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aortic stenosis

Kerstin Piayda, Katharina Hellhammer, Verena Veulemans, Tobias Zeus
Transcatheter aortic valve replacement (TAVR) is a leading-edge therapy option for patients with severe aortic stenosis (AS) and high surgical risk. However, this minimally invasive procedure is associated with specific complications that may be life-threatening. Valvuloplasty balloon entrapment during postdilatation in transcatheter self-expanding aortic valve stent frames has not yet been a focus of interest in this context. Although it is a rare event, it may critically influence outcome, and different management strategies can be considered...
September 23, 2018: Catheterization and Cardiovascular Interventions
Yukiko Hata, Shin Ishizawa, Naoki Nishida
An 82-year-old man was found dead on the road near his home with unwitnessed interval of 3 h from final witness. He had been diagnosed with hypertension and mild aortic stenosis (AS) 13 years before death, and was continuously followed up with medication. Although a recent medical check-up related to cardiac function was stable and consistent with moderate AS, he sometimes complained of general fatigue, anorexia associated with intermittent mild fever and rare vomiting in the weeks before death. At autopsy, no lethal injury or drug intoxication was found, but congenital bicuspid aortic valve (BAV) with central rache was found...
September 12, 2018: Legal Medicine
Shuping Sun, Haibin Wang
In this study, a simple and efficient diagnostic system, which adopts a novel methodology consisting of principal component analysis (PCA)-based feature generation and ellipse models-based classification criterion, is proposed for the diagnosis of a ventricular septal defect (VSD). The three stages corresponding to the diagnostic system implementation are summarized as follows. In stage 1, the heart sound is collected by 3M-3200 electronic stethoscope and is preprocessed using the wavelet decomposition. In stage 2, the PCA-based diagnostic features, [[Formula: see text]], are generated from time-frequency feature matrix ([Formula: see text])...
September 20, 2018: Australasian Physical & Engineering Sciences in Medicine
Rosa Autorino, Luca Tagliaferri, Maura Campitelli, Daniela Smaniotto, Alessia Nardangeli, Gian Carlo Mattiucci, Gabriella Macchia, Benedetta Gui, Maura Miccò, Floriana Mascilini, Gabriella Ferrandina, Gyorgy Kovacs, Vincenzo Valentini, Maria Antonietta Gambacorta
Purpose: To compare the survival and toxicity outcomes in patients with endometrial cancer treated with either high-dose-rate (HDR) or low-dose-rate (LDR) vaginal brachytherapy (VBT) following external beam radiotherapy (EBRT). Material and methods: From January 2000 to December 2014, patients with endometrial cancer after radical hysterectomy with/without pelvic and/or para-aortic lymphadenectomy were treated with adjuvant EBRT (45 Gy, 1.8 Gy/day to the whole pelvis) and subsequent VBT boost (HDR dose of 7 Gy in one fraction or LDR VBT dose of 25 Gy)...
August 2018: Journal of Contemporary Brachytherapy
Matle J Fung, Liza Thomas, Dominic Y Leung
BACKGROUND: Impairment in left ventricular (LV) systolic strain in aortic stenosis (AS) is well documented. However, alterations in layer-specific LV global longitudinal strain (GLS) and global circumferential strain (GCS) and their recovery following surgical aortic valve replacement (AVR) have not been established. The aim of this study was to examine layer-specific changes in GLS and GCS in patients with AS undergoing AVR and compare these patients with those managed conservatively over 12 months...
September 17, 2018: Journal of the American Society of Echocardiography
A Claire Watkins, Nathan L Maassel, Mehrdad Ghoreishi, Murtaza Y Dawood, Si M Pham, Zachary N Kon, Bradley S Taylor, Bartley P Griffith, James S Gammie
BACKGROUND: Cardiac surgery for structural heart disease has poor outcomes in the presence of cardiogenic shock or advanced heart failure. We applied venoarterial extracorporeal membrane oxygenation (ECMO) to restore end-organ function and resuscitate patients before high-risk cardiac operation. METHODS: Twelve patients with cardiogenic shock and end-organ failure were evaluated for cardiac surgery. The average Society of Thoracic Surgeons (STS) mortality risk was 24% (±13)...
September 17, 2018: Annals of Thoracic Surgery
Dorota Długosz, Klaudiusz Bolt, Wai S Sam, Tomasz Nawara, Olga Kruszelnicka, Bernadeta Chyrchel, Andrzej Surdacki
No abstract text is available yet for this article.
September 20, 2018: Kardiologia Polska
Mateusz K Hołda, Paweł Iwaszczuk, Karolina Wszołek, Jakub Chmiel, Andrzej Brzychczy, Mariusz Trystuła, Marcin Misztal
BACKGROUND: Abdominal aortic aneurysm (AAA) and coronary atherosclerosis share common risk factors. In this study, a single-center management experience of patients with a coexistence of AAA and coronary artery disease (CAD) is presented. METHODS: 271 consecutive patients who underwent elective AAA repair were reviewed. Coronary imaging in 118 patients was considered suitable for exploration of AAA coexistence with CAD. RESULTS: Significant coronary stenosis (> 70%) were found in 65...
September 20, 2018: Cardiology Journal
Paweł Kleczyński, Paweł Petkow Dimitrow, Artur Dziewierz, Agata Wiktorowicz, Tomasz Rakowski, Andrzej Surdacki, Dariusz Dudek
BACKGROUND: There is a paucity of data regarding response of cerebral blood flow to the postural unloading maneuver and its impact on the risk of syncope in patients with aortic stenosis (AS). The aim of the present study was to assess effects of orthostatic stress test on changes in carotid and vertebral artery blood flow and its association with syncope in patients with severe AS. METHODS: 108 patients were enrolled (72 with and 36 patients without syncope) with severe isolated severe AS...
September 20, 2018: Cardiology Journal
Daisuke Ueshima, Luca Nai Fovino, Gianpiero D'Amico, Sorin J Brener, Giovanni Esposito, Giuseppe Tarantini
Transcatheter aortic valve replacement (TAVR) has been recognized as a well-established alternative to surgical aortic valve replacement (SAVR) for symptomatic aortic stenosis with high surgical risk. With this updated systematic review and meta-analysis, we evaluated TAVR vs. SAVR in low- and intermediate-risk subjects. Studies comparing TAVR and SAVR in low-risk patients (defined as STS ≤ 8% or EuroSCORE ≤ 20%) were identified with electronic searches. The principal endpoint was all-cause mortality at short term (< 3 months), 1, and 2 years...
September 19, 2018: Cardiovascular Intervention and Therapeutics
Takashi Kunihara
Aortic valvuloplasty (AVP) has been performed less frequently than mitral valvuloplasty. The survival benefit of AVP over replacement has been demonstrated. Therefore, standardization of AVP is crucial for its widespread adoption. The hemodynamic advantage of AVP of preserving the native aortic valve may be one reason for the survival benefit. Recent guidelines still recommend AVP in selected cases compared with the less restricted recommendation for mitral valvuloplasty, although recent studies have proposed earlier indication for surgical intervention...
September 19, 2018: Journal of Medical Ultrasonics
Pedro A Lemos, Marcia Makdisse
No abstract text is available yet for this article.
August 1, 2018: Catheterization and Cardiovascular Interventions
Arka Chatterjee, William B Hillegass
No abstract text is available yet for this article.
August 1, 2018: Catheterization and Cardiovascular Interventions
Li Xiao-Dong, Liu Xin-Yao, Xu Hui, Wang Xiao-Cong
Subaortic stenosis (SAS) is a congenital heart disease, and its association with hypertrophic cardiomyopathy is very rare and clinically underappreciated. We report here a case of a 45-year-old female who was admitted to our hospital with chest tightness and shortness of breath. Both transthoracic and transesophageal echocardiography revealed asymmetric left ventricular hypertrophy and a membrane-like echo below the level of the aortic valve. This patient was diagnosed with membranous SAS with hypertrophic cardiomyopathy...
September 19, 2018: Journal of Clinical Ultrasound: JCU
Cristina Alonso-Montes, María Martín, Laura Martínez-Arias, Eliecer Coto, Manuel Naves-Díaz, César Morís, Jorge B Cannata-Andía, Isabel Rodríguez
BACKGROUND: Bicuspid aortic valve (BAV) is a heterogeneous and still not fully understood condition, with diverse genetic etiology and associated phenotypes ranging from aortic stenosis or regurgitation to aneurysm and dissection. Several genes have been associated with the presence of BAV, notably some members of the GATA family of transcription factors that play important roles in cardiac embryogenesis. METHODS: A case-control study with 122 unrelated and ethnically matched patients with bicuspid and 154 with tricuspid aortic valve was performed...
September 19, 2018: European Journal of Clinical Investigation
Akshay Patel, Kajan Mahendran, Michael Collins, Mahmoud Abdelaziz, Saib Khogali, Heyman Luckraz
Objectives: The aim of this retrospective series is to describe the prevalence and clinical significance of the incidental findings found during pre-transcatheter aortic valve implantation (TAVI) work-up and to ascertain the clinical course of such patients. Methods: Consecutive patients undergoing TAVI from 2013 to 2015 where a TAVI CT assessment was performed (n=138) were included in the study. All incidental findings that were not expected from the patient's history were discussed at the TAVI multidisciplinary meeting in order to ascertain the clinical significance of said findings and whether they would alter the proposed course of treatment...
2018: Open Heart
Satoshi Hayano, Yusuke Okuno, Makiko Tsutsumi, Hidehito Inagaki, Yoshie Fukasawa, Hiroki Kurahashi, Seiji Kojima, Yoshiyuki Takahashi, Taichi Kato
BACKGROUND: Supravalvular aortic stenosis (SVAS) is a congenital heart disease affecting approximately 1:25,000 live births. SVAS may occur sporadically, be inherited in an autosomal dominant manner, or be associated with Williams-Beuren syndrome, a complex developmental disorder caused by a microdeletion of chromosome 7q11.23. ELN on 7q11.23, which encodes elastin, is the only known gene to be recurrently mutated in less than half of SVAS patients. METHODS: Whole-exome sequencing (WES) was performed for seven familial SVAS families to identify other causative gene mutations of SVAS...
September 13, 2018: International Journal of Cardiology
P Bacik, P Poliacikova, G Kaliska
INTRODUCTION: We aimed to identify predictive factors for pacemaker requirement and determine the rate of pacemaker dependency in a single centre patient group. METHODS AND REULTS: Out of 116 patients, who underwent transcatheter aortic valve implantation at our institution. Absence of atrial fibrillation at time of procedure, pulmonary hypertension, obesity and severity of aortic valve stenosis were predictive for the need of permanent pacemaker implantation after transcatheter aortic valve implantation...
2018: Bratislavské Lekárske Listy
Damian Hudziak, Adrianna M Nowak, Radosław Gocoł, Radosław Parma, Joanna Ciosek, Andrzej Ochała, Marek Deja, Wojciech Wojakowski
AIM OF STUDY: The aim of the study was to assess safety TAVI procedure through the common carotid artery in high-vascular-risk patients. METHODS: The approach was selected by a multidisciplinary (cardiologists and cardiac surgeons) heart team after analyzing preoperative coronary angiography, TTE and MSCT of the peripheral arteries. Patients with the following conditions were qualified to the transcarotid access: severe PAD (stenotic, heavily calcified), tortuous or small diameter < 6 mm iliofemoral arteries, descending and abdominal aortic disease...
September 13, 2018: Minerva Cardioangiologica
Agata Wiktorowicz, Adrian Wit, Artur Dziewierz, Lukasz Rzeszutko, Dariusz Dudek, Pawel Kleczynski
BACKGROUND: Precise calcium evaluation in the aortic complex may be complicated. We aimed to assess the usefulness of a novel semi-automatic algorithm for multi slice computed tomography-derived (MSCT) quantitative estimation of aortic valve calcifications (AVC) in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI). METHODS: Ten patients with severe AS who underwent TAVI with Edwards Sapien S3 26 mm prosthesis and had a pre-procedural MSCT scan were included...
September 13, 2018: Minerva Cardioangiologica
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