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calcific aortic stenosis

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https://www.readbyqxmd.com/read/28183512/a-test-in-context-lipoprotein-a-diagnosis-prognosis-controversies-and-emerging-therapies
#1
REVIEW
Sotirios Tsimikas
Evidence that elevated lipoprotein(a) (Lp[a]) levels contribute to cardiovascular disease (CVD) and calcific aortic valve stenosis (CAVS) is substantial. Development of isoform-independent assays, in concert with genetic, epidemiological, translational, and pathophysiological insights, have established Lp(a) as an independent, genetic, and likely causal risk factor for CVD and CAVS. These observations are consistent across a broad spectrum of patients, risk factors, and concomitant therapies, including patients with low-density lipoprotein cholesterol <70 mg/dl...
February 14, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28179397/dipeptidyl-peptidase-4-induces-aortic-valve-calcification-by-inhibiting-insulin-like-growth-factor-1-signaling-in-valvular-interstitial-cells
#2
Bongkun Choi, Sahmin Lee, Sang-Min Kim, Eun-Jin Lee, Sun Ro Lee, Dae-Hee Kim, Jeong Yoon Jang, Sang-Wook Kang, Ki-Up Lee, Eun-Ju Chang, Jae-Kwan Song
Background -Calcification of the aortic valve leads to increased leaflet stiffness, and consequently to the development of calcific aortic valve disease (CAVD); however, the underlying molecular and cellular mechanisms of calcification remain unclear. Here, we identified that dipeptidyl peptidase-4 (DPP-4, also known as CD26) increases valvular calcification and promotes CAVD progression. Methods -We obtained the aortic valve tissues from humans and murine models (wild type and eNOS(-/-) mice), and cultured the valvular interstitial cells (VICs) and valvular endothelial cells (VECs) from the cusps...
February 8, 2017: Circulation
https://www.readbyqxmd.com/read/28168982/two-decades-of-experience-with-root-remodeling-and-valve-repair-for-bicuspid-aortic-valves
#3
Ulrich Schneider, Susanne K Feldner, Christopher Hofmann, Jakob Schöpe, Stefan Wagenpfeil, Christian Giebels, Hans-Joachim Schäfers
OBJECTIVE: Bicuspid aortic valve anatomy is associated with ascending aortic aneurysm in approximately 50% of individuals and may lead to severe aortic regurgitation with aortic dilatation. Both entities may be treated by valve repair and root remodeling. The objective was to review the cumulative experience of 20 years. METHODS: Between November 1995 and December 2015, 357 patients (324 male; age 10-80 years; mean, 49 ± 13 years) underwent combined bicuspid aortic valve repair and root remodeling...
January 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28129367/differences-in-aortic-valve-and-left-ventricular-parameters-related-to-the-severity-of-myocardial-fibrosis-in-patients-with-severe-aortic-valve-stenosis
#4
Inyoung Song, Sung Min Ko, Jeong Geun Yi, Hyun Keun Chee, Jun Seok Kim
OBJECTIVE: This study investigated the morphological and functional characteristics of the aortic valve and the left ventricular (LV) systolic functional parameters and myocardial mass related to the severity of myocardial fibrosis (MF) in patients with severe aortic valve stenosis (AS). MATERIALS AND METHODS: We retrospectively enrolled 81 patients (48 men; mean age: 59±12 years) with severe AS who underwent transthoracic echocardiography (TTE), cardiac computed tomography (CCT), and cardiovascular magnetic resonance (CMR) within 1 month and subsequent aortic valve surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28118978/the-impact-of-imperfect-frame-deployment-and-rotational-orientation-on-stress-within-the-prosthetic-leaflets-during-transcatheter-aortic-valve-implantation
#5
Jonathon Bailey, Nick Curzen, Neil W Bressloff
TAVI devices are manufactured with cylindrical frames. However, the frames are rarely cylindrical post-deployment since deformation due to localised under expansion can be induced by calcified material on the native valve leaflets exerting irregular forces upon the frame. Consequently, the leaflets within a deformed TAVI device may undergo elevated stress during operation, which may lead to premature device failure. Using computational analysis a complete TAVI device model was simulated undergoing deployment into an aortic root model derived from CT data for a patient with severe calcific aortic stenosis, followed by a pressure simulated cardiac cycle...
December 29, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#6
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105997/first-successful-transcatheter-double-valve-replacement-from-a-transapical-access-and-nine-month-follow-up
#7
Robert Bauernschmitt, Stefan Bauer, Christian Liewald, Ramiz Emini, Wolfgang Oechsner, Meinrad Beer, Ralf Sodian, Andreas Liebold
AIMS: While TAVI is the treatment of choice in patients with aortic stenosis considered inoperable or at high risk, interventional replacement of the mitral valve is still in the preclinical or early clinical phase. Our aim was to report on the first transcatheter double valve replacement into native valves from a transapical access. METHODS AND RESULTS: A 67-year-old, highly symptomatic female patient considered inoperable due to severe calcification of the mitral annulus and comorbidities was scheduled for transcatheter double valve replacement by the local Heart Team...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#8
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28068801/the-prevalence-of-lipoprotein-a-measurement-and-degree-of-elevation-among-2710-patients-with-calcific-aortic-valve-stenosis-in-an-academic-echocardiography-laboratory-setting
#9
Michael J Wilkinson, Gary S Ma, Calvin Yeang, Lawrence Ang, Monet Strachan, Anthony N DeMaria, Sotirios Tsimikas, Bruno Cotter
Lipoprotein(a; Lp[a]) and its associated oxidized phospholipids are causal, genetic risk factors for calcific aortic valve stenosis (CAVS). We determined the prevalence of Lp(a) measurement among 2710 patients with CAVS and 1369 control patients (∼50% of study group) without CAVS with an echocardiogram between January 2010 and February 2016 in an academic echocardiography laboratory. Lipoprotein(a) measurements were performed at a referral laboratory using an isoform-independent assay. The prevalence of any Lp(a) measurement was 4...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28064153/comparison-of-valve-performance-of-the-mechanically-expanding-lotus-and-the-balloon-expanded-sapien3-transcatheter-heart-valves-an-observational-study-with-independent-core-laboratory-analysis
#10
Osama I I Soliman, Nahid El Faquir, Ben Ren, Ernest Spitzer, Lennart van Gils, Hans Jonker, Marcel L Geleijnse, Gerrit-Anne van Es, Jan G Tijssen, Nicolas M van Mieghem, Peter P T de Jaegere
AIMS: The Lotus and SAPIEN3 are second-generation transcatheter heart valves, which are designed to minimize paravalvular aortic regurgitation (PAR) after transcatheter aortic valve replacement (TAVR). We sought to compare both devices for valve performance and with emphasis on PAR by independent core laboratory analysis. METHODS AND RESULTS: A total of 162 (79 Lotus and 83 SAPIEN3) consecutive patients (51% female, 80 ± 8 years, Logistic EuroSCORE 14.8 ± 9...
January 6, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28057890/in-vitro-3d-model-and-mirna-drug-delivery-to-target-calcific-aortic-valve-disease
#11
REVIEW
Casper F T van der Ven, Pin-Jou Wu, Mark W Tibbitt, Alain van Mil, Joost P G Sluijter, Robert Langer, Elena Aikawa
Calcific aortic valve disease (CAVD) is the most prevalent valvular heart disease in the Western population, claiming 17000 deaths per year in the United States and affecting 25% of people older than 65 years of age. Contrary to traditional belief, CAVD is not a passive, degenerative disease but rather a dynamic disease, where initial cellular changes in the valve leaflets progress into fibrotic lesions that induce valve thickening and calcification. Advanced thickening and calcification impair valve function and lead to aortic stenosis (AS)...
February 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28044253/transvenous-inoue-balloon-aortic-valvuloplasty-with-intra-aortic-balloon-pump-in-treating-cardiogenic-shock-due-to-critical-calcific-aortic-stenosis
#12
Yoshihito Sakata
A 90-year-old female with severe peripheral vascular disease developed cardiogenic shock (CS) due to critical aortic stenosis (AS). The balloon aortic valvuloplasty was emergently performed via transvenous and transseptal antegrade approach (ante-BAV), which saved arterial accesses for intra-aortic balloon pump (IABP) and enabled us to use the Inoue balloon. The IABP augmented systemic perfusions and controlled left heart filling pressures. Multiple times of inflations with stepwisely increased balloon diameters were performed under IABP support (ante-Inoue-BAV + IABP), resulting in remarkable improvements both in clinical and hemodynamic conditions...
January 2, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28039339/concomitant-mitral-annular-calcification-and-severe-aortic-stenosis-prevalence-characteristics-and-outcome-following-transcatheter-aortic-valve-replacement
#13
Yigal Abramowitz, Yoshio Kazuno, Tarun Chakravarty, Hiroyuki Kawamori, Yoshio Maeno, David Anderson, Zev Allison, Geeteshwar Mangat, Wen Cheng, Ambarish Gopal, Hasan Jilaihawi, Michael J Mack, Raj R Makkar
AIMS: Calcified aortic stenosis (AS) and mitral annular calcification (MAC) have certain similar etiology and pathophysiological mechanisms. MAC is frequently encountered in pre-procedural computed tomography (CT) imaging of patients that undergo transcatheter aortic valve replacement (TAVR), but its prognostic implications for these patients have not been thoroughly investigated. This study sought to evaluate the prevalence of MAC among patients with severe AS and to assess the clinical implications of MAC on these patients during and following TAVR...
December 30, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28028747/non-occlusive-mesenteric-ischemia-accompanied-by-aortic-regurgitation-after-transcatheter-aortic-valve-implantation
#14
Kentaro Meguro, Junro Ishizaki, Tomoyoshi Yanagisawa, Toshimi Koitabashi, Tadashi Kitamura, Junya Ako
An 81-year-old male with severe symptomatic aortic stenosis with ventricular tachycardia was referred for treatment. Balloon aortic valvuloplasty was performed under cardiopulmonary resuscitation. Though transcatheter aortic valve implantation (TAVI) was considered high risk for annulus rupture and aortic regurgitation due to annular calcification, TAVI was performed because of extremely high surgical risk. Moderate-to-severe aortic regurgitation (AR) remained and progression of acidosis could not be managed with continuous hemodiafiltration...
December 27, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28010874/predictors-of-paravalvular-regurgitation-after-transcatheter-aortic-valve-implantation-for-aortic-stenosis-using-new-generation-balloon-expandable-sapien-3
#15
Hidehiro Kaneko, Frank Hoelschermann, Grit Tambor, Sung-Han Yoon, Michael Neuss, Christian Butter
Paravalvular regurgitation (PVR) is a common and serious complication after transcatheter aortic valve implantation (TAVI). New-generation balloon-expandable SAPIEN 3 has an outer sealing skirt to minimize PVR. However, the predictors of PVR after SAPIEN 3 transcatheter heart valve (THV) implantation have not been well investigated. We sought to clarify the determinants of PVR after TAVI using SAPIEN 3 with quantitative multidetector computed tomography (MDCT) assessment. This study analyzed 281 patients with severe symptomatic aortic stenosis who underwent TAVI using SAPIEN 3...
November 16, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28009958/retrograde-snare-technique-to-overcome-hostile-aortic-arch-anatomy-during-transcatheter-aortic-valve-implantation
#16
Rodney De Palma, Nawsad Saleh, Andreas Ruck, Magnus Settergren
Percutaneous valve implantation is a recognized therapy for calcific aortic stenosis in those patients who are inoperable or at high surgical risk. The transfemoral approach is the most frequently used method for device delivery, but a tortuous calcific aorta and the inflexibility of large-caliber endovascular equipment can impede progress or even cause the procedure to be abandoned. Herein, the use of a technique employing a snare to safely overcome device obstruction in the aortic arch of an elderly female patient is described...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28005568/dilemma-in-the-therapeutic-management-of-low-gradient-aortic-stenosis
#17
Marie-Annick Clavel, Nancy Côté, Philippe Pibarot
PURPOSE OF REVIEW: Grading of aortic stenosis is essential in aortic stenosis management patients. However, despite clear thresholds provided in the guidelines, up to 30% of patients have discordant grading of aortic stenosis. The management of patients with low gradients/velocity despite tight aortic valve area is challenging. RECENT FINDINGS: Recent studies demonstrated that patients with or without low flow may have a severe aortic stenosis despite a low gradient...
March 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/27940769/progressive-aortic-stenosis-in-homozygous-familial-hypercholesterolemia-after-liver-transplant
#18
Margaret Greco, Joshua D Robinson, Osama Eltayeb, Irwin Benuck
Early onset coronary artery disease and aortic calcifications are characteristic features of patients with homozygous familial hypercholesterolemia. Standard medical therapy includes dietary modification, pharmacotherapy, and lipoprotein apheresis to lower serum low-density lipoprotein cholesterol (LDL-C). Liver transplant is a surgical option for the treatment of homozygous familial hypercholesterolemia and can lead to normal cholesterol levels. Vascular calcifications are known to progress despite standard medical therapy and have been reported after liver transplant in the setting of rejection...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27931555/risk-factor-profile-of-calcific-aortic-stenosis
#19
I Sathyamurthy, Shaji Alex, K Kirubakaran, G Sengottuvelu, K N Srinivasan
BACKGROUND: Calcific aortic stenosis and coronary artery disease share common risk factors. In some of the previous studies statins have been used to retard the progression of aortic stenosis, but the results were inconsistent. METHODS: One hundred and ten patients of CAS above the age of 40 years have undergone clinical, biochemical and echocardiographic evaluation. Coronary angiograms were done in 66% of them. RESULTS: Male to female ratio was 2:1...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27930358/histological-findings-and-predictors-of-cerebral-debris-from-transcatheter-aortic-valve-replacement-the-alster-experience
#20
Tobias Schmidt, Ozan Akdag, Peter Wohlmuth, Thomas Thielsen, Dimitry Schewel, Jury Schewel, Hannes Alessandrini, Felix Kreidel, Ralf Bader, Maria Romero, Elena Ladich, Renu Virmani, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: Histopathological analyses of debris captured by a cerebral protection system during transcatheter aortic valve replacement have been reported, but the origin of the captured debris was not determined and risk factors were not defined. METHODS AND RESULTS: Embolic debris was analyzed from 322 filters used in a dual-cerebral-filter protection system implemented during transcatheter aortic valve replacement for 161 patients (mean age 81 years, 82 male [51%], logistic EuroSCORE 19% [interquartile range 12-31%])...
November 10, 2016: Journal of the American Heart Association
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