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Aortic stenosis guidelines

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https://www.readbyqxmd.com/read/29119223/-acute-myocardial-infarction-in-patients-with-st-segment-elevation-myocardial-infarction-esc-guidelines-2017
#1
REVIEW
H Thiele, S Desch, S de Waha
This article gives an update on the management of acute ST-segment elevation myocardial infarction (STEMI) according to the recently released European Society of Cardiology guidelines 2017 and the modifications are compared to the previous STEMI guidelines from 2012. Primary percutaneous coronary intervention (PCI) remains the preferred reperfusion strategy. New guideline recommendations relate to the access site with a clear preference for the radial artery, use of drug-eluting stents over bare metal stents, complete revascularization during the index hospitalization, and avoidance of routine thrombus aspiration...
November 8, 2017: Herz
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#2
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29106494/impact-of-pulmonary-hypertension-on-long-term-outcome-in-patients-with-severe-aortic-stenosis
#3
Franck Levy, Yohann Bohbot, Khalil Sanhadji, Dan Rusinaru, Anne Ringle, Quentin Delpierre, Sondes Smaali, Mesut Gun, Sylvestre Marechaux, Christophe Tribouilloy
Aims: Pulmonary hypertension (PH) is common in severe symptomatic left-sided valvular disease, particularly in aging populations. Inconsistent results have been reported concerning the association between PH and adverse outcomes after aortic valve replacement for aortic stenosis (AS). We therefore retrospectively investigated the prognostic significance of PH using peak tricuspid regurgitation velocity (TRV), as defined by the current European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines, in a large cohort of patients with severe AS...
June 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria-%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#4
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29072064/transcatheter-aortic-valve-implantation-tavi-in-2017-recent-advances-and-future-development
#5
Florian Hecker, Mani Arsalan, Won-Keun Kim, Thomas Walther
Transcather aortic valve implantation (TAVI) has become a safe and indispensable treatment option for patients with severe symptomatic aortic stenosis (AS) who are at high or prohibitive surgical risk. In the past years, outcomes after TAVI have improved significantly and TAVI has emerged as a qualified alternative to surgical aortic valve replacement (SAVR) in the treatment of intermediate risk patients. Besides optimized patient screening, advanced imaging and increased examiner experience, transcatheter heart valve (THV) design addressed several key issues like vascular complications, pacemaker implantation and paravalvular leakage rates and improved considerably over time...
October 25, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29064293/transcatheter-aortic-valve-implantation-where-are-we-now
#6
Mark Mariathas, John Rawlins, Nick Curzen
Transcatheter aortic valve implantation (TAVI) was first used in clinical practice in 2002. Since 2002, there has been a rapid increase in TAVI activity in patients with symptomatic severe aortic stenosis. This has been supported by systematic randomized data comparing TAVI against the gold standard treatment for the last 50 years' surgical aortic valve replacement. TAVI is now currently a recommended therapeutic intervention in the treatment of severe aortic stenosis patients who are deemed either high risk or inoperable...
October 24, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29021260/risk-stratification-of-severe-aortic-stenosis-with-preserved-left-ventricular-ejection-fraction-using-peak-aortic-jet-velocity-an-outcome-study
#7
Yohann Bohbot, Dan Rusinaru, Quentin Delpierre, Sylvestre Marechaux, Christophe Tribouilloy
BACKGROUND: Current guidelines consider aortic valve replacement reasonable in asymptomatic patients with very severe aortic stenosis (AS); however, the definition of very severe AS based on peak aortic jet velocity (Vmax) remains unclear with a 5-m/s cutoff in US guidelines and 5.5 m/s in European guidelines. Because ≈20% of patients with severe AS and preserved left ventricular ejection fraction have Vmax in this range, we aimed to assess the relationship between Vmax and mortality and determine the best threshold to define very severe AS...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29020347/transcatheter-aortic-valve-implantation-in-lower-risk-patients-what-is-the-perspective
#8
Giuseppe Tarantini, Luca Nai Fovino, Bernard J Gersh
In the last decade, transcatheter aortic valve implantation (TAVI), a disruptive technology, has revolutionized the therapy of symptomatic severe aortic stenosis, and current guidelines state that the recommendations for TAVI and surgical aortic valve replacement (SAVR) are equivalent in patients at high-risk. Increased operator experience, technical advances in the new generation of transcatheter heart valves (THV) and excellent TAVI results in recently published randomized controlled trials have led to the expansion of TAVI indication as an alternative to SAVR in intermediate-risk subjects, given appropriate patient selection...
August 24, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28988212/updated-2017-european-and-american-guidelines-for-prosthesis-type-and-implantation-mode-in-severe-aortic-stenosis
#9
EDITORIAL
Catherine M Otto, Helmut Baumgartner
No abstract text is available yet for this article.
October 7, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28943483/permanent-decline-of-renal-function-after-infrarenal-abdominal-aortic-aneurysm-repair-frequency-and-risk-factors
#10
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Andreas Kribben, Stefan Herget-Rosenthal
BACKGROUND: Permanent renal function decline, and development and deterioration of chronic kidney disease (CKD) are associated with serious complications. How frequent is renal function decline after infrarenal abdominal aortic aneurysm (iAAA) repair according to current definitions and what are its risk factors, especially potentially modifiable ones? METHODS: Retrospective observational study including all patients with elective or urgent iAAA repair from 2007 to 2011...
September 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28910289/how-tavi-registries-report-clinical-outcomes-a-systematic-review-of-endpoints-based-on-varc-2-definitions
#11
REVIEW
Shixuan Zhang, Peter L Kolominsky-Rabas
INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has been demonstrated to be an alternative treatment for severe aortic stenosis in patients considered as high surgical risk. Since its first human implantation by Cribier et al., TAVI has been shown to increase survival rate and quality of life for high surgical risks patients. The objective of this study is to provide an overview of TAVI registries and the reporting clinical outcomes based on the VARC-2 definitions. In addition, the comparability and adherence of VARC-2 reporting within the identified TAVI registries was reviewed...
2017: PloS One
https://www.readbyqxmd.com/read/28877303/association-of-guideline-adherence-for-serial-evaluations-with-survival-and-adverse-clinical-events-in-patients-with-asymptomatic-severe-aortic-stenosis
#12
Aisha Ahmed, Paul Sorajja, Ross F Garberich, R Saeid Farivar, Kevin M Harris, Mario Gössl
Importance: For patients with asymptomatic severe aortic stenosis and normal left ventricular function, current practice guidelines empirically recommend serial evaluations every 6 to 12 months. The benefit of this clinical monitoring is unknown. Objective: To determine the association of guideline adherence with clinical outcomes in patients with asymptomatic severe aortic stenosis. Design, Setting, and Participants: This retrospective cohort study involved 300 patients with asymptomatic severe aortic stenosis who were seen in the ambulatory Minneapolis Heart Institute at Abbott Northwestern Hospital...
October 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28872094/-transcatheter-aortic-valve-implantation-present-and-development-trend
#13
Yi He, Haiting Zhou, Shuqiang Zhu, Yongbing Wu
Currently, although surgical aortic valve replacement (SAVR) is still the golden standard in treatment of severe aortic stenosis according to the guideline, transcatheter aortic valve implantation (TAVI) is gradually becoming a common treatment for patients who are prohibitive or in high risk for SAVR. Recently, the valve manufacturers, including medical companies in China, are making their utmost to develop valve device, leading remarkable results achieved by TAVI. With the complications being controlled, TAVI displays promising future...
August 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28856517/bicuspid-aortic-valve-related-aortopathy
#14
REVIEW
Sina Stock, Salah A Mohamed, Hans-Hinrich Sievers
Bicuspid aortic valve related aortopathy is known to significantly increase the risk for catastrophic aortic events and, therefore, represents a considerable health burden. Albeit of ongoing research in this field including genetic, molecular, hemodynamic and morphologic aspects, bicuspid aortic valve related aortopathy still represents an imperfectly understood disorder. This lack in knowledge results in a lack of consistency considering different therapeutic approaches. Recent studies have provided new insights into the etiology and clinical impacts of bicuspid aortic valve related aortopathy in different clinical settings, leading to a growing body of opinion towards a more individualized surgical approach than currently provided by the guidelines...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28827255/self-reported-health-status-treatment-decision-and-survival-in-asymptomatic-and-symptomatic-patients-with-aortic-stenosis-in-a-western-norway-population-undergoing-conservative-treatment-a-cross-sectional-study-with-18-months-follow-up
#15
Kjersti Oterhals, Rune Haaverstad, Jan Erik Nordrehaug, Geir Egil Eide, Tone M Norekvål
OBJECTIVES: To investigate symptoms and self-reported health of patients conservatively treated for aortic stenosis (AS) and to identify factors associated with treatment decision and patient outcomes. DESIGN: A cross-sectional survey with an 18-month follow-up. SETTING: One tertiary university hospital in Western Norway. PARTICIPANTS: In all, 1436 patients were diagnosed with AS between 2000 and 2012, and those 245 still under conservative treatment in 2013 were included in this study...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28814490/clinical-features-and-prognosis-of-patients-with-isolated-severe-aortic-stenosis-and-valve-area-less-than-1-0-cm-2
#16
Praveen Mehrotra, Katrijn Jansen, Timothy C Tan, Aidan Flynn, Judy W Hung
OBJECTIVE: Current guidelines define severe aortic stenosis (AS) as an aortic valve area (AVA)≤1.0 cm(2), but some authors have suggested that the AVA cut-off be decreased to 0.8 cm(2). The aim of this study was, therefore, to better describe the clinical features and prognosis of patients with an AVA of 0.8-0.99 cm(2). METHODS: Patients with isolated, severe AS and ejection fraction ≥55% with an AVA of 0.8-0.99 cm(2) (n=105) were compared with those with an AVA<0...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28780662/bicuspid-aortic-valvulopathy-and-associated-aortopathy-a-review-of-contemporary-studies-relevant-to-clinical-decision-making
#17
REVIEW
Michael H Kwon, Thoralf M Sundt
The bicuspid aortic valve (BAV) phenotype is becoming increasingly recognized as a complex and heterogeneous clinical entity, with some but not all patients developing accelerated degrees of both aortic insufficiency (AI) and aortic stenosis (AS) in comparison to patients with tricuspid aortic valves (TAV). In addition, there remains a well-established association between the BAV phenotype and aortic enlargement independent of valve function as well as progression among some to ascending aortic aneurysm and the attendant concern over risk of aortic dissection...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28759471/the-ross-procedure-in-adults-which-patients-which-disease
#18
Amine Mazine, Ismail El-Hamamsy, Maral Ouzounian
PURPOSE OF REVIEW: The purpose of this article is to review the contemporary evidence surrounding the use of the Ross procedure in young and middle-aged adults and to identify the subset patients who are most likely to derive a benefit from this operation. RECENT FINDINGS: In appropriately selected young and middle-aged adults undergoing aortic valve replacement (AVR), the Ross procedure is currently the only operation that can restore long-term survival that is equivalent to that of the age-matched healthy general population...
November 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#19
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28671804/valvular-heart-disease-in-adults-etiologies-classification-and-diagnosis
#20
REVIEW
Steven M Hollenberg
The prevalence of valvular heart disease (VHD) in the United States was estimated to be approximately 2.5% in the 1990s. The prevalence currently is thought to be increasing because of more accurate diagnostic methods and aging of the population. Mitral regurgitation (MR) is the most common valve defect, followed by aortic stenosis (AS) and aortic regurgitation (AR). Degenerative disease is the most common etiology of MR, AS, and AR, though these forms of VHD also can be caused by congenital valve defects, systemic inflammatory diseases, endocarditis, and many other conditions...
June 2017: FP Essentials
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