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Tavr echo

Jeremy Ben-Shoshan, Arie Steinvil, Yaron Arbel, Yan Topilsky, Leehee Barak, Michal Entin-Meer, Ran Levy, Arie Lorin Schwartz, Gad Keren, Ariel Finkelstein, Shmuel Banai
BACKGROUND: Transcatheter aortic valve replacement (TAVR) exposes the systemic vasculature to increased mechanical forces. Endothelial adaptation to mechanical stimuli is associated with angiogenic activation through various growth factors. We studied the potential angiogenic shift evoked by TAVR. METHODS: From a cohort of 69 consecutive patients undergoing TAVR, we excluded patients with conditions known to affect angiogenic factors, and serum vascular endothelial growth factor (VEGF) and angiopoietin (Ang)-1 and Ang-2 were assessed by ELISA...
June 25, 2016: Canadian Journal of Cardiology
Avais Jabbar, Ayush Khurana, Ashfaq Mohammed, Rajiv Das, Azfar Zaman, Richard Edwards
Transcatheter aortic valve replacement (TAVR) is conventionally performed under general anesthesia (GA) allowing intraoperative transoesophageal echocardiogram imaging. We present our experience in patients having the procedure under local anesthesia (LA), who were subsequently transferred to a low dependency unit postprocedure, to assess safety and length of hospital stay. We retrospectively assessed all the transfemoral TAVR procedures conducted at our center from January 03, 2011. Of 216 patients, 145 had the procedure under GA and 71 under LA...
August 30, 2016: American Journal of Cardiology
Hashrul N Rashid, Liam M McCormick, Robert P Gooley, Ian T Meredith
A 79-year-old man with stable chronic obstructive pulmonary disease was found to have an abdominal aortic aneurysm and worsening dyspnoea. Echocardiography demonstrated critical aortic stenosis. Simultaneous endovascular aneurysm repair (EVAR) and transcatheter aortic valve replacement (TAVR) was recommended due to high surgical risk. Procedural strategy was to perform balloon valvuloplasty (BAV), followed by EVAR then TAVR. The initial 25 mm Lotus valve adopted a barrel shape suggestive of an undersized valve and was thus replaced with a 27 mm valve...
August 30, 2016: Cardiovascular Intervention and Therapeutics
José G Díez, Michael Schechter, Kathryn G Dougherty, Ourania Preventza, Joseph S Coselli
Transcatheter aortic valve replacement (TAVR) is a well-established method for replacing native aortic valves; however, it was conceived for elderly patients with aortic valve stenosis, and the lack of data on long-term durability has led practitioners to restrict the use of TAVR to patients who have short life expectancies. Here, we describe the case of a 21-year-old woman who had undergone 3 previous open aortic valve replacements and who presented with symptoms of recurrent valvular failure. Transthoracic echocardiograms and computed tomographic angiograms revealed a degenerating aortic root homograft with substantial calcification, moderate-to-severe aortic valve stenosis, and severe aortic valve regurgitation...
August 2016: Texas Heart Institute Journal
Sarkis Kiramijyan, Marco A Magalhaes, Edward Koifman, Romain Didier, Ricardo O Escarcega, Sa'ar Minha, Nevin C Baker, Smita I Negi, Rebecca Torguson, Jiaxiang Gai, Petros Okubagzi, Federico M Asch, Michael A Gaglia, Itsik Ben-Dor, Lowell F Satler, Augusto D Pichard, Ron Waksman
BACKGROUND: The prevalence of concomitant significant mitral regurgitation (MR) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) ranges from 2% to 33%. The impact of significant MR on post-TAVR outcomes remains controversial. METHODS: The data from a cohort of patients with symptomatic severe AS undergoing TAVR at out institution were retrospectively analyzed. The last transthoracic echocardiogram (TTE) before the index TAVR procedure was selected as the baseline assessment of the degree of MR...
August 2016: American Heart Journal
Jeffrey J Popma, Michael J Reardon, Steven J Yakubov, James B Hermiller, J Kevin Harrison, Thomas G Gleason, John V Conte, G Michael Deeb, Stanley Chetcuti, Jae K Oh, Michael J Boulware, Jian Huang, David H Adams
OBJECTIVES: The aim of this study was to determine the relationship between aortoventricular (AoV) angulation on clinical outcomes after self-expanding transcatheter aortic valve replacement (TAVR) in patients with severe aortic stenosis who were deemed suboptimal for surgery. BACKGROUND: Multidetector computed tomographic (MDCT) imaging of the aortovalvular complex has become a prerequisite for case planning with self-expanding TAVR. The effect of aortic angulation, an index of an unfolded or "horizontal" aorta, on procedural outcome after self-expanding TAVR is not known...
August 2016: JACC. Cardiovascular Imaging
Venkatesh Y Anjan, Howard C Herrmann, Philippe Pibarot, William J Stewart, Samir Kapadia, E Murat Tuzcu, Vasilis Babaliaros, Vinod H Thourani, Wilson Y Szeto, Joseph E Bavaria, Susheel Kodali, Rebecca T Hahn, Mathew Williams, D Craig Miller, Pamela S Douglas, Martin B Leon
IMPORTANCE: Low-flow (LF) severe aortic stenosis (AS) is an independent predictor of mortality in patients undergoing aortic valve replacement (AVR). Little is known about improvement in flow after AVR and its effects on survival. OBJECTIVE: To determine whether higher flow (left-ventricular stroke volume index [LVSVI]) after transcatheter AVR (TAVR) would indicate better clinical outcomes in this at-risk population. DESIGN, SETTING, AND PARTICIPANTS: A substudy analysis of data from the Placement of Aortic Transcatheter Valves (PARTNER) randomized clinical trial and continued-access registry was conducted...
August 1, 2016: JAMA Cardiology
Stephen H Little, Jae K Oh, Linda Gillam, Partho P Sengupta, David A Orsinelli, João L Cavalcante, James D Chang, David H Adams, George L Zorn, Amy W Pollak, Sahar S Abdelmoneim, Michael J Reardon, Hongyan Qiao, Jeffrey J Popma
BACKGROUND: The CoreValve US High-Risk Clinical Study compared clinical outcomes and serial echocardiographic findings in patients with severe aortic valve stenosis after transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis or surgical aortic valve replacement (SAVR). METHODS AND RESULTS: Eligible patients were randomly assigned 1:1 to TAVR with a self-expanding bioprosthesis or SAVR (N=747). Echocardiograms were obtained at baseline, discharge, 30 days, 6 months, and 1 year after the procedure and were analyzed at a central core laboratory...
June 2016: Circulation. Cardiovascular Interventions
Susheel Kodali, Vinod H Thourani, Jonathon White, S Chris Malaisrie, Scott Lim, Kevin L Greason, Mathew Williams, Mayra Guerrero, Andrew C Eisenhauer, Samir Kapadia, Dean J Kereiakes, Howard C Herrmann, Vasilis Babaliaros, Wilson Y Szeto, Rebecca T Hahn, Philippe Pibarot, Neil J Weissman, Jonathon Leipsic, Philipp Blanke, Brian K Whisenant, Rakesh M Suri, Raj R Makkar, Girma M Ayele, Lars G Svensson, John G Webb, Michael J Mack, Craig R Smith, Martin B Leon
AIMS: Based on randomized trials using first-generation devices, transcatheter aortic valve replacement (TAVR) is well established in the treatment of high-risk (HR) patients with severe aortic stenosis (AS). To date, there is a paucity of adjudicated, prospective data evaluating outcomes with newer generation devices and in lower risk patients. We report early outcomes of a large, multicentre registry of inoperable, HR, and intermediate-risk (IR) patients undergoing treatment with the next-generation SAPIEN 3 transcatheter heart valve (THV)...
July 21, 2016: European Heart Journal
Jinling Chen, Nasir Nawaz, Zachary Fox, Caroline Komlo, Saif Anwaruddin, Nimesh Desai, Dinesh Jagasia, Howard C Herrmann, Yuchi Han
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an established therapy in high-risk patients with severe aortic stenosis. Among patients with reduced left ventricular ejection fraction (LVEF), it is unclear which patients will derive maximal benefit from TAVR. METHODS: Clinical and echocardiographic data of patients with severe aortic stenosis and low LVEF (≤50%) who underwent TAVR at a single institution during 2009-2013 were retrospectively analyzed...
May 2016: Catheterization and Cardiovascular Interventions
R Hilling-Smith, A Chong, S Cox
Percutaneous closure of paravalvular leaks is becoming a more widely practiced technique. We describe the technique we used to deploy an Amplatzer PFO closure device to treat a prosthetic mitral paravalvular leak. The procedure was performed under real time 3D trans-oesophageal echo and fluoroscopic guidance requiring a trans-septal puncture and utilising an 035″ Safari wire which was developed for TAVR implantation. An excellent result was achieved acutely and at 4 month follow-up. © 2016 Wiley Periodicals, Inc...
April 16, 2016: Catheterization and Cardiovascular Interventions
M Rizwan Sardar, Georges I Kaddissi, Sajjad A Sabir, Simon K Topalian
The left atrial dissection is a very infrequently encountered complication after valve replacement and never seen after Transcatheter aortic valve replacement (TAVR). We present an 84-year-old female, who underwent successful transapical TAVR and consequently developed contained left atrial dissection seen on transesophageal echocardiogram. The patient remained stable throughout the procedure and was monitored in critical care unit with conservative management. Although there is low associated intraop mortality, prompt recognition is paramount with follow-up serial imaging...
June 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Paul N Fiorilli, Saif Anwaruddin
No abstract text is available yet for this article.
April 2016: Journal of Invasive Cardiology
Sarkis Kiramijyan, Marco A Magalhaes, Edward Koifman, Romain Didier, Ricardo O Escarcega, Nevin C Baker, Smita I Negi, Sa'ar Minha, Rebecca Torguson, Gai Jiaxiang, Federico M Asch, Zuyue Wang, Petros Okubagzi, Michael A Gaglia, Itsik Ben-Dor, Lowell F Satler, Augusto D Pichard, Ron Waksman
The incidence of aortic regurgitation (AR) after transcatheter aortic valve replacement (TAVR) in a self-expanding and a balloon-expandable system is controversial. This study aimed to examine the incidence and severity of post-TAVR AR with the CoreValve (CV) versus the Edwards XT Valve (XT). Baseline, procedural, and postprocedural inhospital outcomes were compared. The primary end point was the incidence of post-TAVR AR of any severity, assessed with a transthoracic echocardiogram, in the CV versus XT groups...
May 1, 2016: American Journal of Cardiology
Thomas Chin, Padmanabhan Priyesh, Ashequl M Islam
For appropriate patients with severe symptomatic aortic stenosis with a prohibitively high surgical risk, trans-catheter aortic valve replacement (TAVR) is now established as a viable option. Thrombosis on the intra-ventricular guide-wire during TAVR is a recognized complication (Wiper et al., Cardiovasc Revasc Med 2014). There is an obvious potential for embolization with particular concern for stroke in this situation. We describe a case in which a >1cm thrombus was noted on the intra-ventricular guide-wire by trans-esophageal echocardiogram (TEE) during a TAVR procedure...
September 2, 2015: Catheterization and Cardiovascular Interventions
Tomo Ando, Anthony A Holmes, Cynthia C Taub, Joseph J DeRose, David P Slovut
BACKGROUND: In transcatheter aortic valve replacement (TAVR) the trans-apical approach (TA) is associated with apical myocardial injury but it is unknown if this injury impacts myocardial function. This study was performed to assess the impact of TA on apical longitudinal strain (ALS) and global longitudinal strain (GLS) after TAVR. METHODS: 44 consecutive patients (age 81 ± 7 years, 48% male) underwent TAVR via trans-femoral (TF) (n=27) or TA (n=17) approach. Speckle-tracking analysis of left ventricular longitudinal strain was performed on images from peri-procedure transesophageal echocardiograms immediately before and after valve implantation...
2015: American Journal of Cardiovascular Disease
Matthias Renker, Akos Varga-Szemes, U Joseph Schoepf, Stefan Baumann, Davide Piccini, Michael O Zenge, Wolfgang G Rehwald, Edgar Müller, Jeremy D Rier, Helge Möllmann, Christian W Hamm, Daniel H Steinberg, Carlo N De Cecco
OBJECTIVES: Due to the high prevalence of renal failure in transcatheter aortic valve replacement (TAVR) candidates, a non-contrast MR technique is desirable for pre-procedural planning. We sought to evaluate the feasibility of a novel, non-contrast, free-breathing, self-navigated three-dimensional (SN3D) MR sequence for imaging the aorta from its root to the iliofemoral run-off in comparison to non-contrast two-dimensional-balanced steady-state free-precession (2D-bSSFP) imaging. METHODS: SN3D [field of view (FOV), 220-370 mm(3); slice thickness, 1...
April 2016: European Radiology
Ali Elkharbotly, Augustin Delago, Mohammad El-Hajjar
Transcatheter aortic valve replacement (TAVR) is well established for patients who cannot undergo surgery (Leon et al., N Engl J Med 2010;363:1597) or are high risk for surgery (Smith et al., N Engl J Med 2011;364:2187-2198). Experience with the TAVR procedure has led to recent reports of successful transcatheter mitral valve replacement (TMVR) procedures (Cheung et al., J Am Coll Cardiol 2014;64:1814; Seiffert et al., J Am Coll Cardiol Interv 2012;5:341-349) separately or simultaneously with the TAVR. However, these reports were of simultaneous valve-in-valve procedures (Cheung Anson, et al...
June 23, 2015: Catheterization and Cardiovascular Interventions
Florent Le Ven, Christophe Thébault, Abdellaziz Dahou, Henrique B Ribeiro, Romain Capoulade, Haïfa Mahjoub, Marina Urena, Luis Nombela-Franco, Ricardo Allende Carrera, Marie-Annick Clavel, Éric Dumont, Jean Dumesnil, Robert De Larochellière, Josep Rodés-Cabau, Philippe Pibarot
OBJECTIVE: Low flow (LF), defined as stroke volume index (SVi) <35 mL/m(2), prior to the procedure has been recently identified as a powerful independent predictor of early and late mortality in patients undergoing transcatheter aortic valve replacement (TAVR). The objectives of this study were to determine the evolution of SVi following TAVR and to assess the determinants and impact on mortality of early postprocedural SVi (EP-SVi). METHODS: We retrospectively analysed the clinical, Doppler echocardiographic and outcome data prospectively collected in 255 patients who underwent TAVR...
August 2015: Heart: Official Journal of the British Cardiac Society
Eduardo De Marchena, Julian Mesa, Sydney Pomenti, Christian Marin Y Kall, Ximena Marincic, Kazuyuki Yahagi, Elena Ladich, Robert Kutz, Yaar Aga, Michael Ragosta, Atul Chawla, Michael E Ring, Renu Virmani
OBJECTIVES: This paper reviews the published data and reports 3 cases of thrombosis involving CoreValve (Medtronic, Minneapolis, Minnesota) and 1 involving Edward Sapien (Edwards Lifesciences, Irvine, California) devices. Three of these cases had pathological findings at autopsy. BACKGROUND: Only a limited number of cases of valve dysfunction with rapid increase of transvalvular aortic gradients or aortic insufficiency post-transcatheter aortic valve replacement (TAVR) have been described...
April 27, 2015: JACC. Cardiovascular Interventions
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