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Aortic valve replacement

Toshimitsu Tsugu, Mitsushige Murata, Keitaro Mahara, Shiro Iwanaga, Keiichi Fukuda
Aortic regurgitation resulting from blunt chest trauma has been reported only 95 times, to our knowledge. The noncoronary and right coronary cusps are the cardiac structures most often injured. Although the aortic leaflets can appear to be undamaged after nonpenetrating trauma, they can have pathologic abnormalities and insufficient function. Some cases of posttraumatic aortic regurgitation progress slowly. Aortic valve replacement is the optimal treatment. We present the case of a then-62-year-old man who has lived more than 5 years after blunt-trauma aortic regurgitation...
October 2016: Texas Heart Institute Journal
Tsuyoshi Isawa, Norio Tada, Tatsushi Ootomo
Coronary obstruction during or after transcatheter aortic valve replacement is a rare and catastrophic sequela that occurs most frequently just after valve implantation. Even rarer is the delayed clinical presentation, in some few patients, of coronary obstruction on the day after self-expandable valve implantation. Here we describe a case of balloon-expandable (not self-expandable) transcatheter aortic valve replacement, followed by partial obstruction of the left main coronary artery on the day after that procedure in a 93-year-old man, despite normal left ventricular contraction just after valve implantation...
October 2016: Texas Heart Institute Journal
Sameer Arora, Amol A Bahekar
The management of concomitant obstructive coronary artery disease and severe aortic stenosis in poor surgical candidates is an evolving topic. Although the typical current practice is to perform percutaneous revascularization before transcatheter aortic valve replacement (TAVR), some data have emerged regarding revascularization after performing TAVR. We present the case of a 90-year-old man with multivessel coronary artery disease who was at prohibitive risk for surgical aortic valve replacement. We first performed TAVR with use of hemodynamic support, then Impella-assisted multivessel percutaneous coronary intervention on the patient's unprotected left main coronary artery...
October 2016: Texas Heart Institute Journal
Ruggero De Paulis, Salvatore D'Aleo, Alessandro Bellisario, Andrea Salica, Luca P Weltert, Raffaele Scaffa, Lorenzo Guerrieri Wolf, Daniele Maselli, Michele Di Mauro
BACKGROUND: Structural valve deterioration (SVD) is the Achilles' heel of bioprostheses. Its correlation with younger age is well known. In recent years we exclusively reserved use of small-size Mitroflow valve prostheses (LivaNova, London, United Kingdom) to an older patient population with small aortic annuli. This study aimed to assess the incidence of SVD and its effect on patient survival and need for reoperation. MATERIALS AND METHODS: Two hundred five patients (aged 75...
September 28, 2016: Journal of Thoracic and Cardiovascular Surgery
Yochun Jung, Byoung Hee Ahn, Kyo Seon Lee, In Seok Jeong, Sang Gi Oh, Kook Joo Na, Kye Hun Kim
BACKGROUND: The association between the anatomy of a single coronary artery (SCA) and the surgical risk of aortic valve replacement (AVR) remains unclear due to a lack of studies on this topic. CASE PRESENTATION: A 73-year-old woman underwent AVR for aortic stenosis. Preoperative coronary angiography results showed a SCA arising from the left coronary sinus. The Manouguian procedure was performed for a small aortic annulus. Intraoperatively, an extracorporeal membrane oxygenator (ECMO) was needed for bypass weaning failure due to newly developed right ventricular dysfunction...
October 24, 2016: Journal of Cardiothoracic Surgery
Hacı Ahmet Kasapkara, Abdullah Nabi Aslan, Hüseyin Ayhan, Serdal Baştuğ, Hakan Süygün, Telat Keleş, Tahir Durmaz, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) has been accepted as an alternative to surgery in high risk or inoperable patients with severe aortic stenosis (AS). Although transfemoral approach is the most often preferred means of access, in patients with severe ilio-femoral arteriopathy, other vascular access sites may be required. The aim of the present study was to report our experience with trans-subclavian approach for TAVR using different valve systems. METHODS: Among 273 patients undergoing TAVR between June 2011 and May 2016, 10 patients (mean age: 68...
October 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
John Jose, Geetesh Manik, Mohamed Abdel-Wahab
Transcatheter aortic valve implantation (TAVI) has revolutionized the management of elderly patients with symptomatic severe aortic stenosis in the western world. It is a valuable alternative to surgical aortic valve replacement in patients, who are inoperable or at high surgical risk due to co-morbidities. The prevalence of aortic stenosis increases sharply with age after the sixth decade and is expected to have a significant impact on the geriatric health care system of India, given the rapid increase in life expectancy in recent years...
September 2016: Indian Heart Journal
Ashvarya Mangla, Saurabh Gupta
Transcatheter aortic valve replacement (TAVR) has rapidly emerged as the standard of care for severe symptomatic aortic stenosis in patients whose comorbidities put them at prohibitive risk for surgical aortic valve replacement (SAVR). Several trials have demonstrated superior outcomes with TAVR compared to medical management alone. TAVR has also shown favorable outcomes in patients at high risk for SAVR. TAVR can be associated with significant vascular complications, which adversely impact outcomes, and operators should be cognizant of their early recognition and appropriate management...
September 2016: Indian Heart Journal
Neeraj Awasthy, Ria Garg, S Radhakrishnan, Savitri Shrivastava
: Balloon aortic valvuloplasty (BAV) is a well accepted modality of treatment in congenital aortic stenosis in all age groups. Although in infants and children it is the modality of choice, in adolescents and young adults, it is of debatable efficacy. AIM: To evaluate long-term results of aortic valvuloplasty particularly in adolescent and adults (>12 years) and compare the outcome in other age groups that are <1 year and between 1 are 11 years. SETTING: Tertiary referral center...
September 2016: Indian Heart Journal
Christopher Lau, Mario Gaudino, Andrea Mazza, Monica Munjal, Leonard N Girardi
Structural valve deterioration with biologic composite valve grafts previously required reoperative aortic root replacement. We present a technique for avoiding repeated root replacement. Exposure is by a transverse incision through the Dacron graft. The valve is disassembled within the graft, and a new prosthesis is implanted. We used this technique in 11 patients with good success.
November 2016: Annals of Thoracic Surgery
Stefan Büttner, Helge Weiler, Carolin Zöller, Benjamin Koch, Andreas Zierer, Andreas M Zeiher, Helmut Geiger, Mariuca Vasa-Nicotera, Ingeborg A Hauser, Stephan Fichtlscherer
Management of dialysis patients with valvular heart disease waitlisted for kidney transplantation is challenging. Development of severe aortic valve stenosis can lead to the exclusion from the transplant program or even death while on the waiting list. In dialysis patients, surgical aortic valve replacement is associated with a high perioperative risk with increased morbidity and mortality. In contrast, transcatheter aortic valve implantation emerges as a viable option for dialysis patients. Herein, we present the long-term follow-up of successful kidney transplantation after TAVI in a diabetic patient receiving long-term hemodialysis...
November 2016: Annals of Thoracic Surgery
Heike Baumgarten, John J Squiers, William T Brinkman, J Michael DiMaio, Ambarish Gopal, Michael J Mack, Robert L Smith
Mitral annular calcification (MAC) is a chronic degenerative process at the fibrous base of the mitral valve. It is a feared diagnosis in the context of mitral valve operations because of the risk of severe adverse events such as atrioventricular disruption, injury to the circumflex artery during debridement, and difficult placement of annular sutures. We report a series of 3 consecutive female patients with severe circular MAC who underwent successful mitral valve replacement through a lateral minithoracotomy with use of an inverted transcatheter aortic valve...
November 2016: Annals of Thoracic Surgery
Julia Götte, Wolfgang Hemmer, Detlef Roser, Markus Liebrich, Nicolas Doll
We report the case of a 83-year-old man who had undergone a full root replacement with a stentless bioprosthesis 15 years earlier. He was now diagnosed with severe aortic valve regurgitation secondary to leaflet degeneration, moderate mitral regurgitation, and single-vessel coronary artery disease. To reduce cross-clamp time and technical difficulties a sutureless aortic prosthesis was used. His surgery and postoperative course were uneventful. This is the first report of the successful use of a sutureless aortic valve prosthesis in a patient after bioprosthetic full root replacement who required additional mitral repair and coronary artery bypass surgery...
November 2016: Annals of Thoracic Surgery
Vance G Nielsen, Samata R Paidy, Camron A Meek, Tiffany K Thornton, Scott D Lick
We present a case of a patient undergoing aortic valve replacement being inadvertently administered 5000 U of bovine thrombin instead of heparin for anticoagulation for cardiopulmonary bypass. The labeling error was made within the operating room pharmacy. The key to survival of this patient was a rapid diagnosis, administration of antithrombin and heparin, and removal of cardiac and great vessel thrombi. It is recommended that point of care anesthesia providers `prepare heparin for cardiopulmonary bypass anticoagulation, as thrombin is not used in anesthetic practice and is not contained within anesthesia cabinet medication drawers...
October 22, 2016: International Journal of Legal Medicine
Charat Thongprayoon, Wisit Cheungpasitporn, Narat Srivali, Andrew M Harrison, Wonngarm Kittanamongkolchai, Kevin L Greason, Kianoush B Kashani
BACKGROUND: The aim of this study was to compare the incidence of post-procedural acute kidney injury (AKI) and other renal outcomes in patients undergoing transapical (TA) and transfemoral (TF) approaches for transcatheter aortic valve replacement (TAVR). METHODS: All consecutive adult patients undergoing TAVR for aortic stenosis from 1 January 2008 to 30 June 2014 at a tertiary referral hospital were included. AKI was defined based on Kidney Disease Improving Global Outcomes (KDIGO) criteria...
October 21, 2016: Renal Failure
Hiroaki Osada, Hiroyuki Nakajima, Katsuaki Meshii, Motoaki Ohnaka
A 75-year-old man who had undergone ascending aorta replacement for acute Type A aortic dissection presented with a recurring high fever. Transesophageal echocardiography revealed that a vegetation had formed on the re-dissected intimal flap of the noncoronary sinus of Valsalva. This didactic case suggests that antibiotic prophylactic measures be considered for aortic dissection flaps as for irregular valves susceptible to infective endocarditis.
February 2016: Aorta (Stamford, Conn.)
Maria João Sousa, Vasco Alves, Sofia Cabral, Nuno Antunes, Luís Sousa Pereira, Filomena Oliveira, João Silveira, Severo Torres
Mitral valve aneurysms are rare and occur most commonly in association with aortic valve endocarditis. Transesophageal echocardiography is the most sensitive imaging modality for the diagnosis of this entity and its potential complications, such as leaflet rupture and mitral regurgitation, which mandate prompt surgical intervention. We present the case of a 70-year-old male patient with aortic valve endocarditis complicated with a ruptured aneurysm of the anterior mitral valve leaflet and associated severe mitral regurgitation, diagnosed by transesophageal echocardiography, with impressive images...
October 17, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Fadi J Sawaya, Ole De Backer
No abstract text is available yet for this article.
October 24, 2016: JACC. Cardiovascular Interventions
Jochen Reinöhl, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Manfred Zehender, Constantin von Zur Mühlen, Christoph Bode, Peter Stachon
OBJECTIVES: The aim of this study was to assess how the introduction of transcatheter aortic valve replacement (TAVR) has changed clinical practice and outcome in patients who have previously undergone coronary artery bypass grafting (CABG). BACKGROUND: A significant proportion of patients admitted for aortic valve replacement have previously undergone CABG and are therefore at increased operative risk in case of redo surgery. METHODS: In-hospital outcome data were analyzed from patients with or without previous CABG undergoing isolated surgical aortic valve replacement or TAVR in Germany from 2007 to 2013...
October 24, 2016: JACC. Cardiovascular Interventions
Helene Eltchaninoff
No abstract text is available yet for this article.
October 24, 2016: JACC. Cardiovascular Interventions
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