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Aortic valve disease

Philip Sarajlic, Alicja Wolk, Magnus Bäck, Susanna C Larsson
BACKGROUND: Physical activity is associated with lower risk of coronary and cerebrovascular disease but its potential role in prevention of aortic valve stenosis (AVS) is unclear.Methods and Results:We investigated whether physical activity influences AVS risk in a cohort of 69,288 adults. During a mean follow-up of 15.3 years, 1,238 AVS cases were diagnosed. No associations were observed between AVS and walking/bicycling (≥1 h/day vs. almost never: hazard ratio 0.92, 95% CI 0.74-1...
July 12, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Daneish Selvakumar, Karan Sian, Stuart Sugito, Taranpreet Singh
Ochronosis is the bluish-black discolouration of connective tissue, including heart valves, joints, kidney and the skin. It is due to the deposition of homogentisic acid (HGA) commonly found in alkaptonuria. Ochronosis in the aortic valve is a rare occurrence and there is limited data available on the most appropriate choice of valve prosthesis in these patients. This case involves a 72-year-old male with symptomatic aortic stenosis and on echocardiogram a severe calcific trileaflet aortic stenosis with normal ejection fraction...
May 2018: Journal of Thoracic Disease
Jing Wang, Hang Zhao, Yue Wang, Howard C Herrmann, Walter R T Witschey, Yuchi Han
Background: Pulmonary arterial hypertension (PAH) and severe aortic valve stenosis (AS) are diseases characterized by increased afterload of the right and left heart, respectively. Our study aims to investigate the differences of myocardial tissue characteristics in the pressure overloaded left and right hearts, especially in the shared interventricular septum, as detected by native T1 and T2 relaxation times. Methods: Eighteen patients with PAH and 19 patients with severe AS in addition to 5 healthy volunteers underwent 1...
May 2018: Journal of Thoracic Disease
Meng-Lin Lee, Thay-Hsiung Chen, Hsien-Da Huang, Shaw-Min Hou
Background: The optimal management of ischemic mitral regurgitation (IMR) is controversial. The aim of this study was to examine our eight years' experience of surgical treatment in patients with IMR, and to compare outcomes of mitral valve repair versus replacement with concomitant coronary artery bypass grafting (CABG). Methods: A retrospective, observational, cohort study was undertaken to collect data on consecutive patients with IMR and coronary artery disease who received CABG and mitral valve surgery in our hospital between January 2008 and December 2015...
May 2018: Journal of Thoracic Disease
Rocco Romagnuolo, Kristen DeMarco, Corey A Scipione, Michael B Boffa, Marlys L Koschinsky
Lipoprotein(a) [Lp(a)] is an enigmatic lipoprotein which has been identified as a causal risk factor for coronary heart disease and calcific aortic valve disease. Lp(a) consists of a low-density lipoprotein (LDL) moiety covalently linked to the unique glycoprotein apolipoprotein(a) [apo(a)]. Apo(a) is homologous to the fibrinolytic zymogen plasminogen and thus may interfere with plasminogen activation. Conversion of native Glu-plasminogen by plasmin to the more readily activatable Lys-plasminogen greatly accelerates plasminogen activation and is necessary for optimal stimulation of plasminogen activation on endothelial cells...
July 4, 2018: Thrombosis Research
Raneem Fallatah, Abdelfatah Elasfar, Osama Amoudi, Mohamed Ajaz, Ibraheem AlHarbi, Reda Abuelatta
To the best of our knowledge, there have not been any reports of total transcatheter approach including stenting of severe coarctation of the aorta (CoA), transcatheter aortic valve replacement (TAVR) for concomitant severe aortic valve stenosis, and percutaneous coronary intervention (PCI) to treat significant coronary artery disease in a single patient. We report a 70-year-old female, who presented with uncontrolled hypertension and acute decompensated heart failure (ADHF) and was found to have severe CoA, severe bicuspid aortic valve (BAV) stenosis, and significant proximal left anterior descending (LAD) coronary artery disease...
July 2018: Journal of the Saudi Heart Association
Ayşe Güler Eroğlu, Sezen Ugan Atik, Betül Çinar, Murat Tuğberk Bakar, İrfan Levent Saltik
We evaluated the natural course of congenital aortic valvular stenosis (AVS) and factors affecting AVS progression during long-term follow-up with echocardiography. Medical records of 388 patients with AVS were reviewed; patients with concomitant lesions other than aortic regurgitation (AR) were excluded. Trivial AVS was defined as a transvalvular Doppler peak systolic instantaneous gradient of < 25 mmHg; mild stenosis, 25-49 mmHg; moderate stenosis, 50-75 mmHg; and severe stenosis, > 75 mmHg...
July 6, 2018: Pediatric Cardiology
Michael N Young, Vikas Singh, Rahul Sakhuja
With the advent of transcatheter aortic valve replacement (TAVR), appropriately selected intermediate-, high-, and extreme-risk patients with severe aortic stenosis (AS) are now offered a less invasive option compared to conventional surgery. In contemporary practice, TAVR is performed predominantly via a transfemoral arterial approach, whereby a transcatheter heart valve (THV) is delivered in a retrograde fashion through the iliofemoral arterial system and thoraco-abdominal aorta, into the native aortic valve annulus...
July 4, 2018: Current Treatment Options in Cardiovascular Medicine
Inna Kaminecki, Renuka Verma, Jacqueline Brunetto, Loyda I Rivera
While the incidence of acute rheumatic fever (ARF) in the United States has declined over the past years, the disease remains one of the causes of severe cardiovascular morbidity in children. The index of suspicion for ARF in health care providers may be low due to decreasing incidence of the disease and clinical presentation that can mimic other conditions. We present the case of a 5-year-old boy with a history of intermittent fevers, fatigue, migratory joint pain, and weight loss following group A Streptococcus pharyngitis...
2018: Case Reports in Pediatrics
Mahmut Yesin, Süleyman Karakoyun, Macit Kalçık, Mustafa Ozan Gürsoy, Sabahattin Gündüz, Mehmet Ali Astarcıoğlu, Emrah Bayam, Sinan Cerşit, Ahmet Güner, Mehmet Özkan
Coronary thromboembolism (CE) is a rare cause of prosthetic valve derived complications. This study investigates the diagnosis and treatment strategies for non-ST elevation acute coronary syndrome (NSTEACS) in patients with prosthetic heart valves. Forty-eight NSTEACS patients with prosthetic heart valves (mitral:27; aortic:14; mitral+aortic:7) were included in this study. All patients underwent transthoracic and transesophageal echocardiographic examination and coronary angiography. Normal coronary angiographic findings, or visible trombus in one of the coronary arteries, international normalized ratio <2, concomitant prosthetic valve thrombosis (PVT) and absence of multivessel atherosclerotic disease favored CE rather than atherothrombosis...
May 11, 2018: American Journal of Cardiology
Thomas Chollet, Bertrand Marcheix, Nicolas Boudou, Meyer Elbaz, Francisco Campelo-Parada, Vincent Bataille, Frederic Bouisset, Olivier Lairez, Jean Porterie, Michel Galinier, Didier Carrie, Thibault Lhermusier
AIMS: We aimed to compare long-term outcomes of transaortic (TAo-AVR) and transfemoral (TF-AVR) transcatheter aortic valve replacement. METHODS AND RESULTS: Consecutive TAo-AVR and TF-AVR cases between January 2012 to December 2015 were compared using a propensity score matching analysis. Primary endpoints were 30-day and 1-year mortality. 644 TAVR patients were included (163 TAo-AVR and 481 TF-AVR). Patients from the TAo-AVR group had more peripheral arterial disease (31...
July 3, 2018: EuroIntervention
Iacopo Fabiani, Nicola Riccardo Pugliese, Enrico Calogero, Lorenzo Conte, Maria Chiara Mazzanti, Cristian Scatena, Claudia Scopelliti, Elena Tantillo, Matteo Passiatore, Marco Angelillis, Giuseppe Antonio Naccarato, Rossella Di Stefano, Anna Sonia Petronio, Vitantonio Di Bello
Aortic valve stenosis (AVS) represents a cluster of different phenotypes, considering gradient and flow pattern. Circulating micro RNAs may reflect specific pathophysiological processes and could be useful biomarkers to identify disease. We assessed 80 patients (81, 76.7-84 years; 46, 57.5%females) with severe AVS. We performed bio-humoral evaluation (including circulating miRNA-1, 21, 29, 133) and 2D-echocardiography. Patients were classified according to ACC/AHA groups (D1-D3) and flow-gradient classification, considering normal/low flow, (NF/LF) and normal/high gradient, (NG/HG)...
July 2, 2018: Scientific Reports
Damiano Regazzoli, Antonio Mangieri, Ozan Demir, Marco B Ancona, Giuseppe Lanzillo, Francesco Giannini, Pier P Leone, Antonio Colombo, Azeem Latib
Tricuspid valve regurgitation has a high prevalence and, when severe, is associated with poor outcomes. Nevertheless, surgical repair or replacement (isolated or as a part of a combined procedure) is rarely performed due to high surgical risk. Therefore, there is a significant unmet clinical need for percutaneous transcatheter-based treatments. Significant development in percutaneous therapies for both aortic and mitral valve disease has been accomplished over the last two decades, while transcatheter therapies for the tricuspid valve are still at an early stage...
June 29, 2018: Minerva Cardioangiologica
Johan van der Merwe, Filip Casselman, Frank Van Praet
The continuous evolution in robotic-, endoscopic- and trans-catheter cardiac interventions resulted in innovative techniques that simultaneously address left ventricular outflow tract obstruction (LVOTO) and concomitant atrioventricular valve (AVV) pathology in the context of hypertrophic obstructive cardiomyopathy (HOCM). We present our brief report of 13 consecutive HOCM patients with concomitant AVV disease, who underwent endoscopic left ventricular septal myomectomy (LVSM) and AVV surgery by Endoscopic Port AccessTM Surgery (EPAS) between March 1st 2010 and October 31st 2015...
2018: Journal of Visualized Surgery
Ruggero De Paulis, Raffaele Scaffa, Andrea Salica, Luca Weltert, Ilaria Chirichilli
Composite valve graft implantation described by Bentall and De Bono is a well-documented technique of aortic root replacement used for a large spectrum of pathologic conditions involving the aortic valve and the ascending aorta. While mechanical valves were initially used, biological prostheses were later introduced in order to avoid long-term anticoagulation and its related complications. The increasing age of patients who undergo aortic root surgery, and data supporting the use of a biological aortic valve in the younger population, have significantly increased the need for a composite biological valved conduit...
2018: Journal of Visualized Surgery
Vincent Chauvette, Amine Mazine, Denis Bouchard
Aortic stenosis has traditionally been addressed with surgical aortic valve replacement (AVR). In recent years, several technologies have emerged as alternative treatment methods for aortic valve disease. Among them, the Perceval (LivaNova, London, UK) is a sutureless valve that has been used in clinical practice for over 10 years. It has been implanted in over 20,000 patients worldwide. With nearly 600 Perceval implants since 2011, the Montreal Heart Institute has developed a worldwide expertise with this technology...
2018: Journal of Visualized Surgery
Robert M Weiss, Yi Chu, Robert M Brooks, Donald D Lund, Justine Cheng, Kathy A Zimmerman, Melissa K Kafa, Phanicharan Sistla, Hardik Doshi, Jian Q Shao, Ramzi N El Accaoui, Catherine M Otto, Donald D Heistad
BACKGROUND: The epithelial growth factor receptor family of tyrosine kinases modulates embryonic formation of semilunar valves. We hypothesized that mice heterozygous for a dominant loss-of-function mutation in epithelial growth factor receptor, which are Egfr Vel/+ mice, would develop anomalous aortic valves, valve dysfunction, and valvular cardiomyopathy. METHODS AND RESULTS: Aortic valves from Egfr Vel/+ mice and control mice were examined by light microscopy at 2...
June 30, 2018: Journal of the American Heart Association
Michael H Chiu, Jonathan G Howlett, Vikas P Kuriachan, Nakul C Sharma
A 58-year-old man with previous mitral/aortic mechanical-valve replacement, aortic root repair, and coronary disease developed severe left-ventricular dysfunction following AV-node ablation/single-chamber pacemaker implantation for management of atrial fibrillation. He then underwent an upgrade to cardiac resynchronization therapy with a defibrillator. To manage his heart failure better, angiotensin-receptor blocker therapy was changed to sacubitril/valsartan, after which symptomatic palpitations with T-wave oversensing occurred...
April 5, 2018: Canadian Journal of Cardiology
T Fuchs-Buder, N Settembre, D Schmartz
A hybrid suite is an operating theater with imaging equipment equivalent to that used in an angiography suite with computed tomography (CT) and magnetic resonance imaging (MRI). They are often situated outside the operating room area and typically serve as multifunctional rooms designed to support a variety of catheter-based endovascular procedures and open surgery to be performed in the same location. The possibility to perform these in the same location facilitates the combination of both approaches to so-called hybrid procedures...
July 2018: Der Anaesthesist
Amir Abbas Mahabadi, Philipp Kahlert, Heike Annelie Kahlert, Iryna Dykun, Bastian Balcer, Michael Forsting, Gerd Heusch, Tienush Rassaf
Although lipoprotein(a) (Lp[a]) is linked with aortic valve calcification and clinical aortic valve stenosis (AVS) in middle-aged cohorts, patients aged ≥70years represent a majority of patients with AVS, in which mechanisms leading to AVS may differ. We sought to determine whether Lp(a) distinguishes patients ≥70years with and without AVS. Wematched 484 patients ≥70years with AVS, scheduled for transcatheter aortic valve implantation with 484 patients without AVS by age group and gender. Lp(a) levels were compared in patients with and without AVS and stratified by presence and absence of clinical coronary artery disease (CAD) manifestation...
May 11, 2018: American Journal of Cardiology
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