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Aortic regurgitation

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https://www.readbyqxmd.com/read/29780725/total-aortic-repair-for-acute-type-a-aortic-dissection-a-new-paradigm
#1
George Matalanis, Shoane Ip
The currently accepted guidelines of open surgical repair for acute type A aortic dissection (ATAAD) include the resection of the primary entry tear, replacement of the ascending aorta and "hemi-arch" with an open distal anastomosis, and aortic valve resuspension and some form of obliteration of the aortic root false lumen. The principal aim being protection against aortic rupture, aortic regurgitation, and coronary ischemia and restoration of antegrade preferential true lumen perfusion. Proponents argue that this operation is tailored to be in the armamentarium of most cardiac surgeons and deliver the lowest early operative risk, while leaving the infrequent long-term sequelae to be dealt with electively by experienced aortic centres...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779973/impact-of-device-host-interaction-on-paravalvular-aortic-regurgitation-with-different-transcatheter-heart-valves
#2
Ramón Rodríguez-Olivares, Nahid El Faquir, Zouhair Rahhab, Lennart van Gils, Ben Ren, Rafi Sakhi, Marcel L Geleijnse, Ron van Domburg, Peter P T de Jaegere, Jose L Zamorano Gómez, Nicolas M Van Mieghem
AIMS: We sought to evaluate the interaction of different aortic root phenotypes with self-expanding (SEV), balloon-expandable (BEV) and mechanically expanded (MEV) and the impact on significant aortic regurgitation. METHODS AND RESULTS: We included 392 patients with a SEV (N = 205), BEV (N = 107) or MEV (N = 80). Aortic annulus eccentricity index and calcification were measured by multi-slice CT scan. Paravalvular aortic regurgitation was assessed by contrast aortography (primary analysis) and transthoracic echocardiography (secondary analysis)...
May 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29778589/significant-mitral-regurgitation-worsens-the-prognosis-and-favors-the-decision-of-conservative-treatment-in-octogenarians-with-severe-symptomatic-aortic-stenosis
#3
Juan José Gómez-Doblas, Miguel Antonio López-Garrido, Víctor Manuel Becerra-Muñoz, Hugo Nelson Orellana-Figueroa, Amelia Carro Hevia, Bernardo García de la Villa, Luis Cornide, Manuel Martínez-Sellés
INTRODUCTION: The coexistence of significant mitral regurgitation (MR) and severe aortic stenosis is prevalent, has a prognostic impact and makes treatment in the elderly population a complex issue. The aim of this study is to determine the prevalence of significant MR among a population of octogenarians and its influence on treatment and prognosis. METHODS: We used the data from PEGASO (Pronóstico de la Estenosis Grave Aórtica Sintomática del Octogenario), a prospective registry that consecutively included 928 patients aged ≥80 years with severe symptomatic aortic stenosis...
May 16, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29778342/one-year-outcomes-associated-with-a-novel-stented-bovine-pericardial-aortic-bioprosthesis
#4
Joseph F Sabik, Vivek Rao, Rüdiger Lange, A Pieter Kappetein, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Neil J Weissman, Himanshu J Patel, Michael J Reardon, Federico M Asch, Cathy Zeng, Robert J M Klautz
OBJECTIVES: The study objectives were to evaluate the safety, effectiveness, and hemodynamic performance of a new stented bovine pericardial aortic valve. METHODS: This trial enrolled patients with symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. We assessed death, valve-related adverse events, functional recovery, and hemodynamic performance at discharge, 3 to 6 months, and 1 year, as required by the US Food and Drug Administration for regulatory approval...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29777372/cardiac-surgery-2017-reviewed
#5
REVIEW
Torsten Doenst, Hristo Kirov, Alexandros Moschovas, David Gonzalez-Lopez, Rauf Safarov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2017, more than 21,000 published references can be found in PubMed when entering the search term "cardiac surgery". This review focusses on conventional cardiac surgery, considering the new interventional techniques only if they were directly compared to classic techniques but also entails aspects of perioperative intensive care management. The publications last year provided a plethora of new and interesting information that helped to quantify classic surgical treatment effects and provided new guidelines for the management of structural heart disease, which made comparisons to interventional techniques easier...
May 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29773412/athlete-s-heart-is-the-morganroth-hypothesis-obsolete
#6
Mark J Haykowsky, T Jake Samuel, Michael D Nelson, Andre La Gerche
In 1975, Morganroth and colleagues reported that the increased left ventricular (LV) mass in highly trained endurance athletes versus nonathletes was primarily due to increased end-diastolic volume while the increased LV mass in resistance trained athletes was solely due to an increased LV wall thickness. Based on the divergent remodelling patterns observed, Morganroth and colleagues hypothesised that the increased "volume" load during endurance exercise may be similar to that which occurs in patients with mitral or aortic regurgitation while the "pressure" load associated with performing a Valsalva manoeuvre (VM) during resistance exercise may mimic the stress imposed on the heart by systemic hypertension or aortic stenosis...
May 1, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29771343/do-surgical-modifications-at-the-annular-level-during-the-ross-procedure-negatively-influence-the-structural-and-functional-durability-of-the-autograft
#7
Anja Lögers, Barbara Rosser, Burkhardt Seifert, Oliver Kretschmar, Michael Hübler, René Prêtre, Lotfi Ben Mime
OBJECTIVES: Do surgical modifications at the annular level (e.g. the modified Ross-Konno procedure or reduction plasty) influence the structure and function of the Ross autograft at the mid-term follow-up? METHODS: From June 2001 to July 2009, 49 patients (37 men and 12 women), mean age 10.5 ± 5.7 years (range 2 weeks to 17.8 years), underwent Ross operations. Twenty-one patients underwent additional aortic annulus reduction plasty and 9 patients a modified Ross-Konno procedure...
May 15, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29764687/intraoperative-aortic-root-pressure-study-for-quantitative-assessment-of-aortic-regurgitation-during-valve-sparing-root-replacement-a-preliminary-report
#8
Yuki Ikeno, Hiroshi Tanaka, Yutaka Okita
No abstract text is available yet for this article.
April 17, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29762934/rescue-tavi-for-aortic-regurgitation-after-left-ventricular-assist-device-implantation-following-preoperative-impella%C3%A2-support
#9
Florian E M Herrmann, Petra Wellmann, Vera von Dossow, Steffen Massberg, Christian Hagl, René Schramm, Maximilian Pichlmaier
A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762933/ross-procedure-following-a-dislodged-transcatheter-aortic-valve-replacement
#10
Samuel R Schnittman, Aaron J Weiss, Robin Varghese, Paul Stelzer
A 36-year-old pregnant woman with a history of rheumatic heart disease and prior aortic valve replacement and mitral valve repair presented to an outside hospital with severe aortic stenosis. The patient had a cardiac arrest upon labor induction and underwent a transcatheter aortic valve replacement (TAVR), which dislodged two days later. Five months later, the patient underwent removal of the dislodged TAVR and a Ross procedure at the authors' institution. The patient was stable upon discharge, with minimal aortic and pulmonary regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762930/cusp-tear-of-trifecta%C3%A2-aortic-bioprosthesis-resulting-in-acute-heart-failure
#11
Anne-Kristin Schaefer, Alfred Kocher, Günther Laufer, Dominik Wiedemann
Herein is presented the case of an 83-year-old male patient in cardiogenic shock with acute aortic regurgitation that occurred six years after aortic valve replacement (AVR) with a 23 mm Trifecta™ valve. Prosthesis endocarditis was initially suspected because of a floating structure attached to the aortic valve that was visible on echocardiography. Emergency redo-AVR surgery was performed, but no signs of endocarditis were found intraoperatively. Hence, cusp tearing of the implanted bioprosthesis was considered to be the reason for the severe aortic regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762918/impact-of-heart-rate-on-flow-measurements-in-aortic-regurgitation
#12
Mats Lidén, Maciej Wodecki, Per Thunberg, Peter Rask
BACKGROUND: Flow measurements using cardiac magnetic resonance imaging (CMRI) enable quantification of the stroke volume, regurgitant volume (RV) and regurgitant fraction (RF) in patients with aortic regurgitation (AR). These variables are used to assess the severity of the valve disease and for the timing of surgery. The aim of the study was to investigate the impact of an increased heart rate on measurement of the RV and RF in patients with AR. METHODS: Among 13 patients with known moderate or severe AR, regurgitant flow measurements, using phase-contrast cine magnetic resonance imaging, were obtained in the ascending aorta...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29760325/role-of-computed-tomography-in-planning-the-appropriate-x-ray-gantry-for-quantitative-aortography-of-post-transcatheter-aortic-valve-implantation-regurgitation
#13
Hiroki Tateishi, Yosuke Miyazaki, Takayuki Okamura, Rodrigo Modolo, Mohammad Abdelghani, Osama I I Soliman, Tetsuro Oda, Akihito Mikamo, Yoshinobu Onuma, Kimikazu Hamano, Masafumi Yano, Patrick W Serruys
BACKGROUND: The clinical robustness of contrast-videodensitometric (VD) assessment of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) has been demonstrated. Correct acquisition of aortic root angiography for VD assessment, however, is hampered by the opacified descending aorta and by individual anatomic peculiarities. The aim of this study was to use preprocedural multi-slice computed tomography (MSCT) to optimize the angiographic projection in order to improve the feasibility of VD assessment...
May 15, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29759854/a-meta-analysis-of-reduced-leaflet-motion-for-surgical-and-transcatheter-aortic-valves-relationship-to-cerebrovascular-events-and-valve-degeneration
#14
Nader Makki, Satya Shreenivas, Dean Kereiakes, Scott Lilly
BACKGROUND: Reduced leaflet motion (RLM) of transcatheter aortic valves (TAV) is observed in up to 4% of cases with similar frequency in surgical valves, with an overall incidence that differs based on prosthesis type and size. This phenomenon likely represents subclinical leaflet thrombosis. Herein we sought to analyze the existing reported literature to assess whether or not RLM is associated with subsequent valve degeneration or cerebrovascular events. METHODS AND RESULTS: We searched PubMed, and EMBASE (2008-2017) to identify relevant studies...
April 5, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29755630/echocardiographic-features-in-bartonella-endocarditis-a-case-series
#15
Orathai Pachirat, Sompop Prathanee, George Watt
Bartonella spp. are emerging pathogens that are reported as the cause of blood culture-negative endocarditis ( BCNE). However, echocardiographic features and assessment of this endocarditis remains unclear. Four patients with B. henselae endocarditis were identified. All patients had underlying cardiac conditions: rheumatic heart disease in three, congenital heart disease in one. Evidence of vegetations was found on the aortic valve in all patients with large, highly mobile vegetations and severely destroyed valves demonstrated by the transthoracic echocardiogram leading to severe aortic regurgitation and heart failure...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29755090/-successful-surgical-repair-of-the-aortic-annular-infective-endocarditis-with-subvalvular-abscess-report-of-a-case
#16
Manabu Shiraishi, Daigo Shinoda, Nobu Yokoyama, Satoshi Itoh
A 49-year-old female was admitted to our hospital with a history of fever for 2 weeks and consciousness disorder.Transthoracic echocardiography demonstrated aortic regurgitation with a mobile fibrous band adhering to the right cusp. Infective endocarditis was diagnosed by positive blood culture and echocardiographic findings. Emergent aortic valve surgery was performed because of uncontrollable infection. A destroyed aortic annulus and subvalvular abscess was found during the operation. Removal of abscess tissue and annuloplasty with self-pericardium were successfully performed...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#17
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29748086/an-updated-meta-analysis-of-tavr-in-patients-at-intermediate-risk-for-savr
#18
Mohamad Lazkani, Nirmal Singh, Carol Howe, Nachiket Patel, Modesto J Colón, Mark Tasset, Orazio Amabile, Michael Morris, H Kenith Fang, Ashish Pershad
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has been approved for use in patients with severe aortic stenosis at intermediate, high and extreme surgical risk. This meta-analysis was performed to assess the safety and efficacy of TAVR compared to surgical aortic valve replacement (SAVR) in intermediate risk patients. METHODS: We searched PubMed, EMBASE, Web of science, and the Cochrane Central Register of Controlled Trials databases for studies comparing TAVR versus SAVR in patients at intermediate surgical risk, with a mean Society of Thoracic Surgeon score of 3-8% or a mean logistic European risk score of 10-20%...
April 20, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29745501/-experimental-study-of-the-effects-of-sinotubular-junction-taper-on-artificial-bioprosthesis-valve-in-pulsatile-flow-condition
#19
Rongxi Jia, Yunfei Ma, Zhaoyong Gu, Youlian Pan, Sicong Liu, Aike Qiao, Chao Guo, Nianguo Dong, Xiaofeng Li, Yinglong Liu
The aim of the present experimental study is to determine the effects of sinotubular junction diameter on artificial bioprosthesis valves. An experimental study was performed for aortic root models with different sinotubular junction taper under pulsatile flow condition. The sinotubular junction diameters were modified to create four models with different sinotubular junction tapers with 0, 1, 3 and 5 degrees, respectively, using three dimensional printing techniques. After installing the testing bioprosthesis valve on the aortic root models, we conducted experiments of the pulsatile flow testing with different stroke volume in the pulsatile circulation simulation system...
June 1, 2017: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
https://www.readbyqxmd.com/read/29743999/transcatheter-mitral-valve-replacement-for-native-and-failed-bioprosthetic-mitral-valves
#20
REVIEW
Kunal Sarkar, Michael J Reardon, Stephen H Little, Colin M Barker, Neal S Kleiman
Transcatheter mitral valve replacement (TMVR) is a novel approach for treatment of severe mitral regurgitation. A number of TMVR devices are currently undergoing feasibility trials using both transseptal and transapical routes for device delivery. Overall experience worldwide is limited to fewer than 200 cases. At present, the 30-day mortality exceeds 30% and is attributable to both patient- and device-related factors. TMVR has been successfully used to treat patients with degenerative mitral stenosis (DMS) as well as failed mitral bioprosthesis and mitral repair using transcatheter mitral valve-in-valve (TMViV)/valve-in-ring (ViR) repair...
July 2017: Methodist DeBakey Cardiovascular Journal
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