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https://www.readbyqxmd.com/read/29285803/balloon-aortic-valvuloplasty-to-improve-candidacy-of-patients-evaluated-for-transcatheter-aortic-valve-replacement
#1
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...
December 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29275015/an-unusual-cause-of-ischemia-after-coronary-bypass-grafting
#2
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...
December 20, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29258711/mechanisms-of-aortic-stenosis
#3
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...
December 16, 2017: 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
#4
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 23, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29158034/different-notch-signaling-in-cells-from-calcified-bicuspid-and-tricuspid-aortic-valves
#5
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...
November 17, 2017: 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
#6
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...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29062752/technical-pitfalls-and-tips-for-the-valve-in-valve-procedure
#7
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
https://www.readbyqxmd.com/read/29025747/uncoupling-protein-2-inhibits-myointimal-hyperplasia-in-preclinical-animal-models-of-vascular-injury
#8
Yan Zhang, Yaolei Zhang, Wei Li, Peijian Wang, Rui Gu, Yaxing Feng, Shujie Wei, Ke Peng, Yunrong Zhang, Linan Su, Qiang Wang, De Li, Dachun Yang, Wing Tak Wong, Yongjian Yang, Shuangtao Ma
BACKGROUND: Intracoronary stent restenosis, characterized by excessive smooth muscle cell (SMC) proliferation and myointimal hyperplasia, remains a clinical challenge. Mitochondrial membrane potential has been linked to the proliferative rate of SMCs. This study aimed to screen a critical gene regulating mitochondrial potential and to confirm its effects on myointimal formation in preclinical animal models. METHODS AND RESULTS: We performed transcriptome screening for genes differentially expressed in ligated versus unligated mouse carotid arteries...
October 12, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28967728/evolution-of-surgical-techniques-for-a-progressive-risk-reduction
#9
Bruno Amato, Mario Santoro, Raffaele Izzo, Giuseppe Servillo, Rita Compagna, Lorenza Di Domenico, Veronica Di Nardo, Giuseppe Giugliano
Advanced age is a strong predictor of high perioperative mortality in surgical patients and patients aged 75 years and older have an elevated surgical risk, much higher than that of younger patients. Progressive advances in surgical techniques now make it possible to treat high-risk surgical patients with minimally invasive procedures. Endovascular techniques have revolutionized the treatment of several vascular diseases, in particular carotid stenosis, aortic pathologies, and severely incapacitating intermittent claudication or critical limb ischemia...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28956773/metoprolol-reduces-hemodynamic-and-metabolic-overload-in-asymptomatic-aortic-valve-stenosis-patients-a-randomized-trial
#10
RANDOMIZED CONTROLLED TRIAL
Nils Henrik Hansson, Jens Sörensen, Hendrik Johannes Harms, Won Yong Kim, Roni Nielsen, Lars Poulsen Tolbod, Jørgen Frøkiær, Kirsten Bouchelouche, Karen Kaae Dodt, Inger Sihm, Steen Hvitfeldt Poulsen, Henrik Wiggers
BACKGROUND: Currently, no pharmacological treatment can modify the natural history of aortic valve stenosis (AS). This underlines the critical need to explore novel treatment strategies, which could postpone or prevent the need for aortic valve replacement in patients with asymptomatic AS. The objectives of this study were to investigate whether metoprolol reduce the hemodynamic and metabolic burden imposed by AS. METHODS AND RESULTS: In a double-blinded design, 40 patients with moderate-severe asymptomatic AS (aortic valve area, 0...
October 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#11
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28882282/acute-success-of-balloon-aortic-valvuloplasty-in-the-current-era-a-national-cardiovascular-data-registry-study
#12
Brian A Boe, Jeffrey D Zampi, Kevin F Kennedy, Natalie Jayaram, Diego Porras, Susan R Foerster, Aimee K Armstrong
OBJECTIVES: The aim of this study was to evaluate practice patterns and outcomes of a contemporary group of patients undergoing balloon aortic valvuloplasty (BAV) for congenital aortic stenosis (AS). BACKGROUND: BAV is the most common treatment for isolated congenital AS. METHODS: Within the IMPACT (Improving Pediatric and Adult Congenital Treatments) Registry, all BAV procedures performed between January 2011 and March 2015 were identified...
September 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28870876/prevalence-and-impact-of-critical-limb-ischemia-on-in-hospital-outcome-in-transcatheter-aortic-valve-implantation-in-germany
#13
Nasser M Malyar, Klaus Kaier, Eva Freisinger, Florian Lüders, Gerrit Kaleschke, Helmut Baumgartner, Lutz Frankenstein, Holger Reinecke, Jochen Reinöhl
AIMS: Peripheral artery disease (PAD) is common in patients with aortic valve stenosis (AS). We assessed the prevalence of critical limb ischemia (CLI) and its impact on in-hospital outcome in patients undergoing transcatheter aortic valve implantation (TAVI) for severe AS. METHODS AND RESULTS: All isolated TAVI in Germany between 2007 and 2013 for AS were analysed regarding stage specific prevalence of PAD, comorbidities, in-hospital complications and mortality using diagnostic and procedural codes...
September 5, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#14
COMPARATIVE STUDY
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28831765/validation-of-transpulmonary-thermodilution-variables-in-hemodynamically-stable-patients-with-heart-diseases
#15
Matthias Peter Hilty, Daniel Peter Franzen, Christophe Wyss, Patric Biaggi, Marco Maggiorini
BACKGROUND: Transpulmonary thermodilution is recommended in the treatment of critically ill patients presenting with complex shock. However, so far it has not been validated in hemodynamically stable patients with heart disease. METHODS: We assessed the validity of cardiac output, global end-diastolic volume index (GEDVI), an established marker of preload thought to reflect the volume of all four heart chambers, global ejection fraction (GEF) and cardiac function index (CFI) as variables of cardiac function, and extravascular lung water index (EVLWI) as indicator of pulmonary edema in 29 patients undergoing elective left and right heart catheterization including left ventricular angiography with stable coronary heart disease and normal cardiac function (controls, n = 11), moderate-to-severe aortic valve stenosis (AS, n = 10), or dilated cardiomyopathy (DCM, n = 8)...
August 22, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28814237/statins-in-aortic-stenosis
#16
Karl Norrington, Emmanuel Androulakis, Evangelos Oikonomou, Georgia Vogiatzi, Dimitris Tousoulis
Calcific aortic stenosis (AS) is the most common form of valvular heart disease in Europe and North America. It is a progressive disease with a prolonged period of asymptomatic latency which eventually leads to critical left ventricular outflow tract obstruction necessitating surgical replacement of the valve. Statins are lipid-lowering drugs with a robust evidence base demonstrating clinical benefit in atherosclerotic coronary artery disease. There has therefore been significant interest in the potential benefit of statins in AS...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28776389/congenital-aortic-stenosis-treatment-outcomes-in-a-nationwide-survey
#17
Merja Kallio, Otto Rahkonen, Ilkka Mattila, Jaana Pihkala
OBJECTIVE: To evaluate treatment outcomes of pediatric valvar aortic stenosis (AS) in a nationwide follow-up. DESIGN: Balloon aortic valvuloplasty (BAV) has been the preferred treatment for congenital AS in Finland since the year 2000. All children treated due to isolated AS during 2000-2014 were included in this retrospective study. Treatment outcomes were categorized into Optimal: residual gradient  ≤35 mmHg and trivial or no aortic regurgitation (AR), Adequate: gradient ≤35 mmHg with mild AR, or Inadequate: gradient >35 mmHg and/or moderate to severe AR...
October 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28770396/mitro-aortic-pathology-a%C3%A2-point-of-view-for-a%C3%A2-fully-transcatheter-staged-approach
#18
REVIEW
G D'Ancona, L Paranskaya, A Öner, S Kische, H Ince
Severe aortic valve stenosis (AVS) and mitral valve regurgitation (MVR) often coexist. Although a fully percutaneous treatment for the two conditions, by means of transcatheter aortic valve implantation (TAVI) followed by MitraClip, can be appealing in selected high-risk candidates, critical and strategical reasoning should be applied. In a 3-year period we have developed a single-centre experience of 14 patients who were managed with a staged percutaneous approach to treat severe AVS and MVR. The average interval from TAVI to MitraClip repair was 101 ± 12 days...
November 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28748765/biomarkers-in-aortic-valve-stenosis-and-their-clinical-significance-in-transcatheter-aortic-valve-implantation
#19
Konstantinos Toutouzas, Konstantinos Stathogiannis, George Latsios, Andreas Synetos, Maria Drakopoulou, Vicky Penesopoulou, Archontoula Michelongona, Eleftherios Tsiamis, Dimitris Tousoulis
Aortic valve stenosis is one of the most common valvular heart disorders and the prevalence will rise as the population ages. Once symptomatic, patients with aortic valve stenosis tend to fare worse with high mortality rates. Aortic valve replacement is indicated in these patients and besides the standard surgical replacement; a less invasive approach, transcatheter aortic valve implantation, has gained momentum and has showed promising and solid results in patients with high surgical risk. An important aspect of evaluating patients with aortic valve stenosis is the ability to choose the best possible candidate for the procedure...
July 27, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28728652/accuracy-of-fractional-flow-reserve-measurements-in-clinical-practice-observations-from-a-core-laboratory-analysis
#20
Mitsuaki Matsumura, Nils P Johnson, William F Fearon, Gary S Mintz, Gregg W Stone, Keith G Oldroyd, Bernard De Bruyne, Nico H J Pijls, Akiko Maehara, Allen Jeremias
OBJECTIVES: The aim of this study was to compare site-reported measurements of fractional flow reserve (FFR) with FFR analysis by an independent core laboratory (CL). BACKGROUND: FFR is an index of coronary stenosis severity that has been validated in multiple trials and is widely used in clinical practice. However, the incidence of suboptimal FFR measurements is unknown. METHODS: Patients undergoing FFR assessment within the CONTRAST (Can Contrast Injection Better Approximate FFR Compared to Pure Resting Physiology) study had paired, repeated measurements of multiple physiological metrics per local practice...
July 24, 2017: JACC. Cardiovascular Interventions
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