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mechanical aortic valve

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https://www.readbyqxmd.com/read/29782425/increased-arterial-stiffness-in-a-cohort-of-pediatric-takayasu-arteritis-patients-in-toronto-adversely-affects-left-ventricular-mechanics
#1
Heynric B Grotenhuis, Florence A Aeschlimann, Wei Hui, Cameron Slorach, Rae S M Yeung, Susanne M Benseler, Timothy J Bradley, Lars Grosse-Wortmann
BACKGROUND/OBJECTIVE: Takayasu arteritis (TA) is characterized by extensive aortic, large and midsize arterial wall inflammation. The aim of this study was to assess the morphological and elastic properties of the aorta and large arteries and the impact on left ventricular (LV) mechanics in children with TA. METHODS: Seven pediatric TA patients (6 female patients, 13.8 ± 3.2 years) were assessed with magnetic resonance imaging, vascular ultrasound, applanation tonometry, and echocardiography from February 2015 until July 2017 and compared with 7 age- and sex-matched controls...
May 19, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29780728/intimal-re-layering-technique-for-type-a-acute-aortic-dissection-reconstructing-the-intimal-layer-continuity-to-induce-remodeling-of-the-false-channel
#2
Eugenio Neri, Enrico Tucci, Giulio Tommasino, Giulia Guaccio, Carmelo Ricci, Pierleone Lucatelli, Marco Cini, Roberto Ceresa, Antonio Benvenuti, Luigi Muzzi
Background: Residual false channel is common after repair of type A acute aortic dissection (TAAAD). Starting from our recent series of TAAAD patients we carried out a retrospective analysis, regarding the failure of primary exclusion at the time of the initial operation. We classified the location of the principal entry tears perfusing the residual false channel. The proposed technique represents our attempt to correct the mechanism of false channel perfusion during primary repair. We describe a new technique designed to address some limitations of standard hemiarch aortic replacement...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29779973/impact-of-device-host-interaction-on-paravalvular-aortic-regurgitation-with-different-transcatheter-heart-valves
#3
Ramón Rodríguez-Olivares, Nahid El Faquir, Zouhair Rahhab, Lennart van Gils, Ben Ren, Rafi Sakhi, Marcel L Geleijnse, Ron van Domburg, Peter P T de Jaegere, Jose L Zamorano Gómez, Nicolas M Van Mieghem
AIMS: We sought to evaluate the interaction of different aortic root phenotypes with self-expanding (SEV), balloon-expandable (BEV) and mechanically expanded (MEV) and the impact on significant aortic regurgitation. METHODS AND RESULTS: We included 392 patients with a SEV (N = 205), BEV (N = 107) or MEV (N = 80). Aortic annulus eccentricity index and calcification were measured by multi-slice CT scan. Paravalvular aortic regurgitation was assessed by contrast aortography (primary analysis) and transthoracic echocardiography (secondary analysis)...
May 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29778849/influence-of-aortic-dilation-on-the-regional-aortic-stiffness-of-bicuspid-aortic-valve-assessed-by-4-dimensional-flow-cardiac-magnetic-resonance-comparison-with-marfan-syndrome-and-degenerative-aortic-aneurysm
#4
Andrea Guala, Jose Rodriguez-Palomares, Lydia Dux-Santoy, Gisela Teixido-Tura, Giuliana Maldonado, Laura Galian, Marina Huguet, Filipa Valente, Laura Gutiérrez, Teresa González-Alujas, Kevin M Johnson, Oliver Wieben, Augusto Sao Avilés, David Garcia-Dorado, Arturo Evangelista
OBJECTIVES: This study sought to ascertain whether patients with a bicuspid aortic valve (BAV) have an intrinsic alteration in regional aortic stiffness compared with patients with tricuspid aortic valve (TAV) and Marfan syndrome (MFS) patients with similar aortic sizes, as well as to assess the influence of ascending aorta (AAo) dilation on regional stiffness parameters in BAV patients. BACKGROUND: Imaging biomarkers as predictors of BAV, MFS, and degenerative AAo aneurysms in TAV patients (DA-TAV) are lacking...
May 11, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29772592/-cardiac-anaesthesia-anaesthesiological-management
#5
Jochen Renner, Berthold Bein, Ole Broch
The anaesthesiological management of patients scheduled for cardiac surgery has been refined distinctively over the last decade due to different reasons. The continuing growth of the elderly patient population and the increasing number of combined cardiac surgery procedures in octogenarians on the one hand are one aspect. The rapid development of minimally invasive cardiac surgery and the enhancements in mechanical, artificial heart assist devices on the other hand can be seen as additional decisive factors...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29770299/regenerative-medicine-therapy-for-single-ventricle-congenital-heart-disease
#6
REVIEW
Chetan Ambastha, Gregory J Bittle, David Morales, Nathaniel Parchment, Progyaparamita Saha, Rachana Mishra, Sudhish Sharma, Alexander Vasilenko, Muthukumar Gunasekaran, Manal T Al-Suqi, Deqiang Li, Peixin Yang, Sunjay Kaushal
One of the most complex forms of congenital heart disease (CHD) involving single ventricle physiology is hypoplastic left heart syndrome (HLHS), characterized by underdevelopment of the left ventricle (LV), mitral and aortic valves, and narrowing of the ascending aorta. The underdeveloped LV is incapable of providing long-term systemic flow, and if left untreated, the condition is fatal. Current treatment for this condition consists of three consecutive staged palliative operations: the first is conducted within the first few weeks of birth, the second between 4 to 6 months, and the third and final surgery within the first 4 years...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29770290/current-surgical-strategies-and-techniques-of-aortic-valve-diseases-in-children
#7
REVIEW
Kun Wang, Huifeng Zhang, Bing Jia
While the long-term outcome of surgical aortic valvotomy (SAV) appears to be better than that of balloon aortic valvuloplasty (BAV) as the primary procedure of aortic valve stenosis, the surgical strategies and techniques of treating aortic valve disease in children in other situations remain controversial. Valve repair should be first considered while replacement is still unavoidable in some cases, and new repair techniques developed by innovative surgeons are gradually becoming adopted. Some complex repair procedures such as cusp extension, leaflet replacement/reconstruction have provided satisfactory outcomes...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29762936/bentall%C3%A2-s-procedure-in-pediatric-mixed-connective-tissue-disease-syndrome-management-of-pediatric-aortic-aneurysm-a-brief-review
#8
Krithika Ramaprabhu, Om Prakash, Noveen Davidson, Sanjay Bhalero, Satish Radhakrishnan, Robert Coelho
Mixed connective tissue disease (MCTD) syndrome in children may lead to large aortic aneurysms, which in turn pose a difficult surgical problem. Valve-sparing root replacement is not always a viable option as the disease process invariably affects the aortic valve leaflets. Among pediatric patients, the Ross procedure is contraindicated on account of weakness of the pulmonary root, while Bentall surgery is the 'gold standard' treatment of aortic aneurysm, with reproducible and excellent long-term results. The case is presented of a three-year-old girl with a large thoracic aortic aneurysm in whom Bentall's surgery was performed, with a good result...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762932/pulmonary-hypertension-as-a-possible-cause-of-paradoxical-low-flow-low-gradient-aortic-stenosis
#9
Yuta Watanabe, Haruhiko Higashi, Katsuji Inoue, Jun Aono, Takafumi Okura, Jitsuo Higaki, Shuntaro Ikeda
Paradoxical low-flow, low-gradient aortic stenosis (LFLG AS) is recognized as a subtype of aortic stenosis. A small left ventricular (LV) cavity with marked LV concentric remodeling leads to a reduced stroke volume in this condition. The case is reported of a paradoxical LFLG AS patient who was undergoing treatment for pulmonary hypertension (PH) and interstitial pneumonia associated with scleroderma. Echocardiography demonstrated enlargement of the right ventricle and a diminished LV cavity. Moreover, the aortic valve opening was restricted despite a preserved LV ejection fraction (61%)...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29762921/long-term-up-to-21-years-follow-up-after-biological-and-mechanical-aortic-valve-replacement-in-younger-patients
#10
Stanislav Tsvelodub, Barbara Pieper, Sina Stock, Hans-Hinrich Sievers, Doreen Richardt
BACKGROUND: Despite the limited durability of biological aortic valves, increasing numbers of younger patients are choosing to receive them, due mainly to the lack of a need for permanent anticoagulation. Few data exist, however, regarding the outcomes of valve replacement in patients aged <55 years, and additional data are required in this patient population. METHODS: Between 1993 and 2014, at the authors' institution, a total of 448 patients (237 males, 101 females; mean age 45...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29761409/the-roles-of-matrix-stiffness-and-%C3%A3-catenin-signaling-in-endothelial-to-mesenchymal-transition-of-aortic-valve-endothelial-cells
#11
Aileen Zhong, Zahra Mirzaei, Craig A Simmons
Valve stiffening is a hallmark of aortic valve stenosis caused by excess extracellular matrix accumulation by myofibroblasts. We aimed to elucidate whether matrix stiffness regulates endothelial-to-mesenchymal transition (EndMT) of adult valvular endothelial cells (VECs) to myofibroblasts as a mechanism to further promote valve fibrosis. In addition, we specifically examined the role of the Wnt/β-catenin signaling pathway in the development of myofibroblasts during EndMT, as Wnt/β-catenin signaling has been implicated in EndMT during heart development, is reactivated in valve disease, and is required for mechanically-regulated myofibrogenesis of valve interstitial cells...
May 14, 2018: Cardiovascular Engineering and Technology
https://www.readbyqxmd.com/read/29753455/effect-of-severe-bioprosthetic-valve-tissue-ingrowth-and-inflow-calcification-on-valve-in-valve-performance
#12
Hoda Hatoum, Jennifer Dollery, Scott M Lilly, Juan A Crestanello, Lakshmi Prasad Dasi
While in vivo studies clearly demonstrate that supra-annular Valve-in-Valve (ViV) implantation provides the highest probability for optimal post-ViV pressure gradients (PG), there is still no physical insight into explaining anomalies where some supra-annular ViV implantations yield high pressure gradients while some sub-annular implantations yield low pressure gradients. The aim of this study is to explain how severe tissue ingrowth and calcification (TIC) in a surgical aortic valve (SAV) can be one physical mechanism leading to anomalous ViV performance characteristic...
May 4, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29751516/engineering-a-3d-bioprinted-model-of-human-heart-valve-disease-using-nanoindentation-based-biomechanics
#13
Dewy C van der Valk, Casper F T van der Ven, Mark C Blaser, Joshua M Grolman, Pin-Jou Wu, Owen S Fenton, Lang H Lee, Mark W Tibbitt, Jason L Andresen, Jennifer R Wen, Anna H Ha, Fabrizio Buffolo, Alain van Mil, Carlijn V C Bouten, Simon C Body, David J Mooney, Joost P G Sluijter, Masanori Aikawa, Jesper Hjortnaes, Robert Langer, Elena Aikawa
In calcific aortic valve disease (CAVD), microcalcifications originating from nanoscale calcifying vesicles disrupt the aortic valve (AV) leaflets, which consist of three (biomechanically) distinct layers: the fibrosa, spongiosa, and ventricularis. CAVD has no pharmacotherapy and lacks in vitro models as a result of complex valvular biomechanical features surrounding resident mechanosensitive valvular interstitial cells (VICs). We measured layer-specific mechanical properties of the human AV and engineered a three-dimensional (3D)-bioprinted CAVD model that recapitulates leaflet layer biomechanics for the first time...
May 3, 2018: Nanomaterials
https://www.readbyqxmd.com/read/29743998/transcatheter-aortic-valve-in-valve-procedure-in-patients-with-bioprosthetic-structural-valve-deterioration
#14
REVIEW
Ross M Reul, Mahesh K Ramchandani, Michael J Reardon
Surgical aortic valve replacement is the gold standard procedure to treat patients with severe, symptomatic aortic valve stenosis or insufficiency. Bioprosthetic valves are used for surgical aortic valve replacement with a much greater prevalence than mechanical valves. However, bioprosthetic valves may fail over time because of structural valve deterioration; this often requires intervention due to severe bioprosthetic valve stenosis or regurgitation or a combination of both. In select patients, transcatheter aortic valve replacement is an alternative to surgical aortic valve replacement...
July 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29740591/postnatal-and-adult-aortic-heart-valves-have-distinctive-transcriptional-profiles-associated-with-valve-tissue-growth-and-maintenance-respectively
#15
Emily Nordquist, Stephanie LaHaye, Casey Nagel, Joy Lincoln
Heart valves are organized connective tissues of high mechanical demand. They open and close over 100,000 times a day to preserve unidirectional blood flow by maintaining structure-function relationships throughout life. In affected individuals, structural failure compromises function and often leads to regurgitant blood flow and progressive heart failure. This is most common in degenerative valve disease due to age-related wear and tear, or congenital malformations. At present, the only effective treatment of valve disease is surgical repair or replacement and this is often impermanent and requires anti-coagulation therapy throughout life...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29739637/adverse-effects-of-left-ventricular-electrical-dyssynchrony-on-cardiac-reverse-remodeling-and-prognosis-after-aortic-valve-surgery
#16
Soo Youn Lee, Chi Young Shim, Geu-Ru Hong, In Jeong Cho, Seng Chan You, Hyuk-Jae Chang, Jong-Won Ha, Namsik Chung
BACKGROUND: Electrical dyssynchrony (ED) is one of the important contributing mechanisms in the progression of heart failure. We hypothesized that ED would interfere with cardiac reverse remodeling and affect prognosis after aortic valve surgery. METHODS: A total of 411 consecutive patients (233 males, mean age 65±11 years) who underwent aortic valve surgery were retrospectively analyzed. The patients were divided into two groups according to the presence of ED [Group 1: no ED (n=382, 93%), Group 2: ED (n=29, 7%)]...
May 5, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29738368/anti-apoptotic-effect-of-%C3%AE-1-blockers-in-ascending-thoracic-aortic-smooth-muscle-cells-the-role-of-hsp70-expression
#17
Ioannis K Rizos, James N Tsoporis, Ioannis K Toumpoulis, Vasileios Salpeas, Shehla Izhar, Angelos G Rigopoulos, Eleftherios A Sakadakis, Thomas G Parker
Heat shock proteins (HSP) play an important role in the cellular adaptation to stress, a requisite for cell survival. The aortic wall appears to be a target for increased expression of HSP during surgical stress. We aimed to define the expression and function of aortic HSP70 in 31 patients with normal ascending thoracic aortic diameter who underwent aortic valve replacement due to aortic valve stenosis (AVS) and in 35 patients with dilated ascending thoracic aorta who underwent replacement of an ascending thoracic aortic aneurysm (ATAA)...
May 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29735584/bioprosthetic-aortic-valve-durability-in-the-era-of-transcatheter-aortic-valve-implantation
#18
REVIEW
Erwan Salaun, Marie-Annick Clavel, Josep Rodés-Cabau, Philippe Pibarot
The main limitation of bioprosthetic valves is their limited durability, which exposes the patient to the risk of aortic valve reintervention. Transcatheter aortic valve implantation (TAVI) is considered a reasonable alternative to surgical aortic valve replacement (SAVR) in patients with intermediate or high surgical risk. TAVI is now rapidly expanding towards the lower risk populations. Although the results of midterm durability of the transcatheter bioprostheses are encouraging, their long-term durability remains largely unknown...
May 7, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29734266/noncoding-rnas-in-calcific-aortic-valve-disease-a-review-of-recent-studies
#19
Wen-Juan Ni, Ying-Zhong Wu, Dong-Hong Ma, Xiao-Min Leng
Calcific aortic valve disease (CAVD) is the most common heart valve disorder in human populations. Nevertheless, there are presently no effective means for its prevention and treatment. It is therefore critical to comprehensively define key mechanisms of the disease. A major focus of cardiovascular research has been characterization of how regulation of gene expression maintains healthy physiologic status of the component tissues of the system and how derangements of gene regulation may become pathological...
May 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29726041/reoperation-for-composite-valve-graft-failure-operative-results-and-midterm-survival
#20
Luis C Maroto, Manuel Carnero, Javier Cobiella, Mónica García, Isidre Vilacosta, Fernando Reguillo, Enrique Villagrán, Carmen Olmos
BACKGROUND AND AIM OF THE STUDY: The replacement of a failed composite valve graft is technically more demanding and is associated with increased morbidity and mortality. We present our technique and outcomes for reoperations for composite graft failures. METHODS: Between September 2011 and June 2017, 14 patients underwent a redo composite graft replacement. Twelve patients (85.7%) were male, and mean age was 58.4 years ± 12 standard deviation (SD). One patient had two previous root replacements...
May 3, 2018: Journal of Cardiac Surgery
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