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https://www.readbyqxmd.com/read/28636475/surgical-aortic-valve-replacement-for-stenosis-of-tavi-device
#1
M Sooknunden, M A Radermecker, J O Defraigne, Vincent Tchana-Sato
We here report the case of a stenosis of the CoreValve(®) system due to reduced mobility of prosthesis cusps for which a surgical replacement of the aortic valve was proposed. The exact mechanism leading to this impaired mobility of the leaflets is yet to be determined. We also underline the fact a transcatheter aortic valve implantation (TAVI) device can be replaced by a surgical replacement without excessive operative risks despite the patient being initially considered as high-risk.
March 1, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28611879/pitfalls-in-electrocardiographic-diagnosis-of-acute-coronary-syndrome-in-low-risk-chest-pain
#2
REVIEW
Semhar Z Tewelde, Amal Mattu, William J Brady
Less than half of patients with a chest pain history indicative of acute coronary syndrome have a diagnostic electrocardiogram (ECG) on initial presentation to the emergency department. The physician must dissect the ECG for elusive, but perilous, characteristics that are often missed by machine analysis. ST depression is interpreted and often suggestive of ischemia; however, when exclusive to leads V1-V3 with concomitant tall R waves and upright T waves, a posterior infarction should first and foremost be suspected...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28610762/early-trifecta-valve-failure-report-of-a-cluster-of-cases-from-a-tertiary-care-referral-center
#3
Ankur Kalra, Hasan Rehman, Mahesh Ramchandani, Colin M Barker, Gerald M Lawrie, Ross M Reul, Michael J Reardon, Neal S Kleiman
BACKGROUND: The Trifecta valve (St Jude Medical, Inc, St Paul, Minn) was approved for commercial use by the US Food and Drug Administration in 2011. Several isolated cases have been reported since then, describing early structural valve deterioration. We report a case series of 8 Trifecta valve failures, describing patients' clinical substrate and management, and the pathologic characteristics of the explanted valves. METHODS: Trifecta valve failure occurred in 7 patients (8 valves) receiving 19-mm (n = 2), 21-mm (n = 3), 23-mm (n = 1), and 25-mm (n = 2) valves...
May 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#4
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28597767/increased-mortality-from-complications-of-pulmonary-hypertension-in-patients-undergoing-transcatheter-aortic-valve-replacement
#5
Raj Parikh, Benson Varghese, Huma N Khatoon, Julie A Kovach, Clifford J Kavinsky, Rajive Tandon
Aortic stenosis (AS) leads to pulmonary hypertension (PH) and right ventricle (RV) failure. Our goal was to describe mortality related to postoperative complications in PH patients undergoing transcatheter aortic valve replacement (TAVR). Ninety-three TAVR patients were analyzed (controls, sPAP < 50 mmHg; cases, sPAP ≥ 50 mmHg). Significant findings in cases included increased mortality (365 days), post-TAVR atrioventricular block (AVB) and acute kidney injury (AKI), and increased mean length of stay (LOS)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28597027/-low-flow-low-gradient-aortic-valve-stenosis-current-evidence
#6
F Tillwich, M A Sherif, S Yücel, A Öner, H Ince
Many patients with severe aortic stenosis have a "low-flow, low-gradient" aortic stenosis. The management of these patients can be quite difficult, as these patients often show impairment of the left ventricle, which can lead to false measurements of the severity of stenosis and also leads to a higher risk during aortic valve replacement. More diagnostic tools than only standard echocardiography are needed to correctly differentiate true severe aortic stenosis from pseudo severe aortic stenosis.
June 9, 2017: Herz
https://www.readbyqxmd.com/read/28591059/left-sinus-of-valsalva-aneurysm-ruptured-into-left-ventricle-a-case-report-of-320-multidetector-ct-findings
#7
Kyungsoo Bae, Kyung Nyeo Jeon, Hyang-Im Lee, Jeong Yoon Jang, Sung Eun Park, Kyeong Hwa Ryu, Hye Jin Baek, Bo Hwa Choi, Jin Il Moon, Soo Buem Cho
RATIONALE: Ruptured aneurysm originating from the left coronary sinus of Valsalva into the left ventricle (LV) is extremely rare. Imaging features of sinus aneurysm has been commonly reported using echocardiography or angiography. Here, we report multidetector computed tomography (MDCT) findings of left sinus of Valsalva aneurysm extending into the LV and caused severe aortic regurgitation (AR) in a 44-year-old male with latent infective endocarditis. The role of MDCT in preoperative surgical planning was also emphasized...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28583685/usefulness-of-the-r-wave-sign-as-a-predictor-for-ventricular-tachyarrhythmia-in-patients-with-brugada-syndrome
#8
Ahmed A Y Ragab, Charlotte A Houck, Lisette J M E van der Does, Eva A H Lanters, Danielle E Burghouwt, Agnes J Q M Muskens, Natasja M S de Groot
Brugada syndrome (BrS) is an autosomal dominant channelopathy which is responsible for a large number of sudden cardiac deaths in young subjects without structural abnormalities. The most challenging step in management of patients with BrS is identifying who is at risk for developing malignant ventricular tachyarrhythmia (VTA). In patients with BrS, conduction delay in the right ventricular outflow tract (RVOT) causes a prominent R wave in lead aVR. This electrocardiographic parameter can be useful to detect these high-risk patients...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28570525/full-root-aortic-valve-replacement-by-stentless-aortic-xenografts-in-patients-with-small-aortic-roots
#9
Reza Tavakoli, Peiman Jamshidi, Max Gassmann
In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial valve might not meet the functional needs. The implantation of a too-small stented pericardial valve, leading to an effective orifice area indexed to a body surface area less than 0.85 cm(2)/m(2), is regarded as prosthesis-patient mismatch (PPM). A PPM negatively affects the regression of left ventricular hypertrophy and thus the normalization of left ventricular function and the alleviation of symptoms...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28545282/-electrocardiogram-characteristics-of-patients-with-ventricular-arrhythmia-originating-from-the-distal-great-cardiac-vein
#10
R L Zheng, D P Zhou, J X Lin, Y C Li, J Li, J Li, R P Yin, J F Lin
Objective: To explore the electrocardiographic characteristics of patients with idiopathic ventricular arrhythmias (VAs) originating from different portions of distal great cardiac veins (DGCV). Methods: The study included 49 patients underwent successful RFCA of premature ventricular complex(PVCs)/ventricular tachycardia(VT) from different portions of the DGCV in our department from July 2009 to March 2016. The surface 12-lead electrocardiogram (ECG) and intraventricular ablation mapping features were analyzed...
April 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28543102/low-flow-low-gradient-aortic-stenosis-still-a-diagnostic-and-therapeutic-challenge
#11
REVIEW
Anja Vogelgesang, Gerd Hasenfuss, Claudius Jacobshagen
Aortic stenosis (AS) is the most frequently observed valvular heart disease. During the symptomatic stage, the rate of death increases dramatically, so that a precise diagnostic approach is taken to guide therapeutic options. Of patients with severe AS, 30% to 50% present with low-flow/low-gradient AS (LF/LGAS) status. This review focuses on LF/LGAS and the best diagnostic and therapeutic management in either classic LF/LGAS with reduced left ventricular ejection fraction (LVEF) or paradoxical LF/LGAS with preserved LVEF...
May 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#12
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28511838/supra-annular-valve-in-valve-implantation-reduces-blood-stasis-on-the-transcatheter-aortic-valve-leaflets
#13
Koohyar Vahidkhah, Ali N Azadani
Leaflet thrombosis following transcatheter aortic valve replacement (TAVR) and Valve-in-Valve (ViV) procedures has been increasingly recognized. This study aimed to investigate the effect of positioning of the transcatheter aortic valve (TAV) in ViV setting on the flow dynamics aspect of post-ViV thrombosis by quantifying the blood stasis in the intra-annular and supra-annular settings. To that end, two idealized computational models, representing ViV intra-annular and supra-annular positioning of a TAV were developed in a patient-specific geometry...
May 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28510739/comparison-of-preoperative-and-intraoperative-assessment-of-aortic-stenosis-severity-by-echocardiography
#14
Y Uda, B Cowie, R Kluger
Background: General anaesthesia and surgically induced changes in cardiac loading conditions may alter flow across the aortic valve. This study examined how echocardiographic assessment of the severity of aortic stenosis (AS) changes during surgery. Methods: Patients who underwent aortic valve replacement for any severity of AS between July 2007 and June 2015 were identified. Peak velocities, mean gradients, and dimensionless indices (DI) measured with preoperative transthoracic echocardiography (TTE) were compared with those measured with intraoperative transoesophageal echocardiography (TOE)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28506602/ventricular-tachycardia-score-a-novel-method-for-wide-qrs-complex-tachycardia-differentiation-explained
#15
Marek Jastrzębski, Piotr Kukla, Danuta Czarnecka
Philosophy, merits and limitations of a novel method for wide QRS complex tachycardia differentiation, based on a scoring system and called the ventricular tachycardia (VT) score, were explained. The following criteria were assigned one point: initial dominant R wave in V1; initial r>40 ms in V1 or V2; notched S in V1; initial R wave in aVR; lead II RWPT≥50 ms; and absence of an RS in leads V1-V6. Atrioventricular dissociation (including fusion/capture beats and partial dissociation) was assigned two points...
April 25, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28441151/recent-clinical-trials-in-valvular-heart-disease
#16
Daniel Kiss, Saif Anwaruddin
PURPOSE OF REVIEW: With widespread adoption of transcatheter aortic valve replacement, there has been a change in the approach to management of valvular heart disease. New interest has taken hold in transcatheter therapies for valvular heart disease, as well as research into pathophysiology and progression of disease. Additionally, several key trials have further refined our understanding of surgical management of valvular heart disease. This review will elucidate recent clinical trial data leading to changes in practice...
July 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28440568/impact-of-t-wave-amplitude-in-lead-avr-on-predicting-cardiac-events-in-ischemic-and-nonischemic-cardiomyopathy-patients-with-an-implantable-cardioverter-defibrillator
#17
Yoshihiro Tanaka, Tetsuo Konno, Yudai Tamura, Toyonobu Tsuda, Hiroshi Furusho, Masayuki Takamura, Kenji Sakata, Masakazu Yamagishi, Kenshi Hayashi
BACKGROUND: T wave amplitudes during ventricular repolarization in the lead aVR (TAaVR) are shown to be associated with adverse cardiac events in patients with several cardiovascular diseases, such as postmyocardial infarction. However, the utility of TAaVR has not been previously evaluated in patients with cardiomyopathy who have received implantable cardioverter defibrillators (ICD). Patients with ischemic or nonischemic cardiomyopathy (ICM or NICM, respectively) and who received an ICD may experience worsening of their condition due to the introduction of electric shock during treatment...
April 25, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#18
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28405096/cardiac-rehabilitation-for-a-skydiver-after-aortic-valve-replacement-for-pure-aortic-regurgitation-and-resection-of-the-ascending-aorta-complicated-by-active-infective-endocarditis-and-heart-block-requiring-a-pacemaker
#19
Tonja R Solomon, Sandra DeJong, Tim Bilbrey, Pasquale Carbone, Mark Campbell, Robert D Parker, Alessandra Lira, Diogo Amarante, Jeffrey M Schussler, Jenny Adams
A professional skydiver underwent aortic valve and ascending aorta replacement complicated by infective endocarditis with root abscess and pacemaker implantation. He then enrolled in the Baylor Heart and Vascular Hospital cardiac rehabilitation (CR) program as part of its specificity of testing and exercise training facility. He performed specific skydiving cardiovascular and muscular strength tests at the beginning and the end of the CR program. His pacemaker was interrogated to ascertain any arrhythmias or lead displacement over the course of the CR program...
April 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28360193/a-role-for-galectin-3%C3%A2-in-the-development-of-early-molecular-alterations-in-short-term-aortic-stenosis
#20
Vanessa Arrieta, Ernesto Martinez-Martinez, Jaime Ibarrola, Virginia Alvarez, Rafael Sádaba, Amaia Garcia-Peña, Amaya Fernández-Celis, Victoria Cachofeiro, Patrick Rossignol, Natalia López-Andrés
Aortic stenosis (AS) is characterized by pressure overload and causes left ventricular (LV) fibrosis and inflammation, two mechanisms that eventually lead to cardiac dysfunction. Galectin-3 (Gal-3), a β-galactoside-binding lectin, promotes cardiac remodelling. In the present study, we investigated the role of Gal-3 in LV remodelling in patients with AS and the effects of Gal-3 blockade in rats subjected to short-term (6-week) supravalvular aortic banding (AS group). Myocardial biopsies were obtained from 25 patients with severe AS referred for aortic valve replacement and from necropsies of 11 cardiovascular disease-free control individuals...
May 1, 2017: Clinical Science (1979-)
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