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mechanical aortic valve

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https://www.readbyqxmd.com/read/29351596/freedom-solo%C3%A2-versus-trifecta%C3%A2-bioprostheses-clinical-and-haemodynamic-evaluation-after-propensity-score-matching
#1
Rui J Cerqueira, Renata Raimundo, Soraia Moreira, Francisca A Saraiva, Marta Andrade, Elson Salgueiro, Jorge Almeida, Mário Jorge Amorim, Paulo Pinho, André P Lourenço, Adelino Leite-Moreira
OBJECTIVES: The goal of this study was to compare the stentless Freedom Solo® (FS) and the stented Trifecta® (TF) aortic bioprostheses with regard to haemodynamic profile, left ventricular mass regression and early and late postoperative outcomes and survival. METHODS: A longitudinal cohort study of consecutive patients undergoing aortic valve replacement (2009-16) with either the FS or TF at 1 centre was performed. Local databases and national records were queried...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29346531/doppler-assessment-of-aortic-stenosis-a-25-operator-study-demonstrating-why-reading-the-peak-velocity-is-superior-to-velocity-time-integral
#2
Stefania Sacchi, Niti M Dhutia, Matthew J Shun-Shin, Massoud Zolgharni, Nilesh Sutaria, Darrel P Francis, Graham D Cole
Aims: Measurements with superior reproducibility are useful clinically and research purposes. Previous reproducibility studies of Doppler assessment of aortic stenosis (AS) have compared only a pair of observers and have not explored the mechanism by which disagreement between operators occurs. Using custom-designed software which stored operators' traces, we investigated the reproducibility of peak and velocity time integral (VTI) measurements across a much larger group of operators and explored the mechanisms by which disagreement arose...
January 15, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29327563/hemodynamic-outcomes-of-the-ross-procedure-versus-other-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#3
Kevin J Um, Graham R McCLURE, Emilie P Belley-Cote, Saurabh Gupta, Ismail Bouhout, Hugo Lortie, Hatim Alraddadi, Ali Alsagheir, Matthias Bossard, William F McINTYRE, Alexandra Lengyel, John W Eikelboom, Maral Ouzounian, Michael W Chu, Dominic Parry, Ismail El-Hamamsy, Richard P Whitlock
INTRODUCTION: Life expectancy in young adults undergoing mechanical or bioprosthetic aortic valve replacement (AVR) may be reduced by up to 20 years compared to age matched controls. The Ross procedure is a durable, anticoagulation-sparing alternative. We performed a systematic review and meta-analysis to compare the valve hemodynamics of the Ross procedure versus other AVR. EVIDENCE ACQUISITION: We searched Cochrane CENTRAL, MEDLINE and EMBASE from inception to February 2017 for randomized controlled trials (RCTs) and observational studies (n≥10 Ross)...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29325903/gata4-loss-of-function-mutation-and-the-congenitally-bicuspid-aortic-valve
#4
Ruo-Gu Li, Ying-Jia Xu, Juan Wang, Xing-Yuan Liu, Fang Yuan, Ri-Tai Huang, Song Xue, Li Li, Hua Liu, Yan-Jie Li, Xin-Kai Qu, Hong-Yu Shi, Min Zhang, Xing-Biao Qiu, Yi-Qing Yang
Aggregating evidence suggests that genetic determinants play a pivotal role in the pathogenesis of the congenitally bicuspid aortic valve (BAV). BAV is of pronounced genetic heterogeneity, and the genetic components underlying BAV in an overwhelming majority of patients remain elusive. In the current study, the whole coding exons and adjacent introns, as well as 5' and 3' untranslated regions of the GATA4 gene, which codes for a zinc-finger transcription factor crucial for the normal development of the aortic valve, were screened by direct sequencing in 150 index patients with congenital BAV...
November 23, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29325642/nhlbi-working-group-recommendations-to-reduce-lipoprotein-a-mediated-risk%C3%A2-of%C3%A2-cardiovascular-disease-and-aortic%C3%A2-stenosis
#5
REVIEW
Sotirios Tsimikas, Sergio Fazio, Keith C Ferdinand, Henry N Ginsberg, Marlys L Koschinsky, Santica M Marcovina, Patrick M Moriarty, Daniel J Rader, Alan T Remaley, Gissette Reyes-Soffer, Raul D Santos, George Thanassoulis, Joseph L Witztum, Simhan Danthi, Michelle Olive, Lijuan Liu
Pathophysiological, epidemiological, and genetic studies provide strong evidence that lipoprotein(a) [Lp(a)] is a causal mediator of cardiovascular disease (CVD) and calcific aortic valve disease (CAVD). Specific therapies to address Lp(a)-mediated CVD and CAVD are in clinical development. Due to knowledge gaps, the National Heart, Lung, and Blood Institute organized a working group that identified challenges in fully understanding the role of Lp(a) in CVD/CAVD. These included the lack of research funding, inadequate experimental models, lack of globally standardized Lp(a) assays, and inadequate understanding of the mechanisms underlying current drug therapies on Lp(a) levels...
January 16, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29317805/compression-of-the-right-coronary-artery-by-an-aortic-pseudoaneurysm-after-infective-endocarditis-an-unusual-case-of-myocardial-ischemia
#6
Juan Lacalzada-Almeida, Alejandro De la Rosa-Hernández, María Manuela Izquierdo-Gómez, Javier García-Niebla, Iván Hernández-Betancor, Juan Alfonso Bonilla-Arjona, Antonio Barragán-Acea, Ignacio Laynez-Cerdeña
A 61-year-old male with a prosthetic St Jude aortic valve size 24 presented with heart failure symptoms and minimal-effort angina. Eleven months earlier, the patient had undergone cardiac surgery because of an aortic root dilatation and bicuspid aortic valve with severe regurgitation secondary to infectious endocarditis by Coxiela burnetii and coronary artery disease in the left circumflex coronary artery. Then, a prosthesis valve and a saphenous bypass graft to the left circumflex coronary artery were placed...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29316662/recurrent-hemorrhagic-conversion-of-ischemic-stroke-in-a-patient-with-mechanical-heart-valve-a-case-report-and-literature-review
#7
Micheal Jace Tarver, Tyler Schmidt, Michael T Koltz
The authors present a unique case of recurrent stroke, discovered to be secondary to hemorrhagic conversion of microemboli from a mechanical aortic valve despite anticoagulation with Coumadin. The complexity of this case was magnified by the patient's young age, a mechanical heart valve (MHV), and a need for anticoagulation to maintain MHV patency in a setting of potentially life-threatening intracranial hemorrhage. Anticoagulant and antiplatelet therapy are risk factors for hemorrhagic conversion post-cerebral ischemia; however, the pathophysiology underlying endothelial cell dysfunction causing red blood cell extravasation is an active area of basic and clinical research...
January 7, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29302950/use-of-impella-5-0-prior-to-transcatheter-aortic-valve-replacement-in-a-patient-with-severe-aortic-stenosis-and-cardiogenic-shock
#8
Dustin W Johnson, John P ErwinIII
The use of transcatheter aortic valve replacement (TAVR) has risen dramatically during the past decade. Notably, the procedure can reduce symptoms and improve prognosis in patients who would otherwise be excluded from intervention due to prohibitive surgical risk. During the same time period, the use of percutaneous mechanical circulatory support devices for patients with severe left ventricular dysfunction, including the Impella System (Abiomed, Inc., Danvers, MA, USA), has also increased. These devices provide superior hemodynamic effects compared to intra-aortic balloon pumping...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302937/stress-analysis-of-transcatheter-aortic-valve-leaflets-under-dynamic-loading-effect-of-reduced-tissue-thickness
#9
Mostafa Abbasi, Ali N Azadani
BACKGROUND: In order to accommodate transcatheter valves to miniaturized catheters, the leaflet thickness must be reduced to a value which is typically less than that of surgical bioprostheses. The study aim was to use finite-element simulations to determine the impact of the thickness reduction on stress and strain distribution. METHODS: A 23 mm transcatheter aortic valve (TAV) was modelled based on the Edwards SAPIEN XT (Edwards Lifesciences, Irvine, CA, USA)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29297708/determinants-of-elevated-carbohydrate-antigen-125-in-patients-with-severe-symptomatic-aortic-valve-stenosis-referred-for-transcatheter-aortic-valve-implantation
#10
Tobias Rheude, Costanza Pellegrini, Wibke Reinhard, Teresa Trenkwalder, Wolfgang Koenig, N Patrick Mayr, Michael Joner, Julio Núñez, Stefan Holdenrieder, Heribert Schunkert, Adnan Kastrati, Christian Hengstenberg, Oliver Husser
PURPOSE: Elevated carbohydrate antigen 125 (CA125) predicts adverse outcome after transcatheter aortic valve implantation (TAVI). While known underlying pathophysiological mechanisms of elevated CA125 include serosal effusions and inflammatory stimuli, clinical determinants associated with elevated CA125 in patients referred for TAVI remain unknown. Therefore, we investigated clinical, laboratory and echocardiographic determinants of elevated CA125 in patients with severe aortic valve stenosis referred for TAVI...
January 3, 2018: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#11
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29286439/isolation-and-characterization-of-primary-rat-valve-interstitial-cells-a-new-model-to-study-aortic-valve-calcification
#12
Cui Lin, Dongxing Zhu, Greg Markby, Brendan M Corcoran, Colin Farquharson, Vicky E Macrae
Calcific aortic valve disease (CAVD) is characterized by the progressive thickening of the aortic valve leaflets. It is a condition frequently found in the elderly and end-stage renal disease (ESRD) patients, who commonly suffer from hyperphosphatemia and hypercalcemia. At present, there are no medication therapies that can stop its progression. The mechanisms that underlie this pathological process remain unclear. The aortic valve leaflet is composed of a thin layer of valve endothelial cells (VECs) on the outer surfaces of the aortic cusps, with valve interstitial cells (VICs) sandwiched between the VECs...
November 20, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29285343/non-invasive-assessment-of-patient-specific-aortic-haemodynamics-from-four-dimensional-flow-mri-data
#13
Lucian Itu, Dominik Neumann, Viorel Mihalef, Felix Meister, Martin Kramer, Mehmet Gulsun, Marcus Kelm, Titus Kühne, Puneet Sharma
We introduce a parameter estimation framework for automatically and robustly personalizing aortic haemodynamic computations from four-dimensional magnetic resonance imaging data. The framework is based on a reduced-order multiscale fluid-structure interaction blood flow model, and on two calibration procedures. First, Windkessel parameters of the outlet boundary conditions are personalized by solving a system of nonlinear equations. Second, the regional mechanical wall properties of the aorta are personalized by employing a nonlinear least-squares minimization method...
February 6, 2018: Interface Focus
https://www.readbyqxmd.com/read/29277548/outcomes-of-video-assisted-minimally-invasive-cardiac-myxoma-resection
#14
Giacomo Bianchi, Rafik Margaryan, Enkel Kallushi, Alfredo Giuseppe Cerillo, Pier Andrea Farneti, Angela Pucci, Marco Solinas
BACKGROUND: Myxomas are the most frequent cardiac tumours. Their diagnosis requires prompt removal. In our centre, for valve surgery we use a minimally invasive approach. Here, we report our experience of cardiac myxoma removal through right lateral mini-thoracotomy (RLMT) with particular focus on its feasibility, efficacy and patient safety. METHODS: Between February 2006 and January 2017, 30 consecutive patients (aged 66±12.6years, range 35-83 years) underwent atrial myxoma resection through video-assisted RLMT...
December 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29273635/prevalence-characteristics-and-outcomes-of-valvular-heart-disease-in-patients-with-atrial-fibrillation-insights-from-the-orbit-af-outcomes-registry-for-better-informed-treatment-for-atrial-fibrillation
#15
Kevin L Thomas, Larry R Jackson, Peter Shrader, Jack Ansell, Gregg C Fonarow, Bernard Gersh, Peter R Kowey, Kenneth W Mahaffey, Daniel E Singer, Laine Thomas, Jonathan P Piccini, Eric D Peterson
BACKGROUND: The presence of valvular heart disease (VHD) may affect the risk of stroke and mortality in patients with atrial fibrillation (AF). Community-based estimates of prevalence and outcomes of specific forms of VHD in patients with AF are lacking. METHODS AND RESULTS: We examined the prevalence of VHD, anticoagulation use, mortality, stroke/transient ischemic attack, and bleeding among a community cohort of patients with AF. Significant VHD was defined as follows: (1) moderate/severe mitral stenosis or mechanical valve; (2) bioprosthetic valve, surgical repair, or balloon valvuloplasty; and (3) moderate/severe aortic regurgitation or stenosis, mitral regurgitation, or tricuspid regurgitation...
December 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29258732/using-a-regent-aortic-valve-in-a-small-annulus-mitral-position-is-a-viable-option
#16
Yaron D Barac, Brittany Zwischenberger, Jacob N Schroder, Mani A Daneshmand, Jack Haney, Jeff Gaca, Andrew Wang, Carmelo A Milano, Donald D Glower
BACKGROUND: Outcome of mitral valve replacement in extreme scenarios of small mitral annulus using the Regent mechanical aortic valve is not well documented. METHODS: Records were examined in 31 consecutive patients undergoing mitral valve replacement using the aortic Regent valve due to a small mitral annulus. RESULTS: Mean age was 60±14 years. Mitral stenosis or mitral annulus calcification was present in 30/31(97%) patients. Concurrent procedures were performed in 17/31(55%) patients...
December 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29258711/mechanisms-of-aortic-stenosis
#17
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/29249300/incidence-and-etiological-mechanism-of-stroke-in-cardiac-surgery
#18
J M Arribas, E Garcia, R Jara, F Gutierrez, L Albert, D Bixquert, J García-Puente, C Albacete, S Canovas, A Morales
OBJECTIVE: We studied patients who had experienced a stroke in the postoperative period of cardiac surgery, aiming to analyse their progression and determine the factors that may influence prognosis and treatment. METHODS: We established a protocol for early detection of stroke after cardiac surgery and collected data on stroke onset and a number of clinical, surgical, and prognostic variables in order to perform a descriptive analysis. RESULTS: Over the 15-month study period we recorded 16 strokes, which represent 2...
December 14, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29244962/expression-of-the-frizzled-receptors-and-their-co-receptors-in-calcified-human-aortic-valves
#19
Ateeque Siddique, Bin Yu, Kashif Khan, Ryan Buyting, Hamood Al-Kindi, Hossny Alaws, Eric Rhéaume, Jean-Claude Tardif, Renzo Cecere, Adel Schwertani
The cellular mechanisms that induce calcific aortic stenosis are yet to be unravelled. Wnt signaling is increasingly being considered as a major player in the disease process. However, the presence of Wnt Frizzled receptors (Fzd) and co-receptors LRP5 and 6 in normal and diseased human aortic valves remains to be elucidated. Immunohistochemistry and qPCR were used to determine Fzd receptor expression in normal and calcified human aortic valve tissue, as well as human aortic valve interstitial cells (HAVICs) isolated from calcified and normal human aortic valves...
December 15, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/29241492/mechanical-intervention-for-aortic-valve-stenosis%C3%A2-in-patients-with-heart-failure-and%C3%A2-reduced%C3%A2-ejection-fraction
#20
REVIEW
Johannes Steiner, Josep Rodés-Cabau, David R Holmes, Martin M LeWinter, Harold L Dauerman
The risk and benefit of mechanical interventions in valvular heart disease have been primarily described among patients with normal ejection fraction. The advent of nonsurgical mechanical interventions for aortic stenosis (transcatheter aortic valve replacement) may alter the risk-benefit ratio for patients who would otherwise be at increased risk for valve surgery. This review describes the epidemiology and pathophysiology of aortic stenosis with heart failure and reduced ejection fraction and summarizes the current registry and clinical trial data applicable to this frequently encountered high-risk group...
December 19, 2017: Journal of the American College of Cardiology
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