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Aortic regurgitation

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https://www.readbyqxmd.com/read/28549026/the-use-of-rapid-deployment-valves-in-combined-aortic-and-mitral-valve-surgery-one-year-clinical-and-echocardiographic-outcomes
#1
Markus Schlömicher, Matthias Bechtel, Zulfugar Taghiyev, Yazan Al-Jabery, Peter Lukas Haldenwang, Vadim Moustafine, Justus Thomas Strauch
OBJECTIVE: Patients undergoing multiple valve surgery represent a high-risk group who could potentially benefit from a reduction of cross-clamp and cardiopulmonary bypass times because prolonged bypass and cross-clamp times are considered independent risk factors for increased morbidity and mortality after cardiac surgery. METHODS: Between July 2013 and November 2014, 16 patients underwent rapid deployment aortic valve replacement with the EDWARDS INTUITY valve system in the setting of concomitant mitral disease...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28545592/impact-of-prosthesis-patient-mismatch-on-short-term-outcomes-after-aortic-valve-replacement-a-retrospective-analysis-in-east-china
#2
Lei Guo, Junnan Zheng, Liangwei Chen, Renyuan Li, Liang Ma, Yiming Ni, Haige Zhao
BACKGROUND: Prosthesis-patient mismatch (PPM) may affect the clinical outcomes of patients undergoing aortic valve replacement (AVR). We aimed to determine the incidence of PPM, its effect on short-term mortality, and the factors contributing to PPM in China. METHODS: We retrospectively examined all consecutive patients with isolated or concomitant AVR at our hospital between January 1, 2013 and December 31, 2015. PPM was defined as an effective orifice area index (EOAi) of ≤ 0...
May 25, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28544843/a-new-sign-of-severe-aortic-regurgitation-detected-through-airflow-analysis-in-mechanical-ventilation
#3
Juan C Garcia-Rubira, Maria J Cristo-Ropero, Manuel Almendro-Delia, Rafael Hidalgo-Urbano
A 72-year-old female with a previous history of aortic valve replacement by biological prosthesis was admitted with progressive heart failure. The clinical course was unfavorable, requiring inotropic support and invasive mechanical ventilation. Auto-triggering of the ventilator from cardiac origin has been previously described, and explained as a consequence of hyperdynamic circulation. In our case, the oscillatory movements due to the aortic regurgitation are transmitted to the airway. Early recognition of this condition can facilitate not only the correction this asynchrony in mechanical ventilation but also should raise the suspicion of aortic regurgitation...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544842/transfemoral-valve-in-valve-in-a-degenerated-small-aortic-bioprosthesis-five-year-follow-up
#4
Stefano Salizzoni, Federico Conrotto, Mauro Rinaldi, Gian Paolo Ussia, Gaetana Ferraro, Mauro Giorgi, Maurizio D'Amico
A small-sized bioprosthesis can limit transcatheter valve-in-valve (V-in-V) implantations. The case is reported of a 91-year-old woman who had successfully undergone a V-in-V procedure with a 26 mm CoreValve in a previously implanted Mitroflow 19 mm valve. At the five-year follow up the prosthesis showed good echocardiographic function and the patient was alive and free from major symptoms. The patient died three months after the follow up examination at the age of 96 years. This case demonstrates the feasibility, with acceptable longterm functioning, of a V-in-V procedure involving a small bioprosthesis...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544841/transcatheter-valve-in-valve-implantation-failing-tricuspid-bioprosthesis-in-a-patient-with-ebstein%C3%A2-s-anomaly
#5
Pedro A Villablanca, Aman M Shah, David F Briceno, Ali N Zaidi, Mei Chau, Mario J Garcia, David Slovut, Cynthia Taub
Transcatheter valve-in-valve (VIV) implantation has been recently proposed as an alternative to surgical reoperative aortic valve replacement in patients with a failing aortic bioprosthesis. Experience with transcatheter VIV implantation at other valve positions is very limited. Herein is reported the case of an 18-year-old man with Ebstein's anomaly and severe tricuspid valve (TV) regurgitation status after bioprosthetic valve replacement, who developed new dyspnea on exertion three years after the initial valve replacement...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544840/redo-tricuspid-valve-repair-with-leaflet-augmentation-using-the-left-atrial-wall
#6
Daisuke Endo, Kenji Kuwaki, Taira Yamamoto, Atsushi Amano
The case is reported of a 79-year-old female who received a patch augmentation of the tricuspid anterior and septal leaflets with a resected left atrial wall to address recurrent tricuspid regurgitation, including tricuspid valve tethering. The patient was admitted to the authors' hospital for chronic heart failure with paravalvular leakage after aortic valve replacement and recurrent severe tricuspid regurgitation. She had undergone two previous cardiac surgeries. Re-tricuspid repair required an augmentation of the tricuspid valve leaflets in addition to tricuspid annuloplasty...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544838/granulomatosis-with-polyangiitis-presenting-with-acute-aortic-and-mitral-regurgitation-case-report-and-big-data-analysis
#7
Sadeer G Al-Kindi, M Amer Al-Aiti, Michael Yang, Richard A Josephson
Granulomatosis with polyangiitis (GPA) is a rare vasculitis that can have multisystem involvement, though cardiac involvement is very rare. The case is described of a 53-year-old woman who presented with acute aortic and mitral valve regurgitation requiring surgical intervention. Pathology from the excised aortic valve showed geographic necrosis concerning for GPA. Subsequent rheumatologic testing was positive for anti-serine proteinase 3 (PR3) antibody, consistent with GPA. A year after the valve surgery the patient was found to have a vegetation of the mitral valve and elevated PR3 antibody levels, and was successfully treated with an intensification of immunosuppression...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544831/aortic-root-surgery-in-marfan-syndrome-medium-term-outcome-in-a-single-center-experience
#8
Christine H Attenhofer Jost, Heidi M Connolly, Christopher G Scott, Naser M Ammash, Juan M Bowen, Hartzell V Schaff
BACKGROUND: The study aim was to analyze the authors' experience with aortic root surgery in Marfan syndrome (MFS), and to expand the surgical outcome data of patients meeting the Ghent criteria (Marfan registry). METHODS: Analyses were performed of data acquired from MFS patients (who met the Ghent criteria), including an aortic root surgery and Kaplan-Meier survival. RESULTS: Between April 2004 and February 2012, a total of 59 MFS patients (mean age at surgery 36 ± 13 years) underwent 67 operations for aortic root aneurysm (n = 52), aortic valve (AV) regurgitation (n = 15), acute aortic dissection (n = 2), and/or mitral valve (MV) regurgitation resulting from MV prolapse (n = 7)...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544830/assessment-of-contributors-of-aortopathy-and-subclinical-left-ventricular-dysfunction-in-normally-functioning-bicuspid-aortic-valves
#9
Kamil Tuluce, Selcen Yakar Tuluce, Ersin Cagri Simsek, Serdar Bayata, Cem Nazli
BACKGROUND: Left ventricular (LV) function and the dimensions of aortic valves from normally functioning bicuspid aortic valve (BAV) patients were compared with those of healthy control patients. A comparison between patients with antero-posterior BAV (BAV-AP) or right-left BAV (BAV-RL) was also performed, and the determinants of aortopathy and LV function were investigated. METHODS: Sixty-eight patients with aortic velocities <2 m/s and trivial or mild aortic regurgitation were included in the study...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544828/acute-aortic-regurgitation-in-the-current-era-of-percutaneous-treatment-pathophysiology-and-hemodynamics
#10
Baris Bugan, Erkan Yildirim, Murat Celik, Uygar Cagdas Yuksel
Aortic regurgitation (AR) is characterized by the backflow of blood from the aorta to the left ventricle. Acute AR typically causes severe pulmonary edema and hypotension, and is a surgical emergency. In chronic AR, however, compensatory mechanisms can clinically compensate for years, with normal left ventricular function and no symptoms. While the hemodynamic mechanisms of chronic AR on the left ventricle are well described, the hemodynamic mechanisms of acute AR are not clear. Most of the literature on acute AR includes either small series or case reports...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544827/procedural-techniques-for-the-management-of-severe-transvalvular-and-paravalvular-aortic-regurgitation-during-tavr
#11
Abdulla A Damluji, Carlos E Alfonso, Mauricio G Cohen
Aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) is associated with an increased risk of mortality. In severe cases, abrupt hemodynamic changes may occur with a sudden increase in left ventricular end-diastolic pressure that results in frank pulmonary edema, hypoxia, and cardiogenic shock. Here, the case is reported of a patient who developed severe AR immediately after valve deployment that led to severe hemodynamic compromise. The procedural techniques necessary for the immediate management of severe transvalvular and paravalvular AR are described...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28543756/perventricular-device-closure-of-doubly-committed-sub-arterial-ventricular-septal-defects-via-a-left-infra-axillary-approach
#12
Sijie Zhou, Liyun Zhao, Taibing Fan, Bin Li, Weijie Liang, Haoju Dong, Shubo Song, Lin Liu
BACKGROUND: This study sought to evaluate the feasibility, safety, and efficacy of perventricular device closure of a doubly committed sub-arterial ventricular septal defect (dcVSD) through a left infra-axillary approach. METHOD: Forty-five patients, with a dcVSD of less than 8 mm in diameter, were enrolled in this study. The pericardium was exposed and opened through a left infra-axillary mini-incision. Two parallel purse-string sutures were placed on the right ventricle outflow tract and under transesophageal echocardiography guidance, a delivery sheath loaded with the device was inserted into the right ventricle and advanced through the defect into the left ventricle...
May 24, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28540089/failed-tavi-in-tavi-implantation-tavi-dislocation-followed-by-ensuing-surgical-graft-resection
#13
Róbert Novotný, Jaroslav Hlubocký, Tomáš Kovárník, Petr Mitáš, Zuzana Hlubocka, Jan Rulíšek, Sevim Ismihan Gulmez, Shubjiwan Kaur Ghotra, Jaroslav Lindner
We are presenting a case report of failed valve-in-valve treatment of severe aortic stenosis. A control ultrasonography after TAVI implantation revealed a severe aortic regurgitation of the graft which was subsequently unresolved with postimplantation dilatation. Second TAVI was implanted with cranial dislocation to the aortic root. Patient underwent a CT examination to clarify the TAVI in TAVI position. Patient underwent a surgical resection of TAVI with implantation of biological aortic valve prosthesis. In situations where TAVI treatment fails or is complicated beyond the possibility of endovascular repair, surgical intervention despite its higher risks is the preferred choice...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28540072/standard-imaging-techniques-in-transcatheter-aortic-valve-replacement
#14
REVIEW
Arash Salemi, Berhane M Worku
Transcatheter aortic valve replacement (TAVR) has become a widely accepted therapeutic option for patients with severe, symptomatic aortic stenosis at intermediate, high, or extreme risk for conventional surgery as determined through a heart team approach. Two valve prostheses are currently available and the Food and Drug Administration (FDA) approved in the United States for TAVR: the self-expandable Medtronic CoreValve (Medtronic, Inc., Minneapolis, MN, USA) and the balloon-expandable Edwards Sapien Valve (Edwards Lifesciences, Irvine CA, USA)...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28536830/transcatheter-aortic-valve-implantation-in-patients-on-corticosteroid-therapy
#15
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Keitaro Mahara, Itaru Takamisawa, Jun Shimizu, Shuichiro Takanashi, Morimasa Takayama
Transcatheter aortic valve implantation (TAVI) is recommended for patients who are inoperable or at high risk for surgical aortic valve replacement (SAVR). Corticosteroid therapy is considered to be a risk factor for SAVR, but there is a paucity of information about TAVI in patients taking corticosteroids. The aim of this study is to elucidate the outcome of TAVI in patients on chronic corticosteroid therapy, compared with SAVR. We retrospectively analyzed patients on corticosteroid therapy who underwent TAVI (n = 21) or SAVR (n = 30) for severe aortic stenosis in Sakakibara Heart Institute...
May 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28535962/predictors-of-paravalvular-regurgitation-after-implantation-of-the-fully-repositionable-and-retrievable-lotus-transcatheter-aortic-valve-from-the-reprise-ii-trial-extended-cohort
#16
Daniel J Blackman, Ian T Meredith, Nicolas Dumonteil, Didier Tchétché, David Hildick-Smith, Mark S Spence, Darren L Walters, Jan Harnek, Stephen G Worthley, Gilles Rioufol, Thierry Lefèvre, Vicki M Houle, Dominic J Allocco, Keith D Dawkins
Paravalvular leak (PVL) after transcatheter aortic valve replacement is associated with worse long-term outcomes. The Lotus Valve incorporates an innovative Adaptive Seal designed to minimize PVL. This analysis evaluated the incidence and predictors of PVL after implantation of the Lotus transcatheter aortic valve. The REPRISE II (REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Evaluation of Safety and Performance) Study With Extended Cohort enrolled 250 high-surgical risk patients with severe symptomatic aortic stenosis...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28535761/the-emerging-role-of-cardiovascular-magnetic-resonance-in-the-evaluation-of-hypertensive-heart-disease
#17
REVIEW
Sophie Mavrogeni, Vasiliki Katsi, Vasiliki Vartela, Michel Noutsias, George Markousis-Mavrogenis, Genovefa Kolovou, Athanasios Manolis
BACKGROUND: Arterial hypertension is the commonest cause of cardiovascular death. It may lead to hypertensive heart disease (HHD), including heart failure (HF), ischemic heart disease (IHD) and left ventricular hypertrophy (LVH). MAIN BODY: According to the 2007 ESH/ESC guidelines, the recommended imaging technique is echocardiography (echo), when a more sensitive detection of LVH than that provided by ECG, is needed. Cardiovascular Magnetic Resonance (CMR), a non-invasive, non-radiating technique, offers the following advantages, beyond echo: a) more reliable and reproducible measurements of cardiac parameters such as volumes, ejection fraction and cardiac mass b) more accurate differentiation of LVH etiology by providing information about tissue characterisation c) more accurate evaluation of myocardial ischemia, specifically if small vessels disease is present d) technique of choice for diagnosis of renovascular, aortic tree/branches lesions and quantification of aortic valve regurgitation e) technique of choice for treatment evaluation in clinical trials...
May 23, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28535198/transcatheter-aortic-valve-implantation-for-recurrent-valsalva-sinus-re-dissection-and-severe-aortic-regurgitation-shortly-after-surgery-for-type-a-aortic-dissection
#18
Elena Caporali, Giovanni Pedrazzini, Stefanos Demertzis, Enrico Ferrari
Delayed aortic regurgitation following Valsalva sinus re-dissection is a well-known complication that can occur at any time after surgery for type-A aortic dissection without root replacement. We describe a case of acute type-A dissection in an 81-year-old lady successfully treated with aortic valve resuspension and ascending aorta replacement with a 28-mm vascular graft. A month later, the patient was readmitted for worsening heart failure and a transthoracic echocardiogram showed severe aortic regurgitation secondary to non-coronary Valsalva sinus re-dissection and non-coronary aortic valve leaflet prolapse also confirmed at computed tomography scan...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28533581/bicuspid-aortic-valve-an-unusual-cause-of-aneurysm-of-left-coronary-sinus-of-valsalva
#19
Euden Bhutia, Dinesh Kumar, Binoy Shankar, Shakti Pad Das, Sunil Kishore
Bicuspid aortic valve is traditionally considered an innocuous congenital anomaly. Due to a better and widespread availability of non-invasive imaging techniques, it has come to the fore that 30% of these cases develop complications, viz., valve abnormality (aortic regurgitation and stenosis), and aneurysm of aortic root and ascending aorta. Sinus of Valsalva aneurysm is an uncommon complication of bicuspid aortic valve and more so those arising from the left coronary sinus are the rarest. These complications generally occur in the third or fourth decade of life...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28532768/prevalence-and-complications-of-bicuspid-aortic-valve-in-chinese-according-to-echocardiographic-database
#20
Yijian Li, Xin Wei, Zhengang Zhao, Yanbiao Liao, Jialing He, Tianyuan Xiong, Yuanning Xu, Wenyu Lv, Yuanweixiang Ou, Hong Tang, Yuan Feng, Mao Chen
As transcatheter aortic valve replacement has become an alternative treatment for patients at high risk for surgical aortic valve replacement, bicuspid aortic valve (BAV) draws our attention again. The reported frequency of BAV was 0.5% to 2% in western population. However, there was no such epidemiologic study in Chinese population. Our study sought to investigate the prevalence and complications of BAV in China by echocardiographic database. A total of 668 cases who were confirmed with BAV, identified from 195,708 echocardiographic records of 157,039 patients in the echocardiographic database of West China Hospital (between June 2008 and June 2012), were analyzed retrospectively...
April 27, 2017: American Journal of Cardiology
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