-patients-with-symptomatic-severe-aortic-stenosis
#15
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/28321002/five-year-outcomes-of-the-first-pivotal-clinical-trial-of-balloon-expandable-transcatheter-aortic-valve-replacement-in-japan-prevail-japan
#16
Yoshiki Sawa, Morimasa Takayama, Tsuyoshi Goto, Shuichiro Takanashi, Tatsuhiko Komiya, Tetsuya Tobaru, Koichi Maeda, Toru Kuratani, Yasushi Sakata
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been an alternative less invasive therapy for high-surgical risk/inoperable patients with aortic valve stenosis (AS) in Japan. We report 5-year outcomes of the first pivotal clinical trial of TAVR in Japan (PREVAIL JAPAN).Methods and Results:A total of 64 patients with AS who were considered unsuitable candidates for surgery were enrolled at 3 centers in Japan (mean age: 84.3±6.1 years, female: 65.6%, STS score: 9.0±4...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#17
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28317163/the-value-of-diastolic-flow-reversal-in-the-descending-thoracic-aorta-as-a-determinant-of-invasively-measured-aortic-pulse-pressure
#18
Hack-Lyoung Kim, Yu Nui Kim, Hee-Jun Kim, Woo-Hyun Lim, Jae-Bin Seo, Sang-Hyun Kim, Myung-A Kim, Joo-Hee Zo
AIM: Although the diastolic flow reversal of the descending aorta has been recognized in patients with aortic regurgitation, its generation without this condition is still unknown. This study was performed to investigate whether flow patterns of the descending thoracic aorta, as measured by echocardiography, can represent invasively measured aortic pulse pressure (APP). METHODS: A total of 100 patients (age, 62.3±11.0 years; men, 62.0%) undergoing invasive coronary angiography (ICA) was analyzed...
March 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/28315200/radiation-induced-cardiovascular-disease
#19
REVIEW
Deepa Raghunathan, Misha Iftikhar Khilji, Saamir A Hassan, Syed Wamique Yusuf
PURPOSE OF REVIEW: Thoracic radiation therapy is an effective treatment for several malignancies, such as Hodgkin's lymphoma and breast cancer. Over the years, however, the incidence of cardiovascular events has increased in these patients, notably in younger survivors who do not have traditional risk factors. This review summarizes the pathology, incidence, clinical presentation, and management of cardiac events after radiation therapy. RECENT FINDINGS: Mediastinal radiation therapy accelerates the atherosclerosis process, resulting in early onset coronary artery disease...
May 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28314643/acute-ascending-aortic-dissection-after-mdma-ecstasy-use-a-case-report
#20
Satoko Kanahara, Mostafa El-Refai, Nasser Lakkis, Rashed Tabbaa
Acute aortic dissection is rare among young patients in the absence of connective tissue disorders. One of the risk factors associated with aortic dissection among young patients is amphetamine use. We report a case of a 37-year-old female with a past medical history of hypertension presenting with syncope and altered mental status who was found to have an acute DeBakey Type I aortic dissection after ingestion of 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy. This is the second case in the literature describing aortic dissection in relation to MDMA use...
November 15, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
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