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Critical aortic stenosis

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https://www.readbyqxmd.com/read/28044267/late-paravalvular-aortic-regurgitation-migration-of-the-valve-or-late-recoil
#1
Ashkan Karimi, Negiin Pourafshar, Ki E Park, Calvin Y Choi, Kiran Mogali, Wade W Stinson, Eddie W Manning, Anthony A Bavry
A 79-year-old man underwent trans-catheter aortic valve replacement for symptomatic severe aortic stenosis with a 26-mm Edwards SAPIEN XT valve. Immediately after valve deployment there was moderate amount of paravalvular leak. Post-dilation was performed with an additional 2 cc of volume, and the paravalvular leak was reduced to trace. Nine months later, trans-thoracic echocardiography revealed moderate to severe paravalvular leak and possible aortic migration of the valve. The patient was brought back for the treatment of the paravalvular leak which was suspected to be due to valve migration...
January 2, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28044253/transvenous-inoue-balloon-aortic-valvuloplasty-with-intra-aortic-balloon-pump-in-treating-cardiogenic-shock-due-to-critical-calcific-aortic-stenosis
#2
Yoshihito Sakata
A 90-year-old female with severe peripheral vascular disease developed cardiogenic shock (CS) due to critical aortic stenosis (AS). The balloon aortic valvuloplasty was emergently performed via transvenous and transseptal antegrade approach (ante-BAV), which saved arterial accesses for intra-aortic balloon pump (IABP) and enabled us to use the Inoue balloon. The IABP augmented systemic perfusions and controlled left heart filling pressures. Multiple times of inflations with stepwisely increased balloon diameters were performed under IABP support (ante-Inoue-BAV + IABP), resulting in remarkable improvements both in clinical and hemodynamic conditions...
January 2, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28040141/prenatal-diagnosis-of-smith-magenis-syndrome-in-two-fetuses-with-increased-nuchal-translucency-mild-lateral-ventriculomegaly-and-congenital-heart-defects
#3
Ting-Ying Lei, Ru Li, Fang Fu, Jun-Hui Wan, Yong-Ling Zhang, Xiang-Yi Jing, Can Liao
OBJECTIVE: Smith-Magenis syndrome (SMS) is a multiple congenital anomalies/mental retardation disorder characterized by an interstitial deletion involving chromosome 17p11.2 containing the retinoic acid-induced 1 (RAI1) gene or due to mutation of RAI1. Few cases have been reported in the medical literature regarding prenatal diagnosis of SMS. We report on the prenatal diagnosis of SMS in two fetuses with increased nuchal translucency (NT), mild lateral ventriculomegaly, and congenital heart defects by whole-genome and high-resolution chromosome microarray analysis (CMA)...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27994841/do-all-critical-aortic-stenosis-with-chest-pain-need-aortic-valve-replacement-a-case-report
#4
Munish Sharma, Daniel A N Mascarenhas
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27990197/transcatheter-aortic-valve-implantation-for-treatment-of-aortic-valve-stenosis-a-health-technology-assessment
#5
(no author information available yet)
BACKGROUND: Surgical aortic valve replacement (SAVR) is the gold standard for treating aortic valve stenosis. It is a major operation that requires sternotomy and the use of a heart-lung bypass machine, but in appropriately selected patients with symptomatic, severe aortic valve stenosis, the benefits of SAVR usually outweigh the harms. Transcatheter aortic valve implantation (TAVI) is a less invasive procedure that allows an artificial valve to be implanted over the poorly functioning valve...
2016: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/27980763/operating-the-blues
#6
Andrew C Chatzis, Meletios A Kanakis, Joanne Sofianidou, Alexandros J Tsoutsinos
A 63-year-old man bearing most signs and symptoms (facial pigmentation, degenerative arthritis, and dark urine) pertinent to his known history of alkaptonuria underwent aortic valve replacement for critical aortic stenosis. Although rare, aortic stenosis is the most common cardiac manifestation of alkaptonuric ochronosis.
December 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27920592/left-main-coronary-ostial-stenosis-after-aortic-valve-replacement-a-case-report
#7
Munish Sharma, Daniel Mascarenhas
Coronary ostial stenosis is a rare but potentially life-threatening complication of aortic valve replacement (AVR). It can present potential complications such as acute coronary syndrome, left ventricular failure, ventricular arrhythmias, or sudden death. Exact pathogenetic mechanism is not known, but a few hypotheses have been proposed. We present a case of left main coronary stenosis 11 months after AVR was done for symptomatic critical aortic stenosis. High index of clinical suspicion and timely coronary angiography helped to determine the exact etiology...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27904162/impact-of-catheterization-lab-computer-software-settings-on-hemodynamic-assessment-of-aortic-stenosis
#8
Zaher Fanari, Anitha Rajamanickam, Mathew Grove, Sumaya Hammami, Cassie Walls, Paul Kolm, William Weintraub, Andrew J Doorey
BACKGROUND: Accurate assessment of Cardiac Output (CO) is a critical measurement in the calculation of aortic valve area (AVA). Due to the known inaccuracy of estimated Fick calculations, many measure thermodilution (TD) CO as well due to previous studies showing better correlation with the gold standard direct CO. Previous studies showed suboptimal correlation between both methods. Most physicians assume that the TD CO is chosen by catheterization laboratory software for AVA evaluation...
July 2016: Delaware Medical Journal
https://www.readbyqxmd.com/read/27895025/medical-treatment-of-aortic-stenosis
#9
Guillaume Marquis-Gravel, Björn Redfors, Martin B Leon, Philippe Généreux
Untreated, severe, symptomatic aortic stenosis is associated with a dismal prognosis. The only treatment shown to improve survival is aortic valve replacement; however, before symptoms occur, aortic stenosis is preceded by a silent, latent phase characterized by a slow progression at the molecular, cellular, and tissue levels. In theory, specific medical therapy should halt aortic stenosis progression, reduce its hemodynamic repercussions on left ventricular function and remodeling, and improve clinical outcomes...
November 29, 2016: Circulation
https://www.readbyqxmd.com/read/27887818/three-dimensional-morphology-of-the-left-ventricular-outflow-tract-impact-on-grading-aortic-stenosis-severity
#10
Luis Caballero, Daniel Saura, María José Oliva-Sandoval, Josefa González-Carrillo, María Dolores Espinosa, Miguel García-Navarro, Mariano Valdés, Patrizio Lancellotti, Gonzalo de la Morena
BACKGROUND: Left ventricular outflow tract (LVOT) measurement is a critical step in the quantification of aortic valve area. The assumption of a circular morphology of the LVOT may induce some errors. The aim of this study was to assess the three-dimensional (3D) morphology of the LVOT and its impact on grading aortic stenosis severity. METHODS: Fifty-eight patients with aortic stenosis were studied retrospectively. LVOT dimensions were measured using 3D transesophageal echocardiography at three levels: at the hinge points (HP) of the aortic valve and at 4 and 8 mm proximal to the annular plane...
January 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/27863908/role-of-echocardiography-for-catheter-based-management-of-valvular-heart-disease
#11
REVIEW
Takahiro Shiota
Catheter-based treatment of valvular heart disease, such as transvalvular aortic valve replacement (TAVR) or mitral clip procedure, has been increasingly accepted as a treatment choice for the past several years. Such new treatment options have been changing the management of patients with valvular heart disease drastically while socio-economic factors regarding their application need to be taken into consideration. The use of echocardiography, including transesophageal echocardiography (TEE), for such catheter-based treatments is essential for the success of the procedures...
January 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27823594/off-the-shelf-fenestrated-and-branched-stent-graft-designs-for-abdominal-aortic-aneurysm-repair
#12
REVIEW
Bernardo C Mendes, Animesh Rathore, Mauricio S Ribeiro, Gustavo S Oderich
Endovascular repair of pararenal and thoracoabdominal aortic aneurysms with fenestrated and branched stent grafts has been increasingly utilized with high technical success and low morbidity and mortality. Freedom from branch-related events has been reported at 89% in 5 years, including any branch-related endoleak, stenosis, kink, disconnection, or occlusion. Patient-specific stent grafts have the advantage of fitting patients' anatomy, but require a 6- to 8-week period for customization. Off-the-shelf stent grafts have been developed based on a relative predictability of renal-mesenteric vessels...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27796963/the-frailty-in-elderly-patients-receiving-cardiac-interventional-procedures-fraser-program-rational-and-design-of-a-multicenter-prospective-study
#13
Gianluca Campo, Rita Pavasini, Elisa Maietti, Elisabetta Tonet, Paolo Cimaglia, Giulia Scillitani, Giulia Bugani, Matteo Serenelli, Fatima Zaraket, Cristina Balla, Filippo Trevisan, Simone Biscaglia, Biagio Sassone, Marcello Galvani, Roberto Ferrari, Stefano Volpato
BACKGROUND: Frailty has become a high-priority issue in cardiovascular medicine because of the aging of cardiovascular patients. Simple and reproducible tools to assess frailty in elderly patients are clearly on demand. Their application may help physicians in the selection of invasive and medical treatments and in the timing and modality of the follow-up. The frailty in elderly patients receiving cardiac interventional procedures (FRASER) program is designed with the aim to validate the use of the short physical performance battery (SPPB) as prognostic tools in patients admitted to hospital for acute coronary syndrome (ACS)...
October 28, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27793620/concomitant-parallel-endografting-and-fenestrated-experience-in-a-regional-aortic-center
#14
Mathew Wooster, Adam Tanious, Shivangi Patel, Neil Moudgill, Martin Back, Murray Shames
BACKGROUND: Off-label parallel endografting (PE) has been increasingly criticized in favor of on-label custom fenestrated endografts. There remain limited direct comparisons, however, between concurrent patient populations treated by similarly experienced operators. Hence, we seek to evaluate the relative efficacy of the two techniques in treating complex aortic pathology. METHODS: All patients treated by PE or with Cook Zenith Fenestrated (Zfen) devices from January 2010 to June 2015 were reviewed, excluding those treated for rupture...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27665337/-balloon-valvuloplasty-for-aortic-stenosis-using-umbilical-vein-access-in-a-newborn-first-experience-in-turkey
#15
Kemal Nişli, Serra Karaca, Aygün Dindar
Balloon valvuloplasty is an effective therapy for severe congenital aortic valve stenosis, with mild aortic insufficiency and minimal intermediate-term restenosis. No consensus currently exists regarding optimal vascular approach for balloon dilatation in newborns with critical or severe aortic valve stenosis. Critical aortic valve stenosis in newborns must be treated promptly and effectively. Transcatheter therapy may offer marked advantages, as surgical therapy has been associated with significant rates of morbidity and mortality...
September 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/27635474/transaortic-transcatheter-aortic-valve-implantation-and-concomitant-off-pump-revascularization
#16
Hardy Baumbach, Samir Ahad, Stephan Hill, Tim Schäufele, Sara Adili, Kristina Wachter, Ulrich F W Franke
An increasing number of patients with severe aortic stenosis and concomitant critical coronary artery disease were referred to our hospital. Some of those patients were classified as high-risk patients qualifying for a transcatheter therapy with the additional need for coronary revascularization. As a consequence of their comorbidities, the established transapical as well as transfemoral approach were either not possible or not favored owing to the indispensable need for coronary revascularization. We present 4 successfully combined off-pump procedures consisting of a transcatheter aortic valve implantation (Edwards SAPIEN XT) via the transaortic approach and an off-pump coronary artery bypass grafting...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27580533/factors-influencing-the-prognosis-of-octogenarians-with-aortic-stenosis-in-the-advanced-aging-societies
#17
Shuai Liang, Kazuto Yamaguchi, Hiroyuki Yoshitomi, Saki Ito, Ryuma Nakashima, Takashi Sugamori, Akihiro Endo, Nobuyuki Takahashi, Kazuaki Tanabe
Objective The recognition of clinical symptoms is critical to developing an effective therapeutic strategy for aortic valve stenosis (AS). Although AS is common, little is known about the factors influencing the natural history of AS patients who are 80 years of age older in advanced aging societies. We investigated the natural history and indications for valve procedures in AS patients of 80 years of age or older. Methods The medical records of 108 consecutive AS patients (moderate grade or higher) who are 80 years of age or older (mean age, 84...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27577944/simultaneous-transcatheter-aortic-valve-implantation-and-drive-by-endovascular-aortic-aneurysm-repair-a-case-of-lotus-valve-retrieved-and-replaced-due-to-an-undersized-valve-after-an-endovascular-aneurysm-repair
#18
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
https://www.readbyqxmd.com/read/27568118/the-functional-significance-of-paradoxical%C3%A2-low-gradient-aortic%C3%A2-valve%C3%A2-stenosis-hemodynamic-findings-during-cardiopulmonary%C3%A2-exercise%C3%A2-testing
#19
Candelas Pérez Del Villar, Raquel Yotti, María Ángeles Espinosa, Enrique Gutiérrez-Ibañes, Alicia Barrio, María José Lorenzo, Pedro Luis Sánchez Fernández, Yolanda Benito, Raquel Prieto, Esther Pérez David, Pablo Martínez-Legazpi, Francisco Fernández-Avilés, Javier Bermejo
OBJECTIVES: The goal of this study was to determine the functional impact of paradoxical low-gradient aortic stenosis (PLGAS) and clarify whether the relevance of the valvular obstruction is related to baseline flow. BACKGROUND: Establishing the significance of PLGAS is particularly challenging. METHODS: Twenty symptomatic patients (77 ± 6 years of age; 17 female subjects) with PLGAS (mean gradient 28 ± 6 mm Hg; aortic valve area 0.8 ± 0...
January 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27566706/role-of-imaging-in-transcatheter-aortic-valve-replacement
#20
REVIEW
Corinna Storz, Tobias Geisler, Mike Notohamiprodjo, Konstantin Nikolaou, Fabian Bamberg
Transcatheter aortic valve replacement (TAVR) has emerged as an effective treatment alternative in patients with severe aortic stenosis (AS) who are deemed surgically high-risk or ineligible for surgery. Pre-procedural imaging, in particular computed tomography (CT), plays an integral part in the planning and performance of TAVR and is crucial for a successful treatment. Novel technological advances in CT include high-pitch, low kV acquisitions, and iterative reconstruction resulting in high image quality at substantially reduced scan duration, contrast volume, and radiation exposure...
October 2016: Current Treatment Options in Cardiovascular Medicine
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