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Portico valve

Thomas Walther, Ganesh Manoharan, Axel Linke, Helge Möllmann, David Holzhey, Stephen G Worthley, Won-Keun Kim, Ulrich Schäfer
OBJECTIVES: To examine the incidence and timing of new-onset left bundle branch block (LBBB) and new permanent pacemaker implantation (PPI) in patients undergoing transcatheter aortic valve implantation (TAVI) using the repositionable, self-expanding Portico™ TAVI system (St. Jude Medical, St Paul, MN, USA). Clinical impact and periprocedural factors associated with new PPI were also assessed. METHODS: A total of 198 high-risk patients without pre-existing pacemaker [83...
March 9, 2018: European Journal of Cardio-thoracic Surgery
Axel Linke, David Holzhey, Helge Möllmann, Ganesh Manoharan, Ulrich Schäfer, Christian Frerker, Stephen G Worthley, A J van Boven, Simon Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Thomas Walther
BACKGROUND: The aim of the Portico TAVI (transcatheter aortic valve implantation) system study was to evaluate outcomes ≤1 year after implantation of a novel resheathable, self-expanding TAVI system in a multicenter patient population with severe aortic stenosis (AS). METHODS AND RESULTS: High-risk patients (n=222) with symptomatic severe AS (mean age, 83.0±4.6 years; 74.3% women) were enrolled across 12 centers in Europe and Australia. The study's primary end point was all-cause mortality at 30 days...
February 2018: Circulation. Cardiovascular Interventions
Silvia Mas-Peiro, Mariuca Vasa-Nicotera, Helge Weiler, Nestoras Papadopoulos, Roberta De Rosa, Andreas M Zeiher, Stephan Fichtlscherer
OBJECTIVES: Transcatheter heart valves such as the self-expandable Portico valve (St. Jude Medical) are being developed to overcome limitations of first-generation devices. Since clinical experience with this valve is still limited in a real-world setting, we investigated its use on an all-comer basis. METHODS: Between October 2015 and October 2016, a total of 100 consecutive patients assessed for transcatheter aortic valve replacement (TAVR) and found suitable for the Portico valve were included...
December 2017: Journal of Invasive Cardiology
M Marwan, N Mekkhala, M Göller, J Röther, D Bittner, A Schuhbaeck, M Hell, G Muschiol, J Kolwelter, R Feyrer, C Schlundt, S Achenbach, M Arnold
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly being offered to high-risk patients with symptomatic aortic valve stenosis. Recent reports have suggested a high incidence of subclinical leaflet thrombosis following bioprosthestic aortic valve replacement. We report the frequency and clinical presentation of leaflet thrombosis identified by cardiac CT in patients referred for follow-up contrast enhanced CT angiography following TAVI. METHODS: 91 consecutive patients referred for follow-up contrast-enhanced CT angiography following TAVI were screened for inclusion in this analysis...
January 2018: Journal of Cardiovascular Computed Tomography
Andrea Denegri, Fabian Nietlispach, Jan Kottwitz, Gabor Suetsch, Philipp Haager, Hector Rodriguez, Maurizio Taramasso, Slayman Obeid, Francesco Maisano
BACKGROUND: Published procedural and short-term outcome of the Portico valve for Transcatheter Aortic Valve Implantation (TAVI) is limited. We report a single-center patient series assessing procedural and 30-day outcome of this device. METHODS AND RESULTS: Procedural and 30-day follow-up data were prospectively collected from a consecutive series of 73 patients (80.7±6.9years, 45% male, mean STS score: 4.8±3.9) with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI)...
November 10, 2017: International Journal of Cardiology
Corinne Marzahn, Cornel Koban, Martin Seifert, Akihiro Isotani, Michael Neuß, Frank Hölschermann, Christian Butter
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an established treatment option for patients with severe aortic stenosis and high surgical risk. Currently, various prosthesis types are available. Atrioventricular block (AVB) requiring pacemaker (PM) implantation is a typical complication after TAVI. This study investigated the recovery of AV node conduction and mid-term outcome of patients with or without PM implantation after TAVI according to prosthesis type. METHODS: From July 2008 to May 2015, 856 transcatheter heart valves were implanted at our center (age: 80...
January 2018: Journal of Cardiology
Helge Möllmann, Axel Linke, David M Holzhey, Thomas Walther, Ganesh Manoharan, Ulrich Schäfer, Karl Heinz-Kuck, Ad J Van Boven, Simon R Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Stephen G Worthley
OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS: Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study...
August 14, 2017: JACC. Cardiovascular Interventions
Marco Barbanti, Sergio Buccheri, Josep Rodés-Cabau, Simona Gulino, Philippe Généreux, Gerlando Pilato, Danny Dvir, Andrea Picci, Giuliano Costa, Corrado Tamburino, Martin B Leon, John G Webb
OBJECTIVE: The aim of this study was to conduct a weighted meta-analysis to determine the rates of acute (≤30days) major outcomes after (TAVR) with second-generation devices. METHODS: A comprehensive search of multiple electronic databases from January 2011 to May 2017 was conducted using predefined criteria. New-generation TAVR devices were defined as any device which received CE mark approval or is still under evaluation for CE marking after CoreValve and SAPIEN XT prostheses...
October 15, 2017: International Journal of Cardiology
Francesco Giannini, Neil Ruparelia, Francesca Del Furia, Vittorio Romano, Marco Ancona, Antonio Mangieri, Damiano Regazzoli, Azeem Latib, Cosmo Godino, Francesco Ancona, Luciano Candilio, Richard Jabbour, Antonio Colombo, Matteo Montorfano
Although the rate of procedural complications during transcatheter aortic valve implantation has decreased because of technological advancement and increased operator experience, device embolization remains a rare but potentially fatal complication, even with new generation devices. We report, to our knowledge, the first case of Portico valve (St Jude Medical, Minneapolis, MN) migration despite apparent optimal initial implantation depth, which was retrieved using a novel strategy after failure of a traditional retrieval technique...
July 2017: Canadian Journal of Cardiology
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
Sami Alnasser, Asim N Cheema, Matheus Simonato, Marco Barbanti, Jeremy Edwards, Ran Kornowski, Eric Horlick, Harindra C Wijeysundera, Luca Testa, Francesco Bedogni, Hafid Amrane, Thomas Walther, Marc Pelletier, Azeem Latib, Jean-Claude Laborde, David Hildick-Smith, Won-Keun Kim, Didier Tchetche, Marco Agrifoglio, Jan-Malte Sinning, Ad J van Boven, Joëlle Kefer, Christian Frerker, Nicolas M van Mieghem, Axel Linke, Stephen Worthley, Anita Asgar, Carmelo Sgroi, Mina Aziz, Haim D Danenberg, Marino Labinaz, Ganesh Manoharan, Anson Cheung, John G Webb, Danny Dvir
BACKGROUND: Transcatheter valve-in-valve implantation is an established therapy for high-risk patients with failed surgical aortic bioprosthesis. There are limited data comparing outcomes of valve-in-valve implantation using different transcatheter heart valves (THV). METHODS AND RESULTS: Patients included in the Valve-in-Valve International Data registry (VIVID) and treated with self-expanding THV devices were analyzed using centralized core laboratory blinded to clinical events...
April 2017: Circulation. Cardiovascular Interventions
Hasan Jilaihawi, Federico M Asch, Eric Manasse, Carlos E Ruiz, Vladimir Jelnin, Mohammad Kashif, Hiroyuki Kawamori, Yoshio Maeno, Yoshio Kazuno, Nobuyuki Takahashi, Richard Olson, Joe Alkhatib, Daniel Berman, John Friedman, Norman Gellada, Tarun Chakravarty, Raj R Makkar
Subclinical leaflet thrombosis was recently described in a randomized trial of transcatheter aortic valve replacement. It was subsequently demonstrated in a series of registries that this was a commonly observed imaging finding seen in all transcatheter and surgical bioprostheses. The phenomenon has aroused considerable interest due to the as-yet-undefined risk for later clinical events and the possibility of pharmacological intervention with anticoagulation. Subclinical leaflet thrombosis is easily detected noninvasively by technically suitable computed tomography (CT) with a high degree of concordance to transesophageal echocardiography findings...
April 2017: JACC. Cardiovascular Imaging
Johannes Kastner, Georg Goliasch, Max-Paul Winter, Olev Luha, Martin Andreas, Irene M Lang
No abstract text is available yet for this article.
September 2017: Coronary Artery Disease
Rui Campante Teles, Cátia Costa, Manuel Almeida, João Brito, Lars Sondergaard, José P Neves, João Abecasis, Henrique M Gabriel
Transcatheter aortic valve implantation (TAVI) has become an important treatment in high surgical risk patients with severe aortic stenosis (AS), whose complications need to be managed promptly. The authors report the case of an 86-year-old woman presenting with severe symptomatic AS, rejected for surgery due to advanced age and comorbidities. The patient underwent a first TAVI, with implantation of a Medtronic CoreValve(®), which became dislodged and migrated to the ascending aorta. Due to the previous balloon valvuloplasty, the patient's AS became moderate, and her symptoms improved...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Giuseppe Bruschi, Paola Colombo, Luca Botta, Stefano Nava, Bruno Merlanti, Oriana Belli, Francesco Musca, Francesco Soriano, Claudio F Russo, Fabrizio Oliva
Transcatheter aortic valve implantation has been designed to treat older patients affected by severe aortic stenosis who are considered high-risk surgical candidates because of multiple comorbidities. The least invasive approach for transcatheter aortic valves implantation should be considered the transfemoral retrograde route, because it is minimally invasive and is feasible with local anesthesia and mild sedation. Despite significant technical improvements in recent years, the transfemoral approach is contraindicated in cases of severe peripheral artery disease...
February 2017: Annals of Thoracic Surgery
Gidon Y Perlman, Anson Cheung, Eric Dumont, Dion Stub, Danny Dvir, Maria Del Trigo, Marc Pelletier, Sami Alnasser, Jian Ye, David Wood, Christopher Thompson, Philipp Blanke, Jonathon Leipsic, Michael A Seidman, Heather LeBlanc, Christopher E Buller, Josep Rodés-Cabau, John G Webb
AIMS: The aim of this study was to examine the short- and medium-term outcomes of transcatheter aortic valve replacement (TAVR) with the self-expanding and repositionable Portico valve (St. Jude Medical, St. Paul, MN, USA). METHODS AND RESULTS: A total of 57 patients underwent TAVR with the Portico valve between March 2012 and August 2014, representing the first-in-human experience and the entire early experience in Canada. Patients were followed up at 30 days and one year with repeat echocardiography and clinical review...
January 20, 2017: EuroIntervention
Matheus Simonato, Ali N Azadani, John Webb, Jonathon Leipsic, Ran Kornowski, Alec Vahanian, David Wood, Nicolo Piazza, Susheel Kodali, Jian Ye, Brian Whisenant, Diego Gaia, Mina Aziz, Tilak Pasala, Julinda Mehilli, Harindra C Wijeysundera, Didier Tchetche, Neil Moat, Rui Teles, Anna Sonia Petronio, David Hildick-Smith, Uri Landes, Stephan Windecker, Yaron Arbel, Oscar Mendiz, Raj Makkar, Elaine Tseng, Danny Dvir
AIMS: Transcatheter heart valve (THV) implantation in failed bioprosthetic valves (valve-in-valve [ViV]) offers an alternative therapy for high-risk patients. Elevated post-procedural gradients are a significant limitation of aortic ViV. Our objective was to assess the relationship between depth of implantation and haemodynamics. METHODS AND RESULTS: Commercially available THVs used for ViV were included in the analysis (CoreValve Evolut, SAPIEN XT and the Portico valve)...
September 18, 2016: EuroIntervention
Marco Barbanti, John G Webb, Claudia Tamburino, Nicolas M Van Mieghem, Raj R Makkar, Nicolò Piazza, Azeem Latib, Jan-Malte Sinning, Kim Won-Keun, Sabine Bleiziffer, Francesco Bedogni, Samir Kapadia, Didier Tchetche, Josep Rodés-Cabau, Claudia Fiorina, Luis Nombela-Franco, Federico De Marco, Peter P de Jaegere, Tarun Chakravarty, Beatriz Vaquerizo, Antonio Colombo, Lars Svensson, Rüdiger Lange, Georg Nickenig, Helge Möllmann, Thomas Walther, Francesco Della Rosa, Yacine Elhmidi, Danny Dvir, Nedy Brambilla, Sebastiano Immè, Carmelo Sgroi, Simona Gulino, Denise Todaro, Gerlando Pilato, Anna Sonia Petronio, Corrado Tamburino
BACKGROUND: Transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. METHODS AND RESULTS: Clinical and echocardiographic outcomes of patients who underwent redo transcatheter aortic valve replacement (TAVR) procedures >2 weeks post procedure were collected from 14 centers. Among 13 876 patients, 50 (0.4%) underwent redo TAVR procedure at participating centers. Indications for redo TAVR were moderate-severe prosthetic aortic valve stenosis (n=10, 21...
September 2016: Circulation. Cardiovascular Interventions
Ganesh Manoharan, Axel Linke, Helge Moellmann, Simon Redwood, Christian Frerker, Jan Kovac, Thomas Walther
AIMS: The aim of this study was to evaluate the safety and performance of the resheathable and repositionable St. Jude Medical Portico self-expanding transfemoral TAVI system. METHODS AND RESULTS: This prospective, single-arm, multicentre study evaluated the 18 Fr Portico system with either a 23 or a 25 mm valve. Patient follow-up was at 30, 90, 180 days and one year. Results up to 30 days are presented. Adverse events were categorised by VARC definitions and adjudicated by an independent events committee...
August 20, 2016: EuroIntervention
Apostolos Tzikas, Hafid Amrane, Francesco Bedogni, Nedy Brambilla, Joelle Kefer, Ganesh Manoharan, Raj Makkar, Helge Möllman, Josep Rodés-Cabau, Ulrich Schäfer, Magnus Settergren, Konstantinos Spargias, Ad van Boven, Thomas Walther, Stephen G Worthley, Lars Sondergaard
The Portico system (St. Jude Medical, Minneapolis, MN, USA) consists of a self-expanding valve prosthesis and a delivery system designed for transcatheter aortic valve replacement (TAVR). We describe this system, its 10-steps implantation procedure, and provide tips and tricks based on our personal experience with this system.
October 2016: Journal of Interventional Cardiology
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