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Critical aortic stenosis

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https://www.readbyqxmd.com/read/29671237/acute-torrential-mitral-regurgitation-during-transcatheter-aortic-valve-replacement-a-case-report
#1
Yoshiyuki Yamashita, Hiromichi Sonoda, Tomoki Ushijima, Akira Shiose
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is a minimally invasive approach to aortic valve replacement. However, critical cardiovascular collapse can occur during the procedure for various reasons. CASE PRESENTATION: A 90-year-old man with severe aortic stenosis and left circumflex artery stenosis developed acute torrential mitral regurgitation (MR) during TAVR. The valve deployment process induced left ventricular dyssynchrony due to left bundle-branch block and myocardial ischemia in the left circumflex artery region with torrential MR...
April 18, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29643128/effects-of-impella-on-coronary-perfusion-in-patients-with-critical-coronary-artery-stenosis
#2
Mohammad Alqarqaz, Mir Basir, Khaldoon Alaswad, William O'Neill
BACKGROUND: Mechanical circulatory support devices are used to maintain hemodynamic stability during high-risk percutaneous coronary interventions. Little is known on the effects of such devices on coronary hemodynamics in patients with significant coronary stenosis. We sought to investigate whether mechanical circulatory support in the form of Impella (Abiomed Inc, Danvers, MA) can improve coronary hemodynamics in the presence of a critical coronary stenosis. METHODS AND RESULTS: We examined coronary perfusion pressures and coronary pressure distal to a critical stenosis using a coronary pressure wire in 11 patients (12 coronary lesions) undergoing high-risk percutaneous coronary interventions with the use of mechanical circulatory support...
April 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29627630/awake-intradural-spinal-tumour-resection
#3
Anan Shtaya, Chan Bao Luong, Erlick Pereira
BACKGROUND: Meningioma is a common slow growing spinal tumour with a predilection for intradural occurrence. Patients usually present with pain followed by ataxia and sensory and sphincter problems. The gold standard treatment in these cases is gross total microsurgical resection under general anaesthesia. However, there exist high anaesthetic risk patients unsuitable for general anaesthesia. Performing spinal surgeries under local anaesthesia and sedation has been reported albeit rarely for mostly minimally invasive procedures but not for open intradural pathologies...
April 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29526358/patients-with-anomalous-aortic-origin-of-the-coronary-artery-remain-at-risk-after-surgical-repair
#4
Shannon N Nees, Jonathan N Flyer, Anjali Chelliah, Jeffrey D Dayton, Lorraine Touchette, David Kalfa, Paul J Chai, Emile A Bacha, Brett R Anderson
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) from the opposite sinus of Valsalva is a rare cardiac anomaly associated with sudden cardiac death (SCD). Single-center studies describe surgical repair as safe, although medium- and long-term effects on symptoms and risk of SCD remain unknown. We sought to describe outcomes of surgical repair of AAOCA. METHODS: We reviewed institutional records for patients who underwent AAOCA repair, from 2001 to 2016, at 2 affiliated institutions...
June 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29444227/the-ross-konno-procedure-in-neonates-and-infants-less-than-3-months-of-age
#5
Eva Sames-Dolzer, Elisabeth Wickenhauser, Michaela Kreuzer, Peter Benedikt, Roland Gitter, Christoph Prandstetter, Gregor Gierlinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Patients with severe left ventricular outflow tract obstruction often suffer from impaired left ventricular function, endocardial fibroelastosis and borderline-sized structures. The early Ross-Konno operation can offer complete repair due to outflow tract stenosis and enable the functional recovery and growth of small structures. METHODS: Between 2008 and March 2017, 44 early Ross-Konno procedures were performed at our centre. Thirty-five patients were neonates, and 9 were infants less than 3 months of age...
February 12, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29439881/prospective-assessment-of-the-frequency-of-low-gradient-severe-aortic-stenosis-with-preserved-left-ventricular-ejection-fraction-critical-impact-of-aortic-flow-misalignment-and-pressure-recovery-phenomenon
#6
Anne Ringle, Anne-Laure Castel, Caroline Le Goffic, François Delelis, Camille Binda, Yohan Bohbot, Pierre Vladimir Ennezat, Raphaëlle A Guerbaai, Franck Levy, André Vincentelli, Pierre Graux, Christophe Tribouilloy, Sylvestre Maréchaux
BACKGROUND: The frequency of paradoxical low-gradient severe aortic stenosis (AS) varies widely across studies. The impact of misalignment of aortic flow and pressure recovery phenomenon on the frequency of low-gradient severe AS with preserved left ventricular ejection fraction (LVEF) has not been evaluated in prospective studies. AIMS: To investigate prospectively the impact of aortic flow misalignment by Doppler and lack of pressure recovery phenomenon correction on the frequency of low-gradient (LG) severe aortic stenosis (AS) with preserved LVEF...
February 10, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29428837/ascending-aortic-stenting-for-acute-supra-aortic-stenosis-from-graft-collapse
#7
Joshua M Lader, Deane E Smith, Cezar Staniloae, Arzhang Fallahi, Sohah N Iqbal, Aubrey C Galloway, Mathew R Williams
A 78 year-old man with remote type-A dissection presented with acute-onset dyspnea. Twenty-two years prior, treatment for his aortic disease required replacement of ascending and arch aneurysms with a Dacron graft using graft inclusion technique. He presented currently in cardiogenic shock. Echocardiography demonstrated new severe hypokinesis of all apical segments. Left-heart catheterization revealed a 120mmHg intra-graft gradient. CT arteriography was unrevealing, but intra-aortic ultrasound demonstrated critical intra-graft stenosis...
February 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29407076/the-prognostic-value-of-coronary-endothelial-and-microvascular-dysfunction-in-subjects-with-normal-or-non-obstructive-coronary-artery-disease-a-systematic-review-and-meta-analysis
#8
Philip Brainin, Daria Frestad, Eva Prescott
AIMS: Coronary vascular dysfunction is linked with poor cardiovascular prognosis in patients without obstructive coronary artery disease (CAD) but a critical appraisal of the literature is lacking. METHODS AND RESULTS: We performed a systematic review and meta-analysis to quantify the cardiovascular risk associated with endothelial dependent and non-endothelial dependent coronary vascular dysfunction in patients with normal or non-obstructive CAD (epicardial stenosis <50%)...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29404717/pulse-oximetry-findings-in-newborns-with-antenatally-diagnosed-congenital-heart-disease
#9
Isabel E Mawson, Pratusha L Babu, John M Simpson, Grenville F Fox
A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of < 1 h (range < 1-9 h) after delivery. Data was stratified by CCHD diagnosis and analysed according to the three different admission Pulsox thresholds, ≤ 90, ≤ 92 and ≤ 95%. Of the 276 neonates studied, 208 were clinically well at admission, with no co-morbidities, gestation > 34 weeks and birth weight > 1...
May 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29388705/echocardiography-in-transcatheter-aortic-valve-implantation-part-1-transthoracic-echocardiography
#10
REVIEW
Tasneem Z Naqvi
Transcatheter aortic valve replacement (TAVR) has been a revolutionary technique in the treatment of degenerative aortic valve stenosis. Selection of appropriate patients and appropriate valve size is crucial for improved patient outcome. Echocardiographic imaging is a critical component for patient selection and plays an important role in the selection of valve size, procedural guidance, and patient follow-up. This review discusses role of echocardiography in patient selection, device implantation, and postimplant follow-up for the first-generation CoreValve as used in pivotal trial...
February 1, 2018: Echocardiography
https://www.readbyqxmd.com/read/29375228/balloon-aortic-valvuloplasty-in-a-premature-neonate-with-critical-aortic-valve-stenosis-weighing-1493-g
#11
Yin-Yu Lin, Ming-Ren Chen
The use of balloon aortic valvuloplasty for congenital aortic valve stenosis was well established in literatures. However, balloon aortic valvuloplasty performed in low body weight neonates had been infrequently reported. Here we report a 5-day-old premature neonate diagnosed critical aortic valve stenosis. Balloon aortic valvuloplasty was performed as first-line therapy while the patient weighed only 1493 g. Balloon aortic valvuloplasty went successfully with transvalvular pressure gradient decreased from 80 mmHg to 44 mmHg...
January 2018: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29373649/application-of-hybrid-stage-i-palliation-for-patients-with-two-ventricular-cavities-and-hypoplastic-left-heart-structures
#12
Akihiko Higashida, Takaya Hoashi, Masataka Kitano, Masatoshi Shimada, Tomohiro Nakata, Hideto Ozawa, Kenichi Kurosaki, Hajime Ichikawa
OBJECTIVES: To assess the feasibility of hybrid Stage I palliation consisting of bilateral pulmonary artery bandings and ductal stenting for patients with 2 ventricular cavities and hypoplastic left heart structures. METHODS: Eleven consecutive patients who underwent hybrid Stage I palliation between 2010 and 2017 were enrolled. The diagnoses were interrupted aortic arch/coarctation of the aorta, ventricular septal defect and significant left ventricular (LV) outflow tract obstruction in 5 patients, critical aortic stenosis and reduced LV contraction in 3 patients and hypoplastic left heart complex in 3 patients...
January 24, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29356195/acute-coronary-syndrome-of-very-unusual-etiology
#13
Raimundo Barbosa-Barros, Andrés R Pérez-Riera, Kimmo Koivula, Jairo de Carvalho Santos, Luiz C de Abreu, Kjell Nikus
Aortitis is one of many possible manifestations of tertiary syphilis. Aortic disease is the most common of all cardiovascular syphilitic lesions. Aortic diseases caused by tertiary syphilis include aortitis, aortic root dilation, aneurysm formation, aortic regurgitation and coronary ostial stenosis. A less common manifestation of syphilitic aortitis is coronary artery ostial narrowing related to aortic wall thickening. We report a case of a 40-year-old male patient admitted with a clinical picture of acute coronary syndrome (unstable angina)...
January 21, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29285803/balloon-aortic-valvuloplasty-to-improve-candidacy-of-patients-evaluated-for-transcatheter-aortic-valve-replacement
#14
Mani Arsalan, Samir Khan, Jake Golman, Molly Szerlip, Cecile Mahoney, Morley Herbert, David Brown, Michael Mack, Elizabeth M Holper
OBJECTIVES: Evaluate the role of balloon aortic valvuloplasty (BAV) in improving candidacy of patients for transcatheter aortic valve replacement (TAVR). BACKGROUND: Patients who are not candidates for TAVR may undergo BAV to improve functional and clinical status. METHODS: 117 inoperable or high-risk patients with critical aortic stenosis underwent BAV as a bridge-to-decision for TAVR. Frailty measures including gait speed, serum albumin, hand grip, activities of daily living (ADL); and NYHA functional class before and after BAV were compared...
February 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29275015/an-unusual-cause-of-ischemia-after-coronary-bypass-grafting
#15
Rania Hammami, Salma Charfeddine, Nizar Elleuch, Hela Fourati, Leila Abid, Samir Kammoun
Coronary subclavian steal syndrome is an uncommon cause of ischemia recurrence after coronary artery bypass grafting. Endovascular treatment of subclavian artery stenosis or occlusion is increasingly common and appears to offer a safe and effective alternative to surgical revascularization. We report a case of recurrent angina after coronary artery bypass grafting for critical subclavian artery stenosis. The anomalous origin of the vertebral artery from the aortic arch was an indication for endovascular treatment...
January 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29258711/mechanisms-of-aortic-stenosis
#16
REVIEW
Hirokuni Akahori, Takeshi Tsujino, Tohru Masuyama, Masaharu Ishihara
The pathobiology of degenerative aortic valve stenosis (AS) is complex and involves multiple features such as fibrosis, inflammation, oxidative stress, angiogenesis, hemorrhage, and osteogenic differentiation. We summarize the mechanism of valve calcification and angiogenesis which is necessary for calcifying processes. A promising therapeutic target is nuclear factor (NF)-κB which activates bone morphogenetic protein (BMP)2 via interleukin-6. BMP2 activates Wnt signaling via msh homeobox 2 causing osteogenic differentiation...
March 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29168984/transcatheter-vs-surgical-aortic-valve-replacement-in-low-to-intermediate-surgical-risk-candidates-a-meta-analysis-and-systematic-review
#17
REVIEW
Safi U Khan, Ahmad N Lone, Muhammad A Saleem, Edo Kaluski
The American and European expert documents recommend transcatheter aortic valve replacement (TAVR) for inoperable or high-surgical-risk patients with severe aortic stenosis. In comparison, efficacy of TAVR is relatively less studied in low- to intermediate-surgical-risk patients. We sought to discover whether TAVR can be as effective as surgical aortic valve replacement (SAVR) in low- to intermediate-surgical-risk candidates. Four randomized clinical trials (RCTs) and 8 prospective matched studies were selected using PubMed/MEDLINE, Embase, and Cochrane Library (inception: March 2017)...
November 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29158034/different-notch-signaling-in-cells-from-calcified-bicuspid-and-tricuspid-aortic-valves
#18
A Kostina, A Shishkova, E Ignatieva, O Irtyuga, M Bogdanova, K Levchuk, A Golovkin, E Zhiduleva, V Uspenskiy, O Moiseeva, G Faggian, J Vaage, A Kostareva, A Rutkovskiy, A Malashicheva
AIMS: Calcific aortic valve disease is the most common heart valve disease in the Western world. Bicuspid and tricuspid aortic valve calcifications are traditionally considered together although the dynamics of the disease progression is different between the two groups of patients. Notch signaling is critical for bicuspid valve development and NOTCH1 mutations are associated with bicuspid valve and calcification. We hypothesized that Notch-dependent mechanisms of valve mineralization might be different in the two groups...
January 2018: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#19
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
February 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29062752/technical-pitfalls-and-tips-for-the-valve-in-valve-procedure
#20
REVIEW
Vinayak Bapat
Transcatheter aortic valve implantation (TAVI) has emerged as a viable treatment modality for patients with severe aortic valve stenosis and multiple co-morbidities. More recent indications include the use of transcatheter heart valves (THV) to treat degenerated bioprosthetic surgical heart valves (SHV), which are failing due to stenosis or regurgitation. Valve-in-valve (VIV) procedures in the aortic position have been performed with a variety of THV devices, although the balloon-expandable SAPIEN valve platform (Edwards Lifesciences Ltd, Irvine, CA, USA) and self-expandable CoreValve platform (Medtronic Inc...
September 2017: Annals of Cardiothoracic Surgery
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