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https://www.readbyqxmd.com/read/28724752/the-fluid-mechanics-of-transcatheter-heart-valve-leaflet-thrombosis-in-the-neo-sinus
#1
Prem A Midha, Vrishank Raghav, Rahul Sharma, Jose F Condado, Ikechukwu U Okafor, Tanya Rami, Gautam Kumar, Vinod H Thourani, Hasan Jilaihawi, Vasilis Babaliaros, Raj R Makkar, Ajit P Yoganathan
Background -Transcatheter heart valve (THV) thrombosis has been increasingly reported. In these studies, thrombus quantification has been based on 2D assessment of a 3D phenomenon. Methods -Post-procedural four-dimensional, volume-rendered CT (4DCT) data of CoreValve, Evolut R, and SAPIEN 3 transcatheter aortic valve replacement (TAVR) patients enrolled in the RESOLVE trial were included in this analysis. Patients on anticoagulation were excluded. SAPIEN 3 and CoreValve/Evolut R patients with and without hypo-attenuated leaflet thickening (HALT) were included in order to study differences between groups...
July 19, 2017: Circulation
https://www.readbyqxmd.com/read/28722131/kept-in-the-loop-longitudinal-strain-volume-relationships-for-the-assessment-of-left-ventricular-mechanical-performance
#2
Stephen P Wright, Robert Lakin, Denise J Wooding, Leah Groves
In health, the aortic valve facilitates unidirectional forward flow from the left ventricle (LV) to the systemic circulation. This article is protected by copyright. All rights reserved.
July 19, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28712720/manual-aspiration-thrombectomy-in-patients-with-acute-stroke-related-calcified-cerebral-emboli
#3
Esther Koh, Hyo Sung Kwak, Gyung-Ho Chung
OBJECTIVE: The aim of this study was to evaluate the effectiveness of mechanical aspiration thrombectomy (MAT) in patients with acute ischemic stroke from calcified cerebral emboli. METHODS: Procedural results were reviewed for acute stroke patients with clinically neurological deficits who underwent recanalization from October 2012 through September 2015. Initial imaging studies and cerebral angiography were analyzed. RESULTS: Of the total number of patients with acute stroke, 5 patients were confirmed to have acute ischemic stroke by calcified cerebral emboli...
July 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28712585/conduction-disturbance-after-isolated-surgical-aortic-valve-replacement-in-degenerative-aortic-stenosis
#4
You Mi Hwang, Jun Kim, Ji Hyun Lee, Minsu Kim, Jongmin Hwang, Joon Bum Kim, Sung-Ho Jung, Suk Jung Choo, Gi Byoung Nam, Kee Joon Choi, Cheol Hyun Chung, Jae Won Lee, You Ho Kim
OBJECTIVE: Conduction disturbances are common in patients with aortic stenosis. We investigated the incidence, reversibility, and prognosis of conduction disorders requiring permanent pacemaker implantation in patients with degenerative aortic stenosis after isolated aortic valve replacement. METHODS: This was a retrospective study conducted at a tertiary care center. We evaluated the incidence of conduction disturbances in patients who underwent isolated surgical aortic valve replacement for aortic stenosis between January 2005 and May 2015...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28704282/excessive-surgical-adhesive-mimicking-aortic-root-abscess-a-case-report
#5
Natalie A Silverton, David A Bull, Candice K Morrissey
Aortic root abscess is a complication of aortic valve endocarditis that is associated with a high morbidity and mortality. The diagnosis usually is made with transesophageal echocardiography, which is highly sensitive and specific for the disease. We present a case of suspected aortic root abscess 1 week after mechanical aortic valve replacement for native valve endocarditis. The diagnosis was made by the use of transesophageal echocardiography but surgical inspection revealed that the paravalvular fluid collection was excessive surgical adhesive...
July 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28695557/impact-of-new-technologies-and-experience-on-procedural-aspects-of-surgical-aortic-valve-replacement-a-process-analysis
#6
Bettina Langhammer, Maria Nucera, Lars Englberger, Eva Roost, David Reineke, Florian Schönhoff, Henriette Most, Bernhard Winkler, Fabian Gisler, Thierry Carrel, Christoph Huber
BACKGROUND: Surgical aortic valve replacement (SAVR) is the treatment of choice in severe symptomatic aortic valve disease. New techniques and prostheses have been recently developed to facilitate the procedure and reduce aortic cross-clamp time (AOx). The aim of this study was to analyse the different procedural steps in order to identify the most time-consuming part during aortic clamping time and to compare impact of experience on procedural aspects. METHODS: AOx during SAVR was divided into five consecutive steps...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28691909/fracturing-mechanics-before-valve-in-valve-therapy-of-small-aortic-bioprosthetic-heart-valves
#7
Peter Johansen, Henrik Engholt, Mariann Tang, Rasmus F Nybo, Per D Rasmussen, Jens Erik Nielsen-Kudsk
AIMS: Patients with degraded bioprosthetic heart valves (BHV) who are not candidates for valve replacement may benefit from transcatheter valve-in-valve (VIV) therapy. However, at smaller sized surgical BHV the resultant orifice may become too narrow. To overcome this, the valve frame can be fractured by a high-pressure balloon prior to VIV. However, knowledge on fracture pressures and mechanics are prerequisites. The aim of this study is to identify the fracture pressures needed in BHV, and to describe the fracture mechanics...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28683947/quantitative-prediction-of-paravalvular%C3%A2-leak-in-transcatheter-aortic%C3%A2-valve-replacement-based-on%C3%A2-tissue-mimicking-3d-printing
#8
Zhen Qian, Kan Wang, Shizhen Liu, Xiao Zhou, Vivek Rajagopal, Christopher Meduri, James R Kauten, Yung-Hang Chang, Changsheng Wu, Chuck Zhang, Ben Wang, Mani A Vannan
OBJECTIVES: This study aimed to develop a procedure simulation platform for in vitro transcatheter aortic valve replacement (TAVR) using patient-specific 3-dimensional (3D) printed tissue-mimicking phantoms. We investigated the feasibility of using these 3D printed phantoms to quantitatively predict the occurrence, severity, and location of any degree of post-TAVR paravalvular leaks (PVL). BACKGROUND: We have previously shown that metamaterial 3D printing technique can be used to create patient-specific phantoms that mimic the mechanical properties of biological tissue...
July 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28674619/on-x-versus-st-jude-medical-regent-mechanical-aortic-valve-prostheses-early-haemodynamics
#9
Robert Xu, Mohammad Rahnavardi, Bradley Pitman, Masoumeh Shirazi, Robert Stuklis, James Edwards, Michael Worthington
OBJECTIVE: We aimed to compare the early haemodynamic data of the On-X and St Jude Medical (SJM) Regent bileaflet mechanical prostheses in the aortic position. METHODS: A retrospective study was performed using data collected prospectively for a national database. Thirty-three patients who had aortic On-X valve (On-X group) and 33 matched patients who had aortic SJM Regent valve (SJM group) were included. The intraoperative and early postoperative data were collected...
2017: Open Heart
https://www.readbyqxmd.com/read/28671806/valvular-heart-disease-in-adults-management-of-prosthetic-heart-valves
#10
John F Trujillo, Steven M Hollenberg
Patients undergoing cardiac valve replacement may receive mechanical or bioprosthetic valves. Mechanical valves require lifelong anticoagulation but are durable and the need for a second surgery is up to eightfold times less than with bioprosthetic valves. Bioprosthetic valves do not require lifelong anticoagulation and thus are associated with fewer bleeding complications but they are less durable and associated with higher morbidity and mortality rates, particularly in younger patients. Anticoagulation with mechanical valves is achieved using warfarin; use of direct-acting oral anticoagulants is not indicated...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28668149/a-novel-technique-for-prosthetic-valve-retrieval-after-transcatheter-aortic-valve-embolization
#11
Francesco Giannini, Neil Ruparelia, Francesca Del Furia, Vittorio Romano, Marco Ancona, Antonio Mangieri, Damiano Regazzoli, Azeem Latib, Cosmo Godino, Francesco Ancona, Luciano Candilio, Richard Jabbour, Antonio Colombo, Matteo Montorfano
Although the rate of procedural complications during transcatheter aortic valve implantation has decreased because of technological advancement and increased operator experience, device embolization remains a rare but potentially fatal complication, even with new generation devices. We report, to our knowledge, the first case of Portico valve (St Jude Medical, Minneapolis, MN) migration despite apparent optimal initial implantation depth, which was retrieved using a novel strategy after failure of a traditional retrieval technique...
July 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28667440/-surgical-treatment-of-aortic-valve-stenosis
#12
O J Liakopoulos, J Merkle, T Wahlers, Y-H Choi
Surgical aortic valve replacement still represents the gold standard in patients with severe symptomatic aortic valve stenosis. In addition to conventional aortic valve replacement by mechanical or biological prostheses via a median sternotomy, novel approaches including minimally invasive strategies and new devices, such as so-called rapid deployment prostheses, are becoming increasingly more established. Autologous replacement strategies including the Ross and the Ozaki procedures have evolved into reliable options at selected centers of excellence...
June 30, 2017: Herz
https://www.readbyqxmd.com/read/28662835/ct-angiography-to-evaluate-coronary-artery-disease-and-revascularization-requirement-before-trans-catheter-aortic-valve-replacement
#13
Alexia Rossi, Carlo N De Cecco, Simon R O Kennon, Lu Zou, Felix G Meinel, William Toscano, Sabrina Segreto, Stephan Achenbach, Jörg Hausleiter, U Joseph Schoepf, Francesca Pugliese
BACKGROUND: Coronary artery disease (CAD) and aortic stenosis share pathophysiological mechanisms and risk factors. We evaluated the clinical utility of coronary computed tomography angiography (CTA) to identify CAD and revascularization requirement in patients with severe aortic stenosis considered for transcatheter aortic valve replacement (TAVR). METHODS: Consecutive patients without known CAD underwent calcium scoring, CTA and invasive coronary angiography (ICA)...
June 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28659818/managing-thoracic-aortic-aneurysm-in-patients-with-bicuspid-aortic-valve-based-on-aortic-root-involvement
#14
REVIEW
Elizabeth Norton, Bo Yang
Bicuspid aortic valve (BAV) can be both sporadic and hereditary, is phenotypically variable, and genetically heterogeneous. The clinical presentation of BAV is diverse and commonly associated with a high prevalence of valvular dysfunction producing altered hemodynamics and aortic abnormalities (e.g., aneurysm and dissection). The thoracic aortic aneurysm (TAA) in BAV frequently involves the proximal aorta, including the aortic root, ascending aorta, and aortic arch, but spares the aorta distal to the aortic arch...
2017: Frontiers in Physiology
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
#15
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/28658982/cerebral-protection-devices-for-transcatheter-aortic-valve-replacement
#16
Yash Jobanputra, Brandon M Jones, Divyanshu Mohananey, Benish Fatima, Krishna Kandregula, Samir R Kapadia
Stroke is a devastating, potential complication of any cardiovascular procedure including transcatheter aortic valve implantation (TAVI). Even clinically silent lesions as detected by magnetic resonance imaging have been associated with poor long-term cognitive outcomes. As a result, extensive efforts have been focused on developing stroke preventative strategies including the development of novel embolic protection devices. These devices aim to reduce this risk by capturing or deflecting emboli away from the cerebral circulation...
July 13, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#17
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28643214/new-generation-devices-for-transfemoral-transcatheter-aortic-valve-replacement-are-superior-compared-with-last-generation-devices-with-respect-to-varc-2-outcome
#18
Julia Seeger, Birgid Gonska, Wolfgang Rottbauer, Jochen Wöhrle
New generation devices for transcatheter aortic valve replacement have been optimized to improve clinical outcome. We compared procedural, in-hospital, 30 days and 12 months outcome of the new generation repositionable Boston Lotus Valve and the balloon-expandable Edwards Sapien 3 valve with the last generation self-expandable Medtronic CoreValve and the balloon-expandable Edwards Sapien XT. Between 2010 and 2015 consecutive patients treated with the Medtronic CoreValve (N = 100), Edwards Sapien XT (N = 100), Edwards Sapien S3 (N = 100) and Boston Lotus device (N = 100) were enrolled...
June 22, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28636475/surgical-aortic-valve-replacement-for-stenosis-of-tavi-device
#19
M Sooknunden, M A Radermecker, J O Defraigne, Vincent Tchana-Sato
We here report the case of a stenosis of the CoreValve(®) system due to reduced mobility of prosthesis cusps for which a surgical replacement of the aortic valve was proposed. The exact mechanism leading to this impaired mobility of the leaflets is yet to be determined. We also underline the fact a transcatheter aortic valve implantation (TAVI) device can be replaced by a surgical replacement without excessive operative risks despite the patient being initially considered as high-risk.
March 1, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28630170/characterization-of-aortic-valve-closure-artifact-during-outflow-tract-mapping-correlation-with-hemodynamics-and-mechanical-valves
#20
Jorge Romero, Olujimi Ajijola, Kalyanam Shivkumar, Roderick Tung
BACKGROUND: Premature ventricular contractions originating in the left ventricle outflow tract represent a significant subgroup of patients referred for catheter ablation. Mechanical artifacts from aortic valve leaflet motion may be observed during mapping, although the incidence and characteristics have not been reported. METHODS AND RESULTS: Twenty-eight consecutive patients with left ventricle outflow tract premature ventricular contraction were included. Electric signals recorded on the ablation catheter not coincident with atrial or ventricular depolarization were analyzed on the recording system...
June 2017: Circulation. Arrhythmia and Electrophysiology
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