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calcific aortic stenosis

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https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#1
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29147686/lipoprotein-a-associated-molecules-are-prominent-components-in-plasma-and-valve-leaflets-in-calcific-aortic-valve-stenosis
#2
Michael Torzewski, Amir Ravandi, Calvin Yeang, Andrea Edel, Rahul Bhindi, Stefan Kath, Laura Twardowski, Jens Schmid, Xiaohong Yang, Ulrich F W Franke, Joseph L Witztum, Sotirios Tsimikas
The LPA gene is the only monogenetic risk factor for calcific aortic valve stenosis (CAVS). Oxidized phospholipids (OxPL) and lysophosphatidic acid generated by autotaxin (ATX) from OxPL are pro-inflammatory. Aortic valve leaflets were categorized pathologically from Both ATX-apoB and ATX-apo(a) were measureable in plasma. Lp(a), autotaxin, OxPL and MDA epitopes progressively increased in immunostaining (p<0.001 for all). Six species of OxPL and LysoPA were identified following extraction from valve leaflets...
June 2017: JACC. Basic to Translational Science
https://www.readbyqxmd.com/read/29136138/calcific-aortic-valve-stenosis-hard-disease-in-the-heart-a-biomolecular-approach-towards-diagnosis-and-treatment
#3
Frederique E C M Peeters, Steven J R Meex, Marc R Dweck, Elena Aikawa, Harry J G M Crijns, Leon J Schurgers, Bas L J H Kietselaer
Calcific aortic valve stenosis (CAVS) is common in the ageing population and set to become an increasing economic and health burden. Once present, it inevitably progresses and has a poor prognosis in symptomatic patients. No medical therapies are proven to be effective in holding or reducing disease progression. Therefore, aortic valve replacement remains the only available treatment option. Improved knowledge of the mechanisms underlying disease progression has provided us with insights that CAVS is not a passive disease...
November 10, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29130612/caliber-and-fitness-of-the-axillary-artery-as-a-conduit-for-large-bore-cardiovascular-procedures
#4
Daniel M Arnett, James C Lee, Michael A Harms, Kathleen E Kearney, Mario Ramos, Bryn M Smith, Emily C Anderson, Rajiv Tayal, James M McCabe
OBJECTIVES: We sought to describe the caliber and vascular health of the subclavian and axillary arteries as related to their potential utilization in complex cardiovascular procedures. BACKGROUND: Patients referred for advanced catheter-based therapies frequently have lower extremity peripheral vascular disease that may prohibit the use of large bore arterial catheters. Utilization of the upper extremity peripheral vasculature is rarely considered as an alternative access strategy...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29121522/effects-of-vitamin-k-antagonist-on-aortic-valve-degeneration-in-non-valvular-atrial-fibrillation-patients-prospective-4-year-observational-study
#5
Kazuhiro Yamamoto, Yukihiro Koretsune, Takashi Akasaka, Akira Kisanuki, Nobuyuki Ohte, Takashi Takenaka, Masaaki Takeuchi, Kiyoshi Yoshida, Kazunori Iwade, Yuji Okuyama, Yutaka Hirano, Yasuharu Takeda, Yasumasa Tsukamoto, Yoshiharu Kinugasa, Satoshi Nakatani, Takashi Sakamoto, Katsuomi Iwakura, Takashi Sozu, Tohru Masuyama
BACKGROUND: The prevalence of atrial fibrillation (AF) is high in elder subjects. Our previous observational study suggested that vitamin K antagonist (VKA) promotes aortic valve degeneration, a principal cause of aortic stenosis in the elderly, and that angiotensin receptor blocker (ARB) attenuates its progression. This study aimed to prospectively investigate these observations in non-valvular AF patients. METHODS: Of enrolled 430 patients with calcification on no or one aortic valve leaflet, all of the planned 4-year follow-up data were obtained in 122 non-valvular AF patients treated with warfarin (warfarin group) and 101 patients with cardiovascular diseases and without AF and prescription of warfarin (non-warfarin group)...
November 6, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29105964/simultaneous-transcatheter-transfemoral-aortic-and-transeptal-mitral-valve-replacement-using-edward-sapien-s3
#6
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105493/a-7-year-single-center-experience-of-transfemoral-tavi-evolution-of-surgical-activity-and-impact-on-vascular-outcome
#7
Fabien Lareyre, Juliette Raffort, Carine Dommerc, Yacoub Habib, François Bourlon, Claude Mialhe
Transcatheter aortic valve implantation (TAVI) has become a well-established alternative to open surgery to treat aortic stenosis. We describe our 7-year TAVI experience using transfemoral access and identity changes in surgical activity and evaluate its impact on postoperative vascular outcomes. Consecutive patients (N = 340) who underwent TAVI with percutaneous transfemoral access were retrospectively included and divided into 4 quartiles according to the date of intervention. Vascular outcomes were classified according to the Valve Academic Research Consortium 2 classification...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29092109/epicardial-adipose-tissue-thickness-independently-predicts-severe-aortic-valve-stenosis
#8
Amir A Mahabadi, Heike A Kahlert, Iryna Dykun, Bastian Balcer, Philipp Kahlert, Tienush Rassaf
BACKGROUND: Epicardial fat tissue (EAT) is associated with coronary as well as aortic valve calcification. The study aim was to determine whether EAT thickness is different in patients with and without aortic valve stenosis (AVS). METHODS: A cohort of 200 consecutive patients with severe AVS and 200 matched patients without AVS were included retrospectively in the study. EAT thickness was quantified, using transthoracic echocardiography, as the space between the epicardial wall of the myocardium and the visceral layer of the pericardium...
May 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29075334/association-of-body-mass-index-and-visceral-fat-with-aortic-valve-calcification-and-mortality-after-transcatheter-aortic-valve-replacement-the-obesity-paradox-in-severe-aortic-stenosis
#9
Jennifer Mancio, Paulo Fonseca, Bruno Figueiredo, Wilson Ferreira, Monica Carvalho, Nuno Ferreira, Pedro Braga, Alberto Rodrigues, Antonio Barros, Ines Falcao-Pires, Adelino Leite-Moreira, Vasco Gama Ribeiro, Nuno Bettencourt
BACKGROUND: Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. AIMS: To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). METHODS: This was a prospective cohort of 170 severe AS patients referred to TAVR...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/29049564/a-new-technique-to-implant-a-transcatheter-inflatable-fully-repositionable-prosthesis-in-aortic-stenosis-with-severe-asymmetric-calcification
#10
Hasan Bushnaq, Christoph Raspé, Alper Öner, Seyrani Yücel, Hüseyin Ince, Sebastian-Patrick Sommer
OBJECTIVES: In contrast to stented transcatheter aortic valves, the Direct Flow Medical (DFM) valve is a stentless bovine aortic bioprosthesis mounted in a non-metallic inflatable frame. Hence, severe asymmetric annular calcification may result in residually elevated transaortic pressure gradients after DFM implantation. We present a novel intraprocedural dilatation (IDIL) technique for successful implantation of the DFM valve in the presence of complex annular calcification. METHODS: Between January 2014 and May 2015, 55 patients underwent DFM valve-based transcatheter aortic valve implantation at our institution...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29048474/transinnominate-approach-for-transcatheter-aortic-valve-replacement-single-centre-experience-of-minimally-invasive-alternative-access
#11
Luigi Pirelli, Jacob S Scheinerman, Derek R Brinster, Nirav C Patel, Alaeldin Eltom, Jonathan M Hemli, Chad A Kliger
OBJECTIVES: Iliofemoral arteries have been the preferred access for transcatheter aortic valve replacement (TAVR). When these arteries are too small, calcified or tortuous, an alternative access must be considered. Transinnominate (TI) access is an extrathoracic approach that does not require manipulation of major neurovascular structures or the apex. The aim of this study is to evaluate the efficacy and safety of TI TAVR as an alternative access in patients with severe aortic stenosis not amenable to a transfemoral approach...
October 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29039313/transcatheter-aortic-valve-replacement-in-patients-with-non-calcific-aortic-stenosis
#12
Tian-Yuan Xiong, Yuan Feng, Yan-Biao Liao, Yi-Jian Li, Zhen-Gang Zhao, Xin Wei, Yuan-Ning Xu, Jia-Fu Wei, Yong Peng, Nicolo Piazza, Darren Mylotte, Mao Chen
AIMS: Limited information exists describing the results of transcatheter aortic valve replacement (TAVR) in patients with symptomatic severe non-calcific aortic stenosis (AS). METHODS AND RESULTS: We retrospectively identified patients with non-calcific AS who received TAVR with self-expanding transcatheter heart valves in our center. Clinical and echocardiographic outcomes, and post-procedural multi-detector computed tomography (MDCT) measures were compared to patients undergoing TAVR for calcific AS...
October 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29036977/-safety-and-feasibility-of-sheathless-transfemoral-aortic-valve-implantation
#13
H J Pei, S Y Teng, T Luo, Y J Wu, Y J Yang, S B Qiao, B Xu, R L Gao
Objective: To investigate the safety and feasibility of sheathless transfemoral aortic valve replacement (TAVR). Methods: In this prospective study, we enrolled 23 patients with severe aortic stenosis (AS) who were inoperable or at high-risk for surgical aortic valve replacement operation in Fuwai hospital From September 2012 to June 2015. Multislice spiral CT and angiography of femoral artery showed that all patients had minimal femoral artery diameters (<6.5 mm) and severe calcification which was not suitable for transfemoral TAVR through sheath...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29026447/epigenome-alterations-in-aortic-valve-stenosis-and-its-related-left-ventricular-hypertrophy
#14
REVIEW
Igor Gošev, Martina Zeljko, Željko Đurić, Ivana Nikolić, Milorad Gošev, Sanja Ivčević, Dino Bešić, Zoran Legčević, Frane Paić
Aortic valve stenosis is the most common cardiac valve disease, and with current trends in the population demographics, its prevalence is likely to rise, thus posing a major health and economic burden facing the worldwide societies. Over the past decade, it has become more than clear that our traditional genetic views do not sufficiently explain the well-known link between AS, proatherogenic risk factors, flow-induced mechanical forces, and disease-prone environmental influences. Recent breakthroughs in the field of epigenetics offer us a new perspective on gene regulation, which has broadened our perspective on etiology of aortic stenosis and other aortic valve diseases...
2017: Clinical Epigenetics
https://www.readbyqxmd.com/read/29024719/calcification-or-not-this-is-the-question-a-one-year-study-of-bovine-pericardial-vascular-patches-cardiocel%C3%A2-in-minipigs
#15
Aida Salameh, Wiebke Greimann, David Vondrys, Martin Kostelka
Objectives A main problem with bioprosthesis used for surgical correction of congenital cardiac malformation is their tendency to shrink and to calcify. Recently, a new material i.e. de-cellularised bovine pericardium (CardioCel(®)) was introduced in clinics. It was proposed that this new patch material should not calcify and should be particularly suitable for the correction of vascular defects in inborn cardiac diseases. The aim of our chronic minipig study was to evaluate the performance of CardioCel(®) patches implanted in aortic and pulmonary artery position, respectively...
October 9, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29019612/unveiling-transthyretin-cardiac-amyloidosis-and-its-predictors-among-elderly-patients-with-severe-aortic-stenosis-undergoing-transcatheter-aortic-valve-replacement
#16
Adam Castaño, David L Narotsky, Nadira Hamid, Omar K Khalique, Rachelle Morgenstern, Albert DeLuca, Jonah Rubin, Codruta Chiuzan, Tamim Nazif, Torsten Vahl, Isaac George, Susheel Kodali, Martin B Leon, Rebecca Hahn, Sabahat Bokhari, Mathew S Maurer
Aims: Transthyretin cardiac amyloidosis (ATTR-CA) has been reported in patients with aortic stenosis (AS) but its prevalence and phenotype are not known. We examine elderly patients with severe symptomatic AS undergoing transcatheter aortic valve replacement (TAVR) and determine the prevalence and phenotype of ATTR-CA non-invasively. Methods and results: We performed technetium-99m pyrophosphate (99mTc-PYP) cardiac scintigraphy prospectively on patients who underwent TAVR, to screen for ATTR-CA...
October 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28986055/gender-differences-in-the-association-of-epicardial-adipose-tissue-and-coronary-artery-calcification-epicheart-study-eat-and-coronary-calcification-by-gender
#17
Jennifer Mancio, Marilia Pinheiro, Wilson Ferreira, Monica Carvalho, Antonio Barros, Nuno Ferreira, Luis Vouga, Vasco Gama Ribeiro, Adelino Leite-Moreira, Ines Falcao-Pires, Nuno Bettencourt
BACKGROUND: The association of epicardial adipose tissue (EAT) and coronary artery calcification (CAC) seems to differ by gender. However, few studies have controlled for body size, and the ideal method for body size indexing has not been explored. OBJECTIVES: To analyse the effect of gender related-body size and-body fat differences on the association of EAT with CAC. METHODS: This was a prospective cohort of 371 severe aortic stenosis patients (77±8...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28977497/cerebral-protection-during-transcatheter-aortic-valve-implantation-in-an-extreme-high-risk-patient
#18
Stephanie Voss, Christian Nöbauer, Rüdiger Lange, Sabine Bleiziffer
Stroke during transcatheter aortic valve replacement is one of the most feared complications. New technologies have been developed, attempting to prevent cerebral embolization of thrombotic and calcific debris. We report a 78-year-old patient (EuroSCORE log 45.6%, STS Stroke Score 5.1%) with calcific aortic stenosis at particular risk for cerebrovascular accidents. The patient underwent transapical transcatheter aortic valve replacement using the dual filter-based Claret Sentinel™ Device for cerebral protection...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28950358/delayed-prosthesis-malposition-after-transcatheter-aortic-valve-implantation-causing-coronaries-obstruction
#19
Francesco Nappi, Cristiano Spadaccio, Jean-Louis Sablayrolles
A case of delayed malposition of a CoreValve device causing obstruction of coronary ostia is described. Nine months after the original implant, the patient developed an acute coronary syndrome and was readmitted to hospital. Angiogram demonstrated an ostial stenosis of both the left main stem and the right coronary ostia, which were filled by a paravalvular leakage of the bioprosthesis. Gated computed tomography scan with 3D reconstruction showed valve malposition with cusps situated 14 mm above the ostium of the right coronary and the presence of fibrous and calcific agglomerations associated to one of the cusp causing a tight stenosis of the left ostium...
July 25, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28938964/predictors-of-permanent-pacemaker-implantation-after-transfemoral-aortic-valve-implantation-with-the-lotus-valve
#20
Mirjam Keßler, Birgid Gonska, Julia Seeger, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Permanent pacemaker implantation (PPMI) after transcatheter aortic valve implantation is of high clinical relevance, but PPMI rates differ widely between valve types. Although the Lotus valve can be repositioned, reported rates for PPMI are high. The predictors of PPMI after Lotus valve implantation have not been defined yet. METHODS: We analyzed the impact of preexisting conduction disturbances, depth of implantation, oversizing, and amount of calcification on PPMI in 216 patients with severe symptomatic aortic stenosis underdoing Lotus valve implantation...
October 2017: American Heart Journal
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