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https://www.readbyqxmd.com/read/28219920/impact-of-coronary-artery-disease-severity-assessed-with-the-syntax-score-on-outcomes-following-transcatheter-aortic-valve-replacement
#1
Jean-Michel Paradis, Jonathon M White, Philippe Généreux, Marina Urena, Darshan Doshi, Tamim Nazif, Rebecca Hahn, Isaac George, Omar Khalique, Kishore Harjai, Laura Lasalle, Benoit M Labbé, Robert DeLarochellière, Daniel Doyle, Éric Dumont, Siamak Mohammadi, Martin B Leon, Josep Rodés-Cabau, Susheel Kodali
BACKGROUND: The influence of coronary artery disease (CAD) on clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) is still controversial. We sought to evaluate the impact of CAD severity as measured by the SYNTAX score (SS) on patients undergoing TAVR. METHODS AND RESULTS: A total of 377 patients who underwent TAVR in 2 high-volume centers in North America were included in our retrospective analysis. A blinded angiographic core laboratory calculated the SS on all available coronary angiograms with the use of quantitative coronary analysis...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28210769/preprocedural-risk-assessment-prior-to-ppvi-with-cmr-and-cardiac-ct
#2
Ladonna Malone, Brian Fonseca, Thomas Fagan, Jane Gralla, Neil Wilson, Micheal DiMaria, Uyen Truong, Lorna P Browne
Percutaneous pulmonary valve intervention (PPVI) is a less invasive and less costly approach to pulmonary valve replacement compared with the surgical alternative. Potential complications of PPVI include coronary compression and pulmonary arterial injury/rupture. The purpose of this study was to characterize the morphological risk factors for PPVI complication with cardiac MRI and cardiac CTA. A retrospective review of 88 PPVI procedures was performed. 44 patients had preprocedural cardiac MRIs or CTAs available for review...
February 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28163921/bioprosthetic-aortic-valve-replacement-12-years-after-percutaneous-aortic-valvuloplasty-in-a-young-female-adult-with-hope-of-pregnancy
#3
Hirohiko Akutsu, Yuichiro Kaminishi, Soki Kurumisawa, Yoshio Misawa
CASE: A 26-year-old woman who had congenital aortic valve stenosis presented with exertional dyspnea. She had undergone percutaneous balloon aortic valvuloplasty 12 years previously at the age of 14. When she was 20 years old, she delivered a neonate by elective cesarean section at the 31st week of gestation because the mean pressure between the left ventricle and the ascending aorta was 52 mmHg. OUTCOME: She successfully underwent aortic valve replacement with a bioprosthetic valve combined with replacement of the ascending aorta in order to make the next pregnancy possible...
October 2016: Acute Med Surg
https://www.readbyqxmd.com/read/28145877/transcatheter-mitral-paravalvular-leak-closure-facilitated-by-preprocedural-cardiac-ct-for-simulation-of-fluoroscopic-anatomy-and-paravalvular-defect-localization
#4
Kasper Korsholm, Ulrik Mortensen, Jesper Møller Jensen, Nicolo Piazza, Pascal Thériault-Lauzier, Jens Erik Nielsen-Kudsk
Paravalvular leakage (PVL) occurs in 6%-15% of cases after surgical heart valve replacement. A percutaneous approach is increasingly used to close PVLs as an alternative to repeat surgery. Computed tomography (CT) can be used for simulation of fluoroscopic cardiac anatomy. This technique allows preprocedural definition of optimal C-arm angulations and PVL localization in reference to fluoroscopic views. It is very helpful for guidewire crossing of the PVL and positioning of the closure device. We report a case with the first use of dedicated software for fluoroscopic simulation (FluoroCT) in transcatheter mitral PVL closure...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28134010/noteworthy-cardiac-surgical-literature-2016
#5
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28129316/coronary-artery-disease-complexity-on-the-outcomes-of-a-staged-approach-of-pci-followed-by-minimally-invasive-valve-surgery
#6
Andrés M Pineda, Saqib A Gowani, Christos G Mihos, Ramesh Chandra, Orlando Santana, Joseph Lamelas, Nirat Beohar
OBJECTIVE: A staged approach of percutaneous coronary intervention (PCI) followed by minimally invasive valve surgery (MIVS) is an alternative to the combined coronary artery bypass graft and valve surgery for patients with concomitant coronary artery (CAD) and valvular heart disease. We sought to evaluate the impact of the complexity of CAD, as assessed by the Syntax score, on the outcomes of the staged approach. METHODS: We retrospectively evaluated 138 patients who underwent PCI and MIVS at our institution between January 2009 and June 2013...
January 27, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28118931/safety-and-efficacy-of-the-percutaneous-transaxillary-access-for-transcatheter-aortic-valve-implantation-using-various-transcatheter-heart-valves-in-100-consecutive-patients
#7
U Schäfer, F Deuschl, N Schofer, C Frerker, T Schmidt, K H Kuck, F Kreidel, J Schirmer, I Mizote, H Reichenspurner, S Blankenberg, H Treede, L Conradi
OBJECTIVES: Transcatheter Aortic Valve Implantation (TAVI) can be performed via the transaxillary approach, but data about complications and procedural outcome is limited. INTRODUCTION: TAVI is an established treatment option for patients at high risk for conventional aortic valve replacement. Nowadays, the transfemoral approach is the most commonly used access for TAVI. Nevertheless, the transfemoral access is not suitable in many patients necessitating alternative approaches...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28117248/characteristics-aetiological-spectrum-and-management-of-valvular-heart-disease-in-a-tunisian-cardiovascular-centre
#8
Faten Triki, Jihen Jdidi, Dorra Abid, Nada Tabbabi, Selma Charfeddine, Sahar Ben Kahla, Mourad Hentati, Leila Abid, Samir Kammoun
BACKGROUND: Valvular heart diseases occur frequently in Tunisia, but no precise statistics are available. AIM: To analyse the characteristics of patients with abnormal valvular structure and function, and to identify the aetiological spectrum, treatment and outcomes of valvular heart disease in a single cardiovascular centre in Tunisia. METHODS: This retrospective study included patients with abnormal valvular structure and function, who were screened by transthoracic echocardiography at a single cardiology department between January 2010 and December 2013...
January 20, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#9
EDITORIAL
James M McCabe, Larry S Dean
Increasing annular calcification portends more adverse outcomes and worse hemodynamic results following percutaneous structural heart interventions. Though the Direct Flow prosthesis did not appear to have significantly different post-procedural gradients based on aortic valve calcium burden in a selected group of patients, the average residual gradients were relatively high in all cases and the presence of a paravalvular leak was more common with increasing valvular calcification. It is unclear how the Direct Flow prosthesis fits into the armamentarium of TAVR prostheses...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#10
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/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#11
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#12
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088437/safety-and-feasibility-of-pci-in-patients-undergoing-tavr-a-systematic-review-and-meta-analysis
#13
REVIEW
Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#14
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28074794/acute-effect-of-treatment-of-mitral-stenosis-on-left-atrium-function
#15
Atooshe Rohani, Shahram Kargar, Afsoon Fazlinejad, Fereshte Ghaderi, Vida Vakili, Homa Falsoleiman, Ramin Khamene Bagheri
AIM: Peak atrial longitudinal strain (PALS) is used to evaluate left atrium (LA) function in patients with mitral stenosis (MS), before and after percutaneous transmitral commissurotomy (PTMC) and mitral valve replacement (MVR). METHODS: Patients with severe symptomatic MS, who were referred to our echocardiographic laboratory for a diagnostic examination before cardiac surgery or PTMC from October of 2014 to October of 2015, were included in the study. RESULT: The peak systolic global LA strain improved post-PTMC (P < 0...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#16
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28045671/bioprosthetic-aortic-paravalvular-leak-is-valve-in-valve-another-solution
#17
Anwar Tandar, David A Bull, Frederick G P Welt
Paravalvular leak (PVL) following aortic valve implantation is a rare complication but may cause potentially serious consequences. It occurs in 2%-10% of surgical aortic valve replacements and 7%-17% of surgical mitral valve replacements. Transcatheter valve replacement data show that significant PVL occurs in 6%-8% of cases. The management of significant PVL has traditionally involved repeat surgical repair. However, many of these patients are considered too high risk to undergo a repeat surgical procedure; hence, a percutaneous transcatheter approach has often been utilized to treat these patients...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28043783/pulmonary-homograft-stenosis-in-the-ross-procedure-incidence-clinical-impact-and-predictors-in-long-term-follow-up
#18
Laura Pardo González, Martin Ruiz Ortiz, Mónica Delgado, Dolores Mesa, Rafael Villalba, Sara Rodriguez, Francisco J Hidalgo, Pedro Alados, Jaime Casares, Jose Suarez de Lezo
BACKGROUND: The Ross procedure is used in the treatment of selected patients with aortic valve disease. Pulmonary graft stenosis can appear in the long-term follow-up after the Ross intervention, but the factors involved and its clinical implications are not fully known. AIM: To describe the incidence, clinical impact and predictors of homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital. METHODS: From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30±11 years; 69% men; 21 aged<18 years), and were followed for echocardiographic homograft stenosis (peak gradient>36mmHg) and surgical or percutaneous homograft reintervention...
December 30, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28018817/transcatheter-valve-unable-to-cure-patient-prosthesis-mismatch-of-mosaic-bioprosthesis
#19
Daniela Serio, Andreas Zierer, Mirko Doss, Anton Moritz
Transcatheter aortic valve implantation (TAVI) has been recently established as a less invasive alternative to conventional aortic valve replacement (CAVR) in patients presenting with expected high procedural risk. The rapid technologic advances and the recent improvement of clinical outcomes with TAVI have made it possible to treat degenerated bioprosthesis using the valve-in-valve implantation concept (Walther T, Simon P, Dewey T, et al. Transapical minimally invasive aortic valve implantation: multicenter experience...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28009960/percutaneous-closure-of-massive-mitral-paravalvular-leak
#20
Tomás Benito-González, Rodrigo Estévez-Loureiro, Armando Pérez de Prado, Emilse Martínez-Paz, Carmen Garrote Coloma, Felipe Fernández-Vázquez
A 59-year-old male with a history of mitral valve replacement several years previously was admitted to the authors' institution with symptoms of advanced heart failure. Echocardiography showed a severe paravalvular dehiscence and surgery was discouraged due to high perioperative risk. A first transcatheter leak closure was unsuccessful despite the correct deployment of various occluding devices. A second percutaneous attempt was carried out with implantation of three Amplatzer Vascular Plug® III devices (five occluders were positioned in total within the oblong defect), leading to a mild residual leakage...
July 2016: Journal of Heart Valve Disease
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