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Critical aortic stenosis

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https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#1
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28684393/critical-aortic-stenosis-presenting-as-stemi
#2
Ying X Gue, Sanjay S Bhandari, Damian J Kelly
A 73-year-old male was brought into hospital with chest pain and inferior ST elevation on ECG. He immediately proceeded to the catheter lab for primary percutaneous coronary intervention. Angiography did not identify any culprit lesions to account for the patient's electrocardiographic changes and ongoing symptoms of chest pain. Bedside echocardiography revealed critical aortic stenosis. Intra-aortic balloon pump was inserted resulting in resolution of chest pain and ST-segment changes. The patient underwent successful aortic valve replacement without the need for coronary intervention...
July 6, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28683542/feasibility-and-applicability-of-static-vascular-outline-roadmapping-during-tavi
#3
Navid Madershahian, Carolyn Weber, Payman Majd, Tanja Rudolph, Elmar Kuhn, Maximilian Scherner, Yeong-Hoon Choi, Kaveh Eghbalzadeh, Volker Rudolph, Cherif Sahyoun, Thorsten Wahlers
BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips "Vascular Outlining" prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two- dimensional vessel margins as a roadmap on live fluoroscopy...
July 5, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28659550/significant-prognostic-value-of-acute-preload-stress-echocardiography-using-leg-positive-pressure-maneuver-for-patients-with-symptomatic-severe-aortic-stenosis-awaiting-aortic-valve-intervention
#4
Hiroki Matsuzoe, Kensuke Matsumoto, Hidekazu Tanaka, Yutaka Hatani, Keiko Hatazawa, Hiroyuki Shimoura, Junichi Ooka, Hiroyuki Sano, Keiko Ryo-Koriyama, Toshiro Shinke, Hirotsugu Yamada, Yutaka Okita, Ken-Ichi Hirata
BACKGROUND: Although aortic valve intervention is recommended for virtually all symptomatic patients with aortic stenosis (AS), how urgently the intervention should be performed remains controversial. The aim of this study was thus to determine whether the preload reserve in response to leg-positive pressure (LPP) maneuver could serve for decision-making for AS patients awaiting aortic valve intervention.Methods and Results:Sixty-eight patients with symptomatic AS, who were referred for aortic valve intervention, were recruited...
June 28, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28651163/ex-vivo-assessment-of-valve-thickness-calcification-of-patients-with-calcific-aortic-stenosis-in-relation-to-in-vivo-clinical-outcomes
#5
Ching-Li Cheng, Hsiao-Huang Chang, Pei-Jung Huang, Wei-Chen Wang, Shan-Yang Lin
Calcific aortic stenosis (AS) plays a critical role in the risk of cardiovascular disease. This preliminary study examined the relationship between the ex vivo valve thickness/calcification and in vivo clinical outcomes of Chinese patients with calcific AS. Six Chinese patients (3 patients with tricuspid aortic valves (TAV)) and 3 patients with. bicuspid aortic valves (BAV) with calcific AS undergoing heart valve replacement were initially chosen for this study. In vivo medical imaging of these calcific AS patients was evaluated using computed tomography and echocardiography...
June 22, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28637928/the-long-noncoding-rna-wisper-controls-cardiac-fibrosis-and-remodeling
#6
Rudi Micheletti, Isabelle Plaisance, Brian J Abraham, Alexandre Sarre, Ching-Chia Ting, Michael Alexanian, Daniel Maric, Damien Maison, Mohamed Nemir, Richard A Young, Blanche Schroen, Arantxa González, Samir Ounzain, Thierry Pedrazzini
Long noncoding RNAs (lncRNAs) are emerging as powerful regulators of cardiac development and disease. However, our understanding of the importance of these molecules in cardiac fibrosis is limited. Using an integrated genomic screen, we identified Wisper (Wisp2 super-enhancer-associated RNA) as a cardiac fibroblast-enriched lncRNA that regulates cardiac fibrosis after injury. Wisper expression was correlated with cardiac fibrosis both in a murine model of myocardial infarction (MI) and in heart tissue from human patients suffering from aortic stenosis...
June 21, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28601321/lysophosphatidylcholine-activates-the-akt-pathway-to-upregulate-extracellular-matrix-protein-production-in-human-aortic-valve-cells
#7
Hui Cheng, Qingzhou Yao, Rui Song, Yufeng Zhai, Wei Wang, David A Fullerton, Xianzhong Meng
BACKGROUND: Overproduction of extracellular matrix (ECM) protein by aortic valve interstitial cells (AVICs) plays an important role in valvular sclerosis (thickening) associated with the early pathobiology of aortic stenosis. Accumulation of oxidized low-density lipoprotein (oxLDL) is observed in sclerotic aortic valve and may have a mechanistic role in valvular disease progression. Lysophosphatidylcholine (LysoPC) is a component of oxLDL and has multiple biological activities. This study was to test the hypothesis that oxLDL and LysoPC upregulate ECM protein production in human AVICs...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28516094/combined-transapical-transcatheter-aortic-valve-replacement-and-thoracic-endovascular-aortic-repair-for-severe-aortic-stenosis-and-arch-aneurysm
#8
Yuanjia Zhu, Eric E Roselli, Jay J Idrees, Samir Kapadia, Lars G Svensson
An 83-year-old male with multiple comorbidities presented with critical aortic stenosis and a saccular aortic arch aneurysm. Through a mini thoracotomy, a balloon expandable transcatheter aortic valve was delivered transapically. A thoracic stent graft was then delivered through the prosthetic valve and deployed in the arch, while a covered stent was deployed in the left common carotid artery. Three-year postoperative computed tomography showed a thrombosed arch aneurysm with decreased size. This case demonstrates the feasibility of using combined transapical transcatheter technologies to treat multicomponent disease in a high-risk patient during a single operation...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28487806/synchronous-carotid-bifurcation-endarterectomy-and-retrograde-kissing-stenting-of-the-innominate-and-left-common-carotid-artery-in-a-patient-with-a-bovine-aortic-arch
#9
Alessandro Robaldo, Guido Carignano, Alberto Balderi, Claudio Novali
Management of the symptomatic multiple stenosis of supra-aortic vessels (MSSVs) in a "bovine" aortic arch (BAA) configuration is infrequently reported. The optimal treatment choice remains debatable. A successful hybrid treatment for a proximal critical stenosis of the innominate and left common carotid artery was performed in a high-risk patient with a tandem symptomatic lesion in the right carotid bifurcation and a concentric vulnerable plaque in the bovine trunk. This case supports the feasibility, safety, and efficacy of a combined carotid bifurcation endarterectomy and retrograde kissing stenting of common carotid arteries with cerebral protection after evaluation of radiological, anatomical, and clinical parameters...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28487320/aortic-valve-annular-sizing-intraoperative-assessment-versus-preoperative-multidetector-computed-tomography
#10
COMPARATIVE STUDY
Isaac George, Laura C Guglielmetti, Nicolas Bettinger, Andrew Moss, Catherine Wang, Nathan Kheysin, Rebecca Hahn, Susheel Kodali, Martin Leon, Vinayak Bapat, Michael A Borger, Mathew Williams, Craig Smith, Omar K Khalique
BACKGROUND: Appropriate valve sizing is critical in aortic valve replacement. We hypothesized that direct intraoperative valve sizing results in smaller aortic annular diameters compared with sizing based on systolic-phase multidetector computerized tomographic (MDCT) imaging. METHODS AND RESULTS: We retrospectively analyzed 78 patients undergoing surgical aortic valve replacement for severe aortic stenosis between 2012 and 2014 at our institution. Preoperative MDCT measurements of the aortic annulus served as basis for assignment to a theoretical surgical valve size, which was then (1) compared to the implanted valve size and (2) to a theoretical transcatheter aortic valve replacement valve size...
May 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28478711/ct-angiography-of-peripheral-arterial-disease-by-256-slice-scanner-accuracy-advantages-and-disadvantages-compared-to-digital-subtraction-angiography
#11
Atul Mishra, Narendra Jain, Anand Bhagwat
BACKGROUND: Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision...
July 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28462224/the-impact-of-frailty-on-mortality-after-transcatheter-aortic-valve-replacement
#12
EDITORIAL
Charat Thongprayoon, Wisit Cheungpasitporn, Kianoush Kashani
Frailty is a notably common problem in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) evaluation. Studies have demonstrated significant associations between frailty and worse outcomes in patients undergoing TAVR including higher risks of disability and mortality and admissions to long-term care facility. While there are multiple methods to identify and measure frailty, there is a critical need for a precise definition of frailty and its standardized assessment protocol based on well-established tests covering all aspects of the frailty, as a syndrome...
March 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28453794/blood-flow-competition-after-aortic-valve-bypass-an-evaluation-using-computational-fluid-dynamics
#13
Koji Kawahito, Naoyuki Kimura, Kenji Komiya, Masanori Nakamura, Yoshio Misawa
OBJECTIVES: Aortic valve bypass (AVB) (apico-aortic conduit) remains an effective surgical alternative for patients in whom surgical aortic valve replacement or transcatheter aortic valve implantation is not feasible. However, specific complications include thrombus formation, possibly caused by stagnation arising from flow competition between the antegrade and retrograde flow, but this has not been fully investigated. The aim of this study was to analyse flow characteristics after AVB and to elucidate mechanisms of intra-aortic thrombus using computational fluid dynamics (CFD)...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28441821/-assessment-of-undiagnosed-critical-congenital-heart-disease-before-discharge-from-the-maternity-hospital
#14
Q M Zhao, F Liu, L Wu, M Ye, B Jia, X J Ma, G Y Huang
Objective: Undiagnosed critical congenital heart disease (CCHD) was assessed before discharge from maternity hospital.Basic information was provided for screening CCHD in the early neonatal stage.Chi-squared test was used for comparison of categorical variables(detection rate of different types of CCHD). Method: A retrospective cohort study was conducted in neonates with CCHD who were admitted to Children's Hospital of Fudan University between 1 January 2012 and 31 December 2015. For comparing with the previously reported undiagnosed rate of CCHD at discharge, CCHD was defined as all duct dependent congenital heart disease (DDCHD) and any cyanotic CHD that required early surgery...
April 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28433492/is-tavr-ready-for-the-global-aging-population
#15
REVIEW
Travis Bergmann, Partho P Sengupta, Jagat Narula
The emergence of the global pandemic of chronic diseases necessitates critical assessment of interventions that can be targeted at both the individual and population levels. Among cardiovascular diseases, the increasing prevalence of valvular heart diseases such as aortic stenosis parallels the rising burden of atherosclerotic cardiovascular diseases. As an alternative to surgical aortic valve replacement, technological innovation has allowed development of minimally invasive transcatheter aortic valve replacement (TAVR)...
April 19, 2017: Global Heart
https://www.readbyqxmd.com/read/28429500/electrocardiographic-appearance-of-aortic-stenosis-before-and-after-aortic-valve-replacement
#16
Ivana I Vranic
BACKGROUND: So far, the specific appearance of QRS complex, ST-segment, and T wave was observed in aortic stenosis (AS). S-wave dynamic change in leads V1 -V3 was not reported in AS. METHODS: In a single-center, prospective study, we included a total number of 1.175 patients who underwent surgical aortic valve replacement (AVR). We conducted 3-year gathering of patients with symptomatic and asymptomatic severe AS, and separated them by hemodynamic stability into groups A and B, through EFLV (of more or less than 50%), AVA (of more or less than 0...
April 21, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28384638/fetal-aortic-valvuloplasty-experience-and-results-of-two-tertiary-centers-in-spain
#17
Alberto Galindo, Enery Gómez-Montes, Olga Gómez, Mar Bennasar, Fàtima Crispi, Ignacio Herraiz, Alberto Mendoza, David Escribano, Enrique García-Torres, Juan Manuel Carretero, Eduard Gratacós, Josep María Martínez
OBJECTIVE: Fetal aortic valvuloplasty (FAV) may avoid progression of critical aortic stenosis (CAS) to hypoplastic left ventricle, improving the options for biventricular circulation (BVC). We describe the results of FAV in 2 referral centers in Spain. METHODS: We analyzed all FAVs performed in the period 2007-2015. The selection of candidates, the technique, and postnatal management were made following an agreed protocol. A descriptive analysis of survival, type of circulation after birth, and complications was made, considering all deaths in the first 48 h after FAV as FAV-related...
April 7, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28377475/diagnosis-imaging-and-clinical-management-of-aortic-coarctation
#18
REVIEW
Elles J Dijkema, Tim Leiner, Heynric B Grotenhuis
Coarctation of the aorta (CoA) is a well-known congenital heart disease (CHD), which is often associated with several other cardiac and vascular anomalies, such as bicuspid aortic valve (BAV), ventricular septal defect, patent ductus arteriosus and aortic arch hypoplasia. Despite echocardiographic screening, prenatal diagnosis of CoA remains difficult. Most patients with CoA present in infancy with absent, delayed or reduced femoral pulses, a supine arm-leg blood pressure gradient (>20 mm Hg), or a murmur due to rapid blood flow across the CoA or associated lesions (BAV)...
April 4, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#19
EDITORIAL
Jonathan Afilalo
No abstract text is available yet for this article.
May 23, 2017: Circulation
https://www.readbyqxmd.com/read/28290812/-transaortic-implantation-of-aortic-valve-bioprosthesis-in-high-risk-patient-with-simultaneous-off-pump-coronary-artery-bypass-grafting
#20
R S Akchurin, T J Imaev, A E Komlev, P M Lepilin, A S Kolegaev, M E Nikonova
Transaortic approach represents an alternative variant of transcatheter aortic valve implantation (TAVI) which combines benefits of antegrade transapical approach and high safety profile characteristic of transfemoral approach. This method has substantial advantages over subclavian and transapical approaches in cases of pronounced myocardial hypertrophy, left ventricular dysfunction, thinning of left ventricular wall. We describe here a hybrid intervention with simultaneous coronary artery bypass grafting and TAVI in a patient from high surgical risk group with multivessel coronary artery involvement and critical aortic stenosis...
December 2016: Kardiologiia
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