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Critical aortic stenosis

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
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 15, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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
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
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...
August 20, 2016: JACC. Cardiovascular Imaging
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
Gang Zhang, Jun Luo, Guo Chen
This paper discusses two male patients with severe aortic stenosis, whose right coronary arteries (RCA) were completely occluded during transcatheter aortic valve implantation (TAVI), leading to fatal hemodynamic disorder. Occlusions of RCA complicated by TAVI are rare. In addition, emergency cardiopulmonary bypass (CPB) played a critical role in rescuing our second patient. Both patients were admitted for "severe aortic stenosis," and TAVIs were performed. The first patient's blood pressure immediately dropped to 70/40 mmHg after the balloon expansion and did not increase much after the administration of aramine or fluid therapy...
September 2016: Frontiers of Medicine
Patrick T O'Gara
No abstract text is available yet for this article.
August 9, 2016: Circulation
Francesca Rusconi, Paola Ceriotti, Michele Miragoli, Pierluigi Carullo, Nicolò Salvarani, Marcella Rocchetti, Elisa Di Pasquale, Stefano Rossi, Maddalena Tessari, Silvia Caprari, Magali Cazade, Paolo Kunderfranco, Jean Chemin, Marie-Louise Bang, Fabio Polticelli, Antonio Zaza, Giuseppe Faggian, Gianluigi Condorelli, Daniele Catalucci
BACKGROUND: L-type calcium channels (LTCCs) play important roles in regulating cardiomyocyte physiology, which is governed by appropriate LTCC trafficking to and density at the cell surface. Factors influencing the expression, half-life, subcellular trafficking, and gating of LTCCs are therefore critically involved in conditions of cardiac physiology and disease. METHODS: Yeast 2-hybrid screenings, biochemical and molecular evaluations, protein interaction assays, fluorescence microscopy, structural molecular modeling, and functional studies were used to investigate the molecular mechanisms through which the LTCC Cavβ2 chaperone regulates channel density at the plasma membrane...
August 16, 2016: Circulation
Claire Galoin-Bertail, André Capderou, Emre Belli, Lucile Houyel
BACKGROUND: The objective of this study was to examine early and long-term results of surgical aortic valvotomy in neonates and infants aged less than four months and to identify predictors of outcome. METHODS: Between August 1994 and April 2012, 83 consecutive patients younger than 4 months of age underwent open heart valvotomy for critical aortic stenosis in our institution. Median age was 17 days (range 0-111 days). We examined clinical records to establish determinants of outcome and illustrate long-term results...
2016: Journal of Cardiothoracic Surgery
Jaeger P Ackerman, John A Smestad, David J Tester, Muhammad Y Qureshi, Beau A Crabb, Nancy J Mendelsohn, Michael J Ackerman
OBJECTIVE: To use whole exome sequencing (WES) of a family trio to identify a genetic cause for polyvalvular syndrome. METHODS AND RESULTS: A male child was born with mild pulmonary valve stenosis and mild aortic root dilatation, and an atrial septal defect, ventricular septal defect, and patent ductus arteriosus that were closed surgically. Subsequently, the phenotype of polyvalvular syndrome with involvement of both semilunar and both atrioventricular valves emerged...
September 2016: Congenital Heart Disease
Patrick T Roughneen, Ghannam A Al-Dossari
We report obstruction of an anomalous right coronary artery traversing between the pulmonary artery and aorta after placement of a 21-mm bovine bioprosthesis for critical aortic stenosis requiring emergency revascularization. Although this anomaly has been associated with sudden death syndrome, acute coronary ischemia resulting from aortic valve replacement in patients with anomalous coronary artery has not been sufficiently highlighted in the literature. Awareness of this issue may decrease the risk of this complication in patients with anomalous coronary anatomy undergoing aortic or pulmonary valve replacement...
August 2016: Annals of Thoracic Surgery
Russell J Everett, David E Newby, Andrew Jabbour, Zahi A Fayad, Marc R Dweck
PURPOSE OF REVIEW: Aortic valve disease is the most common form of heart valve disease in developed countries. Imaging remains central to the diagnosis and risk stratification of patients with both aortic stenosis and regurgitation and has traditionally been performed with echocardiography. Indeed, echocardiography remains the cornerstone of aortic valve imaging as it is cheap, widely available and provides critical information concerning valve hemodynamics and ventricular function. RECENT FINDINGS: Whilst diagnostic in the vast majority of patients, echocardiography has certain limitations including operator variability, potential for measurement errors and internal inconsistencies in severity grading...
2016: Current Cardiovascular Imaging Reports
Mustafa A Altaha, Jeffrey D Jaskolka, Kongteng Tan, Manuela Rick, Peter Schmitt, Ravi J Menezes, Bernd J Wintersperger
PURPOSE: The aim of this study was to evaluate diagnostic performance of non-contrast-enhanced 2D quiescent-interval single-shot (QISS) and 3D turbo spin-echo (TSE)-based subtraction magnetic resonance angiography (MRA) in the assessment of peripheral arteries in patients with critical limb ischemia (CLI). MATERIALS AND METHODS: Nineteen consecutive patients (74 % male, 72.8 ± 9.9 years) with CLI underwent 2D QISS and 3D TSE-based subtraction MRA at 1.5 T...
June 28, 2016: European Radiology
Shi-Min Yuan, Gulimila Humuruola
Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Ramush Bejiqi, Hana Bejiqi, Ragip Retkoceri
BACKGROUND: Obstruction to the left ventricular outflow of the heart may be above the aortic valve (5%), at the valve (74%), or in the subvalvar region (23%). These anomalies represent 3 to 6% of all patients with congenital heart defects (CHD), and it occurs more often in males (male-female ratio of 4:1). AIM: The purpose of this study was to determine the sensitivity and specificity of transthoracic echocardiography in diagnosis of discrete subaortic membrane, to determine convenient time for surgical intervention, and for identifying involvement of the aortic valve by subaortic shelf...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Bibombe P Mwipatayi, Ali Daneshmand, Haider K Bangash, Jackie Wong
Iliacus compartment syndrome is a rare retroperitoneal compartment neuropathy caused by bleeding within the iliacus muscle leading to hematoma formation and compression upon the femoral nerve, causing both sensory and motor deficits. A 75-year-old Caucasian man presented with severe right hip pain associated with motor and sensory deficit in the right lower extremity, 2 weeks post elective balloon aortic valvuloplasty for critical aortic stenosis. A non-contrast computed tomography scan revealed low-attenuation areas in keeping with an iliacus hematoma...
2016: Journal of Surgical Case Reports
Kazuhiko Seya, Ken-Ichi Furukawa, Mari Chiyoya, Zaiqiang Yu, Haruhisa Kikuchi, Kazuyuki Daitoku, Shigeru Motomura, Manabu Murakami, Yoshiteru Oshima, Ikuo Fukuda
An abnormally high serum phosphate level induces calcific aortic stenosis (CAS), which is characterized by ectopic valve calcification and stenosis of the orifice area. Inhibition of ectopic calcification is a critical function of any internal medical therapy for CAS disease. The aim of the present study was to investigate the inhibitory effects of several derivatives of evocarpine, methanolic extracts from the fruits of Evodia rutaecarpa Bentham (Japanese name: Go-Shu-Yu) on the high phosphate-induced calcification of human aortic valve interstitial cells (HAVICs) obtained from patients with CAS...
May 2016: Journal of Pharmacological Sciences
Stefano Muzzarelli, Daniel Suerder, Romina Murzilli, Lucia Donato, Giovanni Pedrazzini, Elena Pasotti, Tiziano Moccetti, Catherine Klersy, Francesco Fulvio Faletra
AIMS: To identify causes of misinterpretation in second generation, dual-source coronary computed tomography angiography (CCTA). METHODS: A retrospective re-interpretation was performed on 100 consecutive CCTA studies, previously performed with a 2×128 slice dual-source CT. Results were compared with coronary angiography (CA). CCTA and CA images were interpreted by 2 independent readers. At CCTA vessel diameter, image quality, plaque characteristics and localization (bifurcation vs...
June 2016: European Journal of Radiology
Takeshi Uzuka, Masanori Nakamura, Tomohiro Nakajima, Shinichi Kusudoh, Hiroaki Usubuchi, Akihiko Tanaka, Noriyasu Watanabe
BACKGROUND: Hemoptysis is a common complication in all kinds of surgery. However, it is rarely critical because it resolves with or without intervention. CASE PRESENTATION: Here the authors present what is believed to be an unprecedented report of a case involving a fatal idiopathic bronchial hemorrhage complication during cardiac surgery. Eighty-five-year-old female with severe aorticvalve stenosis had elective aortic valve replacement. Subsequently, she developed diffuse bilateral severe idiopathic bronchial hemorrhage which required maximum intervention such as external bronchial ligation, V-A ECMO, coil embolization of bronchial artery and internal airway blockage by spigot...
2016: Journal of Cardiothoracic Surgery
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