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Perivalvular leak

Christopher Young, Günther Laufer, Alfred Kocher, Marco Solinas, Francesco Alamanni, Gianluca Polvani, Bruno K Podesser, Jose Ignacio Aramendi, Jose Arribas, Olivier Bouchot, Ugolino Livi, Massimo Massetti, Kim Terp, Christophe Giot, Mattia Glauber
OBJECTIVE: The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif). METHODS: Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system...
February 2018: Journal of Thoracic and Cardiovascular Surgery
Suyon Chang, Young Joo Suh, Kyunghwa Han, Jin Young Kim, Young Jin Kim, Byung-Chul Chang, Byoung Wook Choi
BACKGROUND: The clinical significance of pannus in the prosthetic mitral valve (MV) is not well documented. OBJECTIVES: To investigate the clinical significance of pannus on cardiac computed tomography (CT) in patients with a prosthetic MV. METHODS: A total of 130 patients with previous MV replacement who underwent cardiac CT were retrospectively included in this study. The presence of pannus, paravalvular leak (PVL) around the prosthetic MV and limitation of motion (LOM) of the MV were analyzed using CT...
December 15, 2017: International Journal of Cardiology
José Martínez-Comendador, Mario Castaño, Javier Gualis, Elio Martín, Pasquale Maiorano, Javier Otero
Aortic valve replacement (AVR) is the treatment of choice for aortic valve disease, with excellent results reported in the short- and long-term follow-up. Due to the increasing number of patient comorbidities and older age, various technical alternatives have been developed such as transcatheter aortic valve implantation and, more recently, sutureless valve bioprostheses. For patients with very high surgical risk, transcatheter implantation is becoming the top therapeutic option. However, the percutaneous technique still has major disadvantages including those related to implantation without excision of the diseased native valve without direct view of the annulus, which increases the probability of developing perivalvular leaks and a high percentage of atrioventricular block...
July 1, 2017: Interactive Cardiovascular and Thoracic Surgery
Anas Sarraj, Corazón-Mabel Calle Valda, Daniel-Edgardo Muñoz, Guillermo Reyes
Hemolysis is a well-recognized complication after prosthetic valve replacement, especially with perivalvular leaks. Hemolytic anemia associated with mitral valve (MV) repair is less common. We report the case of a young man with severe hemolytic anemia caused by turbulence of blood flow through a very small quadrangle orifice due to early failure of MV repair. The patient underwent redo MV biologic prosthesis replacement and tricuspid valve annuloplasty. The hemolysis completely disappeared few months later...
April 2017: Annals of Thoracic Surgery
Ricardo Yaryura, Hakim Morsli, Jonathan Hoffberger, Lauren Murray
No abstract text is available yet for this article.
August 22, 2016: JACC. Cardiovascular Interventions
Hisato Takagi, Takuya Umemoto
OBJECTIVES: To determine whether ≥moderate paravalvular aortic regurgitation (PAR) after transcatheter aortic valve implantation (TAVI) independently impairs overall survival and how much the impact on survival is, we performed an updated meta-analysis pooling not unadjusted but adjusted hazard ratios (HRs). METHODS: Databases including MEDLINE and EMBASE were searched through January 2016 using PubMed and OVID. Search terms included paravalvular or perivalvular; regurgitation, leak, or leakage; percutaneous, transcatheter, transluminal, transarterial, transapical, transaortic, transcarotid, transaxillary, transsubclavian, transiliac, transfemoral, or transiliofemoral; and aortic valve...
October 15, 2016: International Journal of Cardiology
Nicola Marchese, Antonio Facciorusso, Carlo Vigna
Blunt chest trauma is a very rare cause of valve disorder. Moreover, mitral valve involvement is less frequent than is aortic or tricuspid valve involvement, and the clinical course is usually acute. In the present report, we describe the case of a 49-year-old man with a perivalvular mitral injury that became clinically manifest one year after a violent, nonpenetrating chest injury. This case is atypical in regard to the valve involved (isolated mitral damage), the injury type (perivalvular leak in the absence of subvalvular abnormalities), and the clinical course (interval of one year between trauma and symptoms)...
December 2015: Texas Heart Institute Journal
Robert C Rennert, David R Santiago-Dieppa, J Scott Pannell, Alexander A Khalessi
Mycotic cerebral aneurysms can present unique neurosurgical challenges. We report a patient with left carotid occlusions, a ruptured left middle cerebral artery mycotic aneurysm, and a rapidly appearing unruptured left anterior cerebral artery/anterior communicating artery (ACA/ACom) mycotic aneurysm in the setting of mitral valve endocarditis with a perivalvular leak and evolving congestive heart failure. Following medical stabilization and antibiotic administration, a combined endovascular (with contralateral access via the ACom) and open surgical approach was used to selectively secure both aneurysms with preservation of distal flow, allowing lifesaving cardiac valve replacement...
November 2015: Journal of Neurological Surgery Reports
Bruno García Del Blanco, Felipe Hernández Hernández, José Ramón Rumoroso Cuevas, Ramiro Trillo Nouche
INTRODUCTION AND OBJECTIVES: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its annual report on the data from the registry of the activity in Spain in 2014. METHODS: Data were voluntarily provided by participating centers. The information was introduced online and was analyzed by the Steering Committee of the Working Group on Cardiac Catheterization and Interventional Cardiology. RESULTS: Data were reported by 106 hospitals...
December 2015: Revista Española de Cardiología
John W Brown, Jack H Boyd, Parth M Patel, Mary L Baker, Amjad Syed, Joe Ladowski, Joel Corvera
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is currently offered to patients who are high-risk candidates for conventional surgical aortic valve replacement. For the past 37 years, off-pump aortic valve bypass (AVB) has been used in elderly patients at our center for this similarly high-risk group. Although TAVR and AVB were offered to similar patients at our center, comparisons of clinical outcomes and hospital economics for each strategy were not reported. METHODS: We reviewed the clinical and financial records of 53 consecutive AVB procedures performed since 2008 with the records of 51 consecutive TAVR procedures performed since 2012...
January 2016: Annals of Thoracic Surgery
Altug Osken, Ercan Aydin, Ramazan Akdemir, Huseyin Gunduz
Paravalvular leaks (PVLs) are a well-recognized complication of prosthetic valve replacement. Perivalvular prosthetic regurgitation causes significant morbidity and is associated with high perioperative mortality if open surgical repair is required. PVLs manifest with symptoms of congestive heart failure, hemolysis, or in most cases, the combination of both. In recent years, the development of imaging and device techniques significantly shortened the duration of fluoroscopy and procedure success was achieved...
April 2015: Heart Views: the Official Journal of the Gulf Heart Association
Matthew J Gillespie, Chikashi Aoki, Satoshi Takebayashi, Toru Shimaoka, Jeremy R McGarvey, Robert C Gorman, Joseph H Gorman
PURPOSE: We describe our initial experience with on-bypass and off-bypass (off-pump) mitral valve replacement with the modified version of our novel catheter-based sutureless mitral valve (SMV) technology, which was developed to atraumatically anchor and seal in the mitral position. DESCRIPTION: The SMV is a self-expanding device consisting of a custom designed nitinol framework and a pericardial leaflet valve mechanism. For the current studies, our original device was modified (SMV2) to reduce the delivery profile and to allow for controlled deployment while still maintaining the key principles necessary for atraumatic anchoring and sealing in the mitral valve position...
April 2015: Annals of Thoracic Surgery
Nishath Quader, Charles J Davidson, Vera H Rigolin
There is considerable interest in percutaneous closure of perivalvular leaks without the need for repeat surgery. Successful percutaneous closure of these defects requires extensive planning and coordination before and during the procedure. However, there is no standardized description of valve pathology in the presence of a prosthetic valve, which adds to the challenge of communication. Transesophageal echocardiography is ideally suited to guide percutaneous mitral valve procedures, because of the proximity of the mitral valve to the esophagus...
May 2015: Journal of the American Society of Echocardiography
Jordan D W Ross, Masashi Ura, Allan Kruger, Jeremy Wright
We present the case of a previously well seventy-four year old male caucasian grazier who presented with mild back pain and was subsequently found to have a large posterior mitral valve leaflet perivalvular abscess associated with mitral annulus calcification and a mycotic infrarenal abdominal aortic aneurysm (AAA) of Staphylococcal origin. He underwent a right axillofemoral bypass with oversewn aorta and a right to left femoral crossover graft, and a subsequent mitral valve repair with decalcification/debridement of the annulus and extensive posterior leaflet reconstruction with pericardium patch...
2014: Journal of Cardiothoracic Surgery
Fernando Hornero Sos, José A Montero Argudo, Ignacio Rodríguez Albarrán, María Bueno Codoñer, José Buendía Miñano, Oscar Gil Albarova, Rafael García Fuster, Sergio Cánovas López, Rafael Payá Serrano, José L Pérez Bosca
INTRODUCTION: Surgical ablation of atrial fibrillation is currently a simple procedure that can be done during cardiac surgery in most patients. A number of different energy sources now available allow to easily create ablation lines in the atria. We describe our experience during the previous three years. PATIENTS AND METHOD: In 93 patients with cardiac problems treated with surgery and permanent atrial fibrillation (longer than 3 months), surgical ablation of the arrhythmia was done at the same time...
October 2004: Revista Española de Cardiología
Juan H Alonso-Briales, Antonio J Muñoz-García, Manuel F Jiménez-Navarro, Antonio J Domínguez-Franco, José M Melero-Tejedor, Isabel Rodríguez-Bailón, José M Hernández-García, Eduardo de Teresa-Galván
Reoperation of patients with perivalvular leaks due to heart failure or hemolysis is associated with increased morbidity and mortality. Percutaneous closure using an Amplatzer device offers a promising alternative. We describe our initial experience between 2004 and 2006, during which we used an Amplatzer device in 8 patients for the percutaneous closure of perivalvular leaks (4 aortic and 4 mitral). The patients were all symptomatic and had a high surgical risk. Device placement was successful in all patients with mitral leaks and in 3 with aortic leaks...
April 2009: Revista Española de Cardiología
Michał Oskar Zembala, Jacek Piegza, Jacek Wacławski, Michał Hawranek, Michael Hilker, Tomasz Niklewski, Jan Głowacki, Monika Parys, Paweł Nadziakiewicz, Piotr Chodór, Krzysztof Wilczek, Roman Przybylski, Mariusz Gąsior, Marian Zembala
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high risk and surgically in operable patients who suffer from severe symptomatic aortic stenosis. However, a significant number of complications, associated with both the learning curve and device specificity, have required attention and subsequent improvement. The Symetis transapical TAVR system is a self-positioning bioprosthesis composed of a non-coronary leaflet of surgical quality porcine tissue valve sewn into a self-expanding nitinol stent that iscovered with a PET-skirt...
2014: Kardiologia Polska
William Prabhu, Paul C Gordon
In patients with symptomatic severe aortic stenosis, surgical aortic valve replacement (SAVR) improves survival, quality of life, and functional status compared with medical therapy. Based on the results of the randomized PARTNER Trial, Transcatheter Aortic Valve Replacement (TAVR) using the Edwards Sapien balloon expandable valve is now available in the United States for patients who are either inoperable due to anatomic concerns or severe medical co-morbidities, or as an alternative in patients considered high risk for SAVR...
February 2014: Rhode Island Medical Journal
Michele Celiento, Luca Filaferro, Aldo D Milano, Gerardo Anastasio, Gabriele Ferrari, Uberto Bortolotti
OBJECTIVE: To evaluate the long-term results of aortic valve replacement (AVR) and mitral valve replacement (MVR) with the Sorin Bicarbon prosthesis (SBP). METHODS: Five hundred seven patients (306 men, 201 women), mean age 62±10 years (range, 21-86 years), received an SBP between 1994 and 2000; AVR was performed in 344 (67%) and MVR in 163 (33%). The main concomitant procedure was coronary artery grafting in 79 patients (16%). Follow-up was 99% complete; mean follow-up was 12...
November 2014: Journal of Thoracic and Cardiovascular Surgery
Daniel Rodríguez Muñoz, Carla Lázaro Rivera, José Luis Zamorano Gómez
Percutaneous closure of paravalvular leaks has grown into becoming a widely considered option for treatment of hemodynamically significant regurgitation in patients with valve prosthesis. Guidance provided by the use of cardiovascular imaging techniques before and during the intervention has proved its relevance to improve accuracy and, with it, the outcome of the procedure. It has also been essential in the successful evolution of the technique and the development of devices specifically designed for it. The present work reviews the role of imaging before, during and after treatment of perivalvular prosthetic leaks and the most recent and significant advances in it...
January 2014: Current Cardiology Reports
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