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https://www.readbyqxmd.com/read/29151260/the-first-case-of-locked-in-leaflet-after-transcatheter-aortic-valve-replacement-in-a-patient-with-bicuspid-aortic-stenosis
#1
Nao Shibata, Kensuke Matsumoto, Takayoshi Toba, Shumpei Mori, Shinsuke Shimoyama, Hidekazu Tanaka, Toshiro Shinke, Ken-Ichi Hirata
This case report is about an 85-year-old woman with bicuspid aortic stenosis (AS). Although preoperative multimodality imaging showed challenging anatomical aspects, transcatheter aortic valve replacement (TAVR) was selected to be performed as a less invasive alternative treatment approach, owing to her comorbidity. Postoperative transesophageal echocardiography and multidetector-row computed tomography revealed the presence of "locked-in leaflet" caused by stent distortion due to pinching by calcified native leaflets, with nodular calcification preventing the full expansion of the valve, which resulted in moderate perivalvular leakage...
November 19, 2017: Echocardiography
https://www.readbyqxmd.com/read/29148249/frailty-in-nonagenarians-a-bridge-too-far
#2
EDITORIAL
Mohammad Morad, William A Gray
There is no clear consensus about the definition of frailty and how to accurately measure it. There is accumulating evidence that frail old patients have worse outcomes after TAVR compared to non-frail patients. Further randomized research is needed to confirm those concerns and to standardize the role of frailty assessment in patient selection for TAVR.
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29143378/management-of-coronary-obstruction-following-transcatheter-aortic-valve-replacement
#3
REVIEW
Ibrahim Sultan, Mary Siki, Tyler Wallen, Wilson Szeto, Prashanth Vallabhajosyula
Although occlusion of the coronary arteries during transcatheter aortic valve replacement is rare, the mortality is high. In this review, we discuss the prevention and management of this complication. Occlusion of coronary ostia is a very rare, but serious, complication of transcatheter aortic valve replacement (TAVR). Although reported as only occurring in <1% of TAVR cases, it carries a high risk of fatality, with some series reporting a mortality rate as high as 40%. We present the management of an occluded left coronary artery after a self-expanding TAVR, and review the incidence, prevention, and management of this complication...
November 16, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29138245/clinical-impact-of-diabetes-mellitus-on-outcomes-after-transcatheter-aortic-valve-replacement-insights-from-the-society-of-thoracic-surgeons-american-college-of-cardiology-transcatheter-valve-therapy-registry
#4
Yigal Abramowitz, Sreekanth Vemulapalli, Tarun Chakravarty, Zhuokai Li, Samir Kapadia, David Holmes, Roland A Matsouaka, Alice Wang, Wen Cheng, James S Forrester, Richard Smalling, Vinod Thourani, Michael Mack, Martin Leon, Raj R Makkar
BACKGROUND: Diabetes mellitus (DM) adversely affects morbidity and mortality for cardiovascular diseases and procedures. Data evaluating the outcomes of transcatheter aortic valve replacement (TAVR) in diabetic patients are limited by small sample size and contradictory results. We aimed to establish the magnitude of risk and the incremental influence of insulin dependency by examining short- and long-term adverse outcomes according to DM status and therapy in the world's largest TAVR registry...
November 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29121410/medication-management-of-patients-undergoing-transcatheter-aortic-valve-replacement
#5
Bethany A Kalich, J Erin Ledford, Ian B Hollis
Aortic stenosis (AS) is the most common form of valvular heart disease. A detailed diagnostic workup is necessary to promptly stage and classify disease severity to determine the optimal management. Medical therapy and valvuloplasty are options that fail to delay or reverse disease progression. Surgical aortic valve replacement (SAVR) is curative but has significant limitations for some patient populations. A newer option, transcatheter aortic valve replacement (TAVR), has become more widely available to patients with intermediate- or high-operative risk...
November 9, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29118948/transcatheter-heart-valve-in-valve-implantation-with-edwards-sapien-bioprosthetic-valve-for-different-degenerated-bioprosthetic-valve-positions-first-iranian-viv-report-with-mid-term-follow-up
#6
Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29118326/incidence-predictors-and-outcome-of-prosthesis-patient-mismatch-after-transcatheter-aortic-valve-replacement-a-systematic-review-and-meta-analysis
#7
Yan-Biao Liao, Yi-Jian Li, Li Jun-Li, Zhen-Gang Zhao, Xin Wei, Jiay-Yu Tsauo, Tian-Yuan Xiong, Yuan-Ning Xu, Yuan Feng, Mao Chen
The aim of this study was to investigate the incidence, predictors and outcome of prosthesis-patient mismatch (PPM) following transcatheter aortic valve replacement (TAVR). A total of 30 articles incorporating 4,691 patients were identified. The pooled incidences of overall, moderate and severe PPM following TAVR were 33.0%, 25.0% and 11.0% respectively. Medtronic CoreValve (MCV) had lower incidence of overall (32% vs: 40%, P < 0.0001) and moderate (23% vs 32%, P < 0.0001) than Edwards Sapien (ESV)...
November 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29105964/simultaneous-transcatheter-transfemoral-aortic-and-transeptal-mitral-valve-replacement-using-edward-sapien-s3
#8
Zaher Fanari, Hadi Mahmaljy, Shalish Nandish, Nilesh J Goswami
Patients with concomitant severe aortic stenosis (AS) and severe mitral stenosis (MS) with mitral annular calcification (MAC) constitute an elderly high-risk population with multiple baseline comorbidities that coexist even before they develop severe valvular dysfunction. Transcatheter mitral valve replacements (TMVR) offer an alternative option for high-risk patient with severe MS with MAC. A simultaneous transfemoral Transcatheter aortic valve replacement (TAVR) and transseptal TMVR is feasible and offers the least invasive approach of management...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105953/comparison-of-self-expanding-and-balloon-expandable-transcatheter-aortic-valves-morphology-and-association-with-paravalvular-regurgitation-evaluation-using-multidetector-computed-tomography
#9
João G Almeida, Sara M Ferreira, Paulo Fonseca, Tiago Dias, Cláudio Guerreiro, Ana Barbosa, Pedro Teixeira, Mónica Carvalho, Wilson Ferreira, Nuno D Ferreira, Pedro Braga, José Ribeiro, Vasco G Ribeiro
OBJECTIVES: Compare final morphology of self-expanding and balloon-expandable prosthesis and association with paravalvular regurgitation (PVR). BACKGROUND: PVR after transcatheter aortic valve replacement (TAVR) remains a frequent complication. A better understanding of the prosthesis geometry may be important to improve selection of the best device for each case and possibly reduce the rates of PVR. METHODS: Retrospective study including patients consecutively submitted to transcatheter aortic valve replacement: August/2007-October/2016...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105330/pvl-closure-after-tavr-yes-we-can-do-it
#10
EDITORIAL
Mehmet Cilingiroglu, Andre Paixao
Paravalvular leak (PVL) remains a significant problem after transcatheter aortic valve replacement. PVL is associated with long-term morbidity and mortality. Percutaneous management of post-TAVR PVL seems to be feasible and should be adopted by the structural heart interventionalist.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102579/long-term-health-benefit-of-tavr-in-patients-with-chronic-lung-disease
#11
Juan A Crestanello, Jeffrey J Popma, David H Adams, G Michael Deeb, Mubashir Mumtaz, Barry George, Jian Huang, Michael J Reardon
OBJECTIVES: This study sought to characterize the long-term effect of chronic lung disease (CLD) on mortality, clinical outcomes, quality of life, and health benefits after transcatheter aortic valve replacement (TAVR) with a self-expanding bioprosthesis. BACKGROUND: The long-term effect of CLD after TAVR is unknown. METHODS: Prevalence and severity of CLD was determined at baseline in high- and extreme-risk patients with aortic stenosis from the CoreValve US Pivotal Trial...
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102344/clinical-outcomes-of-coronary-occlusion-following-transcatheter-aortic-valve-replacement-a-systematic-review
#12
REVIEW
Oluwaseun A Akinseye, Sunil K Jha, Uzoma N Ibebuogu
BACKGROUND: Coronary occlusion (CO) is a rare but serious complication following transcatheter aortic valve replacement (TAVR) with limited published data. We sought to evaluate the immediate and short-term outcomes of CO complicating TAVR. METHODS: Studies, including case reports, case series and original articles published from 2002 to 2016 describing CO following TAVR were identified with a systematic electronic search using the PRISMA Statement. Only studies reporting data on demographic and procedural characteristics, management and follow up outcomes were analyzed...
September 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29100645/subclavian-axillary-access-for-self-expanding-transcatheter-aortic-valve-replacement-renders-equivalent-outcomes-as-transfemoral
#13
Thomas G Gleason, John T Schindler, Robert C Hagberg, G Michael Deeb, David H Adams, John V Conte, George L Zorn, G Chad Hughes, Jia Guo, Jeffrey J Popma, Michael J Reardon
BACKGROUND: Iliofemoral arterial disease can preclude transfemoral (TF) transcatheter aortic valve replacement (TF-TAVR). Transthoracic access by direct aortic or a transapical approach imparts a greater risk of complications and death than TF access. We hypothesized that subclavian/axillary arterial (SCA) access offers equivalent risks and outcomes as TF access. METHODS: The outcomes of 202 patients from the CoreValve (Medtronic, Minneapolis, MN) United States Pivotal Trial Program treated with SCA access were propensity matched with patients treated with TF access and analyzed...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29097068/evaluation-of-cognitive-function-following-transcatheter-aortic-valve-replacement
#14
Masieh Abawi, Rehana de Vries, Pieter R Stella, Pierfrancesco Agostoni, Dirk H M Boelens, Romy C van Jaarsveld, Charlotte S van Dongen, Pieter A F M Doevendans, Mariëlle H Emmelot-Vonk
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is associated with procedural-related neurological events and acute cognitive decline. However, data on the effect of TAVR on mid-term cognitive outcome are scarce. Therefore, we aimed to assess the impact of TAVR on mid-term cognitive outcome using different neurocognitive test batteries. METHODS: Patients with severe aortic valve stenosis scheduled for TAVR were enrolled. Cognitive assessment was performed at baseline and 4 months post-TAVR using an eight-word verbal-learning test ("Immediate Recall Memory Test" [IRMT], "Delayed Recall Memory Test" [DRMT], "Recognition of Verbal Information Test" [RVIT]), global cognitive function ("Mini Mental State Examination" [MMSE]), and executive function ("Trail Making Test" [TMT], "Clock-Drawing Test" [CDT])...
October 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29096029/safety-and-efficacy-of-minimalist-approach-in-transfemoral-transcatheter-aortic-valve-replacement-insights-from-the-optimized-transcatheter-valvular-intervention-transcatheter-aortic-valve-implantation-ocean-tavi-registry
#15
Soh Hosoba, Masanori Yamamoto, Kayoko Shioda, Mitsuru Sago, Yutaka Koyama, Tetsuro Shimura, Ai Kagase, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Shinichi Shirai, Yusuke Watanabe, Kentaro Hayashida
OBJECTIVES: Favourable results have been reported for monitored anaesthesia care that includes local anaesthesia and conscious sedation [minimalist approach (MA)] for transfemoral transcatheter aortic valve replacement (TAVR). However, the efficacy of MA is still controversial in Japan. We describe our experience from a Japanese multicentre registry. METHODS: Between October 2013 and April 2016, 1215 consecutive Japanese patients with symptomatic, severe aortic stenosis undergoing TAVR with self-expandable or balloon-expandable valves were prospectively included in the Optimized transCathEter vAlvular intervention-Transcatheter Aortic Valve Implantation (OCEAN-TAVI) registry...
October 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29093974/aorto-right-ventricular-shunt-after-tavr-rare-complication-of-common-procedure
#16
Abdelkader Almanfi, Ahmad Qurie, Neil Strickman
Background: The primary treatment of symptomatic aortic stenosis is aortic valve replacement. Instead of open chest surgery, transcatheter aortic valve replacement (TAVR) is an alternative intervention for high-risk surgical candidates. Clinical Case: A 92-year-old male presented with progressive exertional dyspnea and recurrent syncopal attacks secondary to severe AS. The patient underwent successful transfemoral TAVR with 29 mm Edwards SAPIEN XT valve. His postoperative course was complicated by aorto-right ventricular shunt...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29081172/-effect-of-transcatheter-aortic-valve-replacement-using-venus-a-valve-for-treating-patients-with-severe-aortic-stenosis
#17
G Y Song, M Y Wang, Y Wang, X B Liu, Y Feng, X Q Kong, Y J Wu
Objective: To evaluate the effect of transcatheter aortic valve replacement(TAVR) using Venus-A valve for treating patients with severe aortic stenosis. Methods: In this prospective study, 101 consecutive severe aortic stenosis patients with high surgical risk(Society of Thoracic Surgeon(STS) score ≥4%) or at prohibitive surgical risk were enrolled from 5 academic cardiovascular centers in China(Fuwai hospital, the second affiliated hospital of Zhejiang university school of medicine, West China hospital of Sichuan university, the first affiliated hospital of Nanjing medical university, Ruijin hospital of Shanghai Jiaotong university school of medicine) from September 2012 to January 2015, and Venus-A valves were used in TAVR for these patients...
October 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29080095/from-corevalve-to-evolut-pro-reviewing-the-journey-of-self-expanding-transcatheter-aortic-valves
#18
REVIEW
Dhruv Mahtta, Islam Y Elgendy, Anthony A Bavry
Transcatheter aortic valve replacement (TAVR) has become standard therapy for patients with severe aortic stenosis who are deemed at least intermediate risk for surgical valve replacement. Over the past decade, several technological advances have taken place to improve the quality and safety of these devices. The current commercially available valves are broadly grouped into balloon expandable and self-expandable valves. The latest iteration of the self-expandable valve is Medtronic's repositionable valve known as the Evolut PRO system...
December 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#19
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29075334/association-of-body-mass-index-and-visceral-fat-with-aortic-valve-calcification-and-mortality-after-transcatheter-aortic-valve-replacement-the-obesity-paradox-in-severe-aortic-stenosis
#20
Jennifer Mancio, Paulo Fonseca, Bruno Figueiredo, Wilson Ferreira, Monica Carvalho, Nuno Ferreira, Pedro Braga, Alberto Rodrigues, Antonio Barros, Ines Falcao-Pires, Adelino Leite-Moreira, Vasco Gama Ribeiro, Nuno Bettencourt
BACKGROUND: Previous studies showed that metabolic syndrome is associated with aortic valve calcification (AVC) and poor outcomes in aortic stenosis (AS). However, if these associations change and how body fat impacts the prognosis of patients in late stage of the disease have been not yet explored. AIMS: To determine the association of body mass index (BMI) and visceral fat with AVC and mortality after transcatheter aortic valve replacement (TAVR). METHODS: This was a prospective cohort of 170 severe AS patients referred to TAVR...
2017: Diabetology & Metabolic Syndrome
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