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Transcatheter aortic valve and coronary occlusion

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https://www.readbyqxmd.com/read/29143378/management-of-coronary-obstruction-following-transcatheter-aortic-valve-replacement
#1
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/29102344/clinical-outcomes-of-coronary-occlusion-following-transcatheter-aortic-valve-replacement-a-systematic-review
#2
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/29050736/-complicated-transcatheter-aortic-valve-endocarditis-with-abscess-and-pseudoaneurysm-value-of-the-ecg-gated-multidetector-computed-tomography-angiography
#3
S Pichard, G Gibault-Genty, A Vienet-Legue, N Baron, R Convers-Domart, J L Georges, B Livarek
A 80-year-old man was admitted to catheterization room for an acute infero-lateral ST-elevation myocardial infarction (STEMI). Coronary angiography showed a thrombotic occlusion of the second left marginal branch, and normal other coronary arteries. The thrombo-embolic mechanism of the STEMI, and the infectious context in this patient who had had a transcatheter aortic valve implantation (TAVI) two months earlier, led us to suspect a bioprosthesis endocarditis. It was confirmed by transthoracic and transoesophageal echocardiography, which showed an aortic-mitral curtain abscess and aortic bioprosthesis vegetations, associated to Enterococcus faecalis bacteriemia...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28725331/a-very-late-presentation-of-a-right-coronary-artery-occlusion-after-transcatheter-aortic-valve-replacement
#4
Roberto Ramirez, Oxana Ovakimyan, Glenmore Lasam, Kristen Lafferty
Involvement of the coronary ostia is a rare complication after transcatheter aortic valve replacement (TAVR). This complication has been more commonly described immediately after valve deployment. This is the first reported case of delayed coronary obstruction caused by TAVR 6 months after the procedure.
June 2017: Cardiology Research
https://www.readbyqxmd.com/read/28588092/stunning-and-right-ventricular-dysfunction-is-induced-by-coronary-balloon-occlusion-and-rapid-pacing-in-humans-insights-from-right-ventricular-conductance-catheter-studies
#5
Richard G Axell, Joel P Giblett, Paul A White, Andrew Klein, James Hampton-Til, Michael O'Sullivan, Denise Braganza, William R Davies, Nick E J West, Cameron G Densem, Stephen P Hoole
BACKGROUND: We sought to determine whether right ventricular stunning could be detected after supply (during coronary balloon occlusion [BO]) and supply/demand ischemia (induced by rapid pacing [RP] during transcatheter aortic valve replacement) in humans. METHODS AND RESULTS: Ten subjects with single-vessel right coronary artery disease undergoing percutaneous coronary intervention with normal ventricular function were studied in the BO group. Ten subjects undergoing transfemoral transcatheter aortic valve replacement were studied in the RP group...
June 6, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28504238/united-kingdom-coronary-and-structural-heart-interventions-from-2010-to-2015
#6
Peter F Ludman, Mark A de Belder, Simon Redwood, Adrian Banning
In the United Kingdom, a clinical data set is completed for every patient undergoing coronary intervention and certain structural interventions, and sent to central servers in the National Institute for Cardiovascular Outcomes Research (NICOR) on behalf of the British Cardiovascular Intervention Society (BCIS). These data are linked to the national mortality register. In addition, data are obtained about the structure of healthcare provision using an annual survey. Analyses of these data are provided for different audiences in several formats...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28504230/macedonia-coronary-and-structural-heart-interventions-from-2010-to-2015
#7
Sasko Kedev, Biljana Zafirovska, Oliver Kalpak, Slobodan Antov, Jorgo Kostov, Igor Spiroski, Hristo Pejkov, Marjan Boshev, Ivan Vasllev, Aleksandar Jovkovski, Hajber Taravari, Danica Petkoska, Darko Kitanoski
The aim of this report is to describe invasive cardiology procedural practice in Macedonia during the period from 2010 to 2015. Details of all consecutive 39,899 patients who underwent cardiovascular, peripheral or structural heart procedures during the period from 2010 until 2015 were examined. Clinical and procedure characteristics, access site, procedural success and complications were analysed. The number of coronary angiographies increased from 5,540 in 2010 to 8,550 in 2015. Transfemoral access (TFA) was present in 4% of coronary angiographies in 2010 and had decreased to 1% in 2015...
May 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28473128/transcatheter-aortic-valve-implantation-within-degenerated-aortic-surgical-bioprostheses-partner-2-valve-in-valve-registry
#8
MULTICENTER STUDY
John G Webb, Michael J Mack, Jonathon M White, Danny Dvir, Philipp Blanke, Howard C Herrmann, Jonathon Leipsic, Susheel K Kodali, Raj Makkar, D Craig Miller, Philippe Pibarot, Augusto Pichard, Lowell F Satler, Lars Svensson, Maria C Alu, Rakesh M Suri, Martin B Leon
BACKGROUND: Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results. OBJECTIVES: The authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR. METHODS: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28379441/preventive-left-main-and-right-coronary-artery-stenting-to-avoid-coronary-ostia-occlusion-in-high-risk-stentless-valve-in-valve-transcatheter-aortic-valve-implantation
#9
Silvia Maggio, Alessia Gambaro, Roberto Scarsini, Flavio Ribichini
Transcatheter aortic valve implantation is becoming an attractive and promising alternative to redo surgery for aortic bioprosthetic valves degeneration, especially in high-risk patients. However, valve-in-valve transcatheter aortic valve implantation itself carries some procedural risks and potential challenges that interventionists must be aware of. An accurate preprocedural planning is fundamental for the prevention of potentially fatal complications. This case describes a novel strategy of simultaneous right and left coronary artery stenting preventing bilateral coronary obstruction in a patient with a stentless surgical aortic valve and extremely low origin of the 2 coronary arteries...
July 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28357625/a-case-of-double-stent-implantation-for-left-main-coronary-artery-occlusion-in-transcatheter-aortic-valve-implantation-using-sapien-xt-device
#10
Masaki Ito, Norio Tada, Tatsushi Ootomo, Naoto Inoue
Transcatheter aortic valve implantation is an established alternative and less invasive procedure to replace heart valves in symptomatic aortic stenosis patients; however, severe, life-threatening complications still exist. Coronary artery occlusion is a primary complication. We report a case of left main coronary artery occlusion after transcatheter aortic valve replacement, which was ameliorated using a double stent implantation technique.
March 29, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28314700/structural-heart-disease-intervention-the-canadian-landscape
#11
MULTICENTER STUDY
Anita W Asgar, Eric Horlick, Kevin McKenzie, Neil Brass, Warren J Cantor, Albert Chan, Anthony Della Siega, Jean Francois Gobeil, Saleem Kassam, Michael P Love, Samer Mansour, Giuseppe Martucci, Najaf Nadeem, Madhu K Natarajan, Vernon Paddock, Josep Rodés-Cabau, Mouhieddin Traboulsi, James L Velianou, Robert C Welsh, David Wood, John G Webb
Cardiovascular disease encompasses coronary artery disease and valvular heart disease, and the prevalence of both increases with age. Over the past decade, the landscape of interventional cardiology has evolved to encompass a new set of percutaneous procedures outside the coronary tree, including transcatheter aortic valve implantation, transcatheter mitral valve repair, and left atrial appendage occlusion. These interventions have sparked a new discipline within interventional cardiology referred to as structural heart disease (SHD) intervention...
September 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28183467/initial-experience-of-a-second-generation-self-expanding-transcatheter-aortic-valve-the-uk%C3%A2-ireland-evolut-r-implanters-registry
#12
MULTICENTER STUDY
Sundeep S Kalra, Sami Firoozi, James Yeh, Daniel J Blackman, Shabnam Rashid, Simon Davies, Neil Moat, Miles Dalby, Tito Kabir, Saib S Khogali, Richard A Anderson, Peter H Groves, Darren Mylotte, David Hildick-Smith, Rajiv Rampat, Jan Kovac, Ashan Gunarathne, Jean-Claude Laborde, Stephen J Brecker
OBJECTIVES: The authors present the UK and Irish real-world learning curve experience of the Evolut R transcatheter heart valve. BACKGROUND: The Evolut R is a self-expanding, repositionable, and fully recapturable second-generation transcatheter heart valve with several novel design features to improve outcomes and reduce complications. METHODS: Clinical, procedural, and 30-day outcome data were prospectively collected for the first 264 patients to receive the Evolut R valve in the United Kingdom and Ireland...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27955854/-transcatheter-aortic-valve-implantation-for-aortic-stenosis-initial-experience
#13
Guillermo Careaga-Reyna, José Luis Lázaro-Castillo, Carlos Alberto Lezama-Urtecho, Enriqueta Macías-Miranda, Juan José Dosta-Herrera, José Galván Díaz
BACKGROUND: Aortic stenosis is a frequent disease in the elderly, and is associated with other systemic pathologies that may contraindicate the surgical procedure. Another option for these patients is percutaneous aortic valve implantation, which is less invasive. We present our initial experience with this procedure. MATERIAL AND METHODS: Patients with aortic stenosis were included once selection criteria were accomplished. Under general anaesthesia and echocardiographic and fluosocopic control, a transcatheter aortic valve was implanted following s valvuloplasty...
December 9, 2016: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/27716868/twelve-month-quality-of-life-improvement-and-all-cause-mortality-in-elderly-patients-undergoing-transcatheter-aortic-valve-replacement
#14
Paweł Kleczyński, Maciej Bagieński, Artur Dziewierz, Łukasz Rzeszutko, Danuta Sorysz, Jarosław Trębacz, Robert Sobczyński, Marek Tomala, Maciej Stąpór, Dariusz Dudek
PURPOSE: Restoration of quality of life (QoL) and improvement of clinical outcomes is crucial in elderly patients undergoing transcatheter aortic valve implantation (TAVI). We sought to evaluate changes in QoL and all-cause mortality 12 months after TAVI. METHODS: A total of 101 patients who underwent TAVI were included. Patients were followed for 12 months. QoL was assessed at baseline and at 1, 6 and 12 months after TAVI using EQ-5D-3L with a visual analog scale (VAS)...
October 10, 2016: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/27697505/computed-tomography-assessment-for-transcatheter-aortic-valve-in-valve-implantation-the-vancouver-approach-to-predict-anatomical-risk-for-coronary-obstruction-and-other-considerations
#15
REVIEW
Philipp Blanke, Jeanette Soon, Danny Dvir, Jong K Park, Christopher Naoum, Shaw-Hua Kueh, David A Wood, Bjarne L Norgaard, Kapilan Selvakumar, Jian Ye, Anson Cheung, John G Webb, Jonathon Leipsic
Valve-in-valve implantation of a transcatheter heart valve into a failed bioprosthetic heart valve has emerged as a treatment alternative to repeat conventional surgery. This requires careful pre-procedural assessment using non-invasive imaging to identify patients at risk for procedure related adverse events, such as ostial coronary occlusion. Herein we report how to comprehensively assess aortic root anatomy using computed tomography prior to transcatheter valve implantation for failed bioprosthetic aortic valves...
November 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27527364/right-coronary-occlusion-following-transcatheter-aortic-valve-implantation-two-case-reports
#16
Gang Zhang, Jun Luo, Guo Chen
This paper discusses two male patients with severe aortic stenosis, whose right coronary arteries (RCA) were completely occluded during transcatheter aortic valve implantation (TAVI), leading to fatal hemodynamic disorder. Occlusions of RCA complicated by TAVI are rare. In addition, emergency cardiopulmonary bypass (CPB) played a critical role in rescuing our second patient. Both patients were admitted for "severe aortic stenosis," and TAVIs were performed. The first patient's blood pressure immediately dropped to 70/40 mmHg after the balloon expansion and did not increase much after the administration of aramine or fluid therapy...
September 2016: Frontiers of Medicine
https://www.readbyqxmd.com/read/27389731/distal-coronary-embolisation-during-transcatheter-aortic-valve-implantation
#17
Akira Tsujimura, Naritatsu Saito, Kenji Minakata, Takeshi Kimura
A 92-year-old woman was admitted to a hospital with severe aortic valve stenosis for transcatheter aortic valve implantation (TAVI). TAVI was performed under general anaesthesia. After balloon valvuloplasty, the patient became hypotensive and transesophageal echocardiography showed severe aortic regurgitation with severely depressed left ventricular wall motion. A 26 mm Sapien XT valve was deployed. However, the ventricular wall motion was still severely depressed. Coronary angiography showed occlusion of the mid-left anterior descending (LAD) artery...
July 7, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27358194/impact-of-coronary-artery-disease-burden-on-12-month-mortality-of-patients-after-transcatheter-aortic-valve-implantation
#18
Pawel Kleczynski, Artur Dziewierz, Maciej Bagienski, Lukasz Rzeszutko, Danuta Sorysz, Jaroslaw Trebacz, Robert Sobczynski, Marek Tomala, Andrzej Gackowski, Dariusz Dudek
OBJECTIVES: The aim of the study was to compare 12-month mortality rate of patients with and without complete coronary revascularization before transcatheter aortic valve implantation (TAVI). BACKGROUND: There are limited data on the impact of coronary artery disease burden in patients with severe aortic stenosis undergoing TAVI. METHODS: One hundred and one consecutive patients undergoing TAVI were enrolled. Of them 16 (15.8%) had an incomplete coronary revascularization...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27315455/transcatheter-aortic-valve-in-valve-treatment-of-degenerative-stentless-supra-annular-freedom-solo-valves-a-single-centre-experience
#19
James Cockburn, Maureen Dooley, Jessica Parker, Andrew Hill, Nevil Hutchinson, Adam de Belder, Uday Trivedi, David Hildick-Smith
BACKGROUND: Redo surgery for degenerative bioprosthetic aortic valves is associated with significant morbidity and mortality. Report results of valve-in-valve therapy (ViV-TAVI) in failed supra-annular stentless Freedom Solo (FS) bioprostheses, which are the highest risk for coronary occlusion. METHODS: Six patients with FS valves (mean age 78.5 years, 50% males). Five had valvular restenosis (peak gradient 87.2 mm Hg, valve area 0.63 cm(2) ), one had severe regurgitation (AR)...
February 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27032472/endovascular-resection-of-the-native-aortic-valve-before-transcatheter-aortic-valve-implantation-state-of-the-art-and-review
#20
REVIEW
Emiliano Navarra, Zahra Mosala Nezhad, Xavier Bollen, Charles-Edouard Gielen, Stefano Mastrobuoni, Laurent De Kerchove, Benoit Raucent, Parla Astarci
Transcatheter aortic valve implantation was introduced into clinical practice in 2002 as a rescue approach in patients presenting with symptomatic severe aortic stenosis but not eligible for conventional aortic valve replacement. This technique allows implantation of a balloon expandable bioprosthesis without resection of the native aortic valve. Several complications are described as a consequence of the residual highly calcified valve being squeezed against the aortic wall by the stent of the implant. This can result in deformation of the metal stent and paravalvular leakage, risk of occlusion of the coronary ostia, or central and peripheral embolization of valvular debris...
September 2016: European Journal of Cardio-thoracic Surgery
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