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Aortic valve replacement

Chengcheng Zhu, Kimberly Kallianos, Travis Henry, Michael D Hope
No abstract text is available yet for this article.
April 2018: Radiology
Muhammet Onur Hanedan, Mehmet Ali Yuruk, Ali Ihsan Parlar, Ugur Ziyrek, Ali Kemal Arslan, Ufuk Sayar, Ilker Mataraci
In elderly, high-risk surgical patients, sutureless aortic valve replacement (AVR) can often be an alternative to conventional AVR; shorter aortic cross-clamp and cardiopulmonary bypass times are the chief advantages. We compared the outcomes of sutureless AVR with those of conventional AVR in 70 elderly patients who underwent concomitant cardiac surgical procedures. We retrospectively analyzed the cases of 42 men and 28 women (mean age, 70.4 ± 10.3 yr; range, 34-93 yr) who underwent cardiac operations plus AVR with either a sutureless valve (group 1, n=38) or a conventional bioprosthetic or mechanical valve (group 2, n=32)...
February 2018: Texas Heart Institute Journal
Tania Pawade, Marie-Annick Clavel, Christophe Tribouilloy, Julien Dreyfus, Tiffany Mathieu, Lionel Tastet, Cedric Renard, Mesut Gun, William Steven Arthur Jenkins, Laurent Macron, Jacob W Sechrist, Joan M Lacomis, Virginia Nguyen, Laura Galian Gay, Hug Cuéllar Calabria, Ioannis Ntalas, Timothy Robert Graham Cartlidge, Bernard Prendergast, Ronak Rajani, Arturo Evangelista, João L Cavalcante, David E Newby, Philippe Pibarot, David Messika Zeitoun, Marc R Dweck
BACKGROUND: Computed tomography aortic valve calcium scoring (CT-AVC) holds promise for the assessment of patients with aortic stenosis (AS). We sought to establish the clinical utility of CT-AVC in an international multicenter cohort of patients. METHODS AND RESULTS: Patients with AS who underwent ECG-gated CT-AVC within 3 months of echocardiography were entered into an international, multicenter, observational registry. Optimal CT-AVC thresholds for diagnosing severe AS were determined in patients with concordant echocardiographic assessments, before being used to arbitrate disease severity in those with discordant measurements...
March 2018: Circulation. Cardiovascular Imaging
Anna Lahori, Jonathan Frogel, John G Augoustides, Prakash A Patel, William J Vernick, Jacob T Gutsche, Jared W Feinman, Saumil Patel, Ray Munroe, Emily J MacKay, Stuart J Weiss, Sanjay Dwarakanath, Richard D Sheu
No abstract text is available yet for this article.
February 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Steven Maximus, Jeffrey C Milliken, Beate Danielsen, Richard Shemin, Junaid Khan, Joseph S Carey
OBJECTIVE: Transcatheter aortic valve replacement (TAVR) procedures were introduced in 2011. Initially, procedures were limited to patients who were not surgical candidates, but subsequently high-risk surgical candidates were considered for TAVR. The influence on aortic valve surgery in California is unknown. METHODS: The California Office of Statewide Health Planning and Development hospitalized patient discharge database was queried for the years 2009 through 2014...
April 2018: Journal of Thoracic and Cardiovascular Surgery
Carl A Johnson, Amber L Melvin, Brandon F Lebow, Amanda Yap, Peter A Knight
Aortic valve replacement through minimally invasive access is increasing. These procedures have several advantages over conventional sternotomy including decreased intensive care unit and hospital length of stay and decreased ventilation time. The right anterior mini-thoracotomy (RAM) approach is potentially attractive in that it completely spares the sternum leading to improved cosmesis, reduced blood loss, and improved patient satisfaction. However, this approach is underutilized due to anticipated technical challenges including difficulty with visualization and annular suture placement...
2018: Journal of Visualized Surgery
Carl A Johnson, Katherine L Wood, Amber L Melvin, Brandon F Lebow, Peter A Knight
Aortic root replacement is typically performed through a median sternotomy. The right anterior mini-thoracotomy approach has been shown to decrease hospital length of stay in aortic valve surgery when compared to sternotomy. This approach is rare in ascending aortic surgery due to technical challenges which include exposure and annular suture placement. Automated suturing technology is now available to facilitate the placement of annular sutures. The use of a camera greatly enhances visualization of the aortic root...
2018: Journal of Visualized Surgery
Katharina Huenges, Bernd Panholzer, Jochen Cremer, Assad Haneya
Left ventricular assist device (LVAD) is nowadays a routine therapy for patients with advanced heart failure. We present the case of a 74-year-old male patient who was admitted to our center with terminal heart failure in dilated cardiomyopathy and ascending aortic aneurysm with aortic valve regurgitation. The LVAD implantation with simultaneous aortic valve and supracoronary ascending aortic replacement was successfully performed.
2018: Case Reports in Medicine
Cagdas Baran, Mustafa Serkan Durdu, Fatih Gumus, Mehmet Cakici, Mustafa Bahadir Inan, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: Sutureless aortic valve replacement (SU-AVR) is an alternative technique to standard aortic valve replacement. We evaluated our experience with the Perceval SU-AVR with concomitant mitral valve surgery, with or without tricuspid valve surgery, and aimed to discuss the technical considerations. METHODS: From January 2013 through June 2016, 30 patients with concomitant severe mitral valve disease, with or without tricuspid valve disease, underwent SU-AVR with the Perceval prosthesis in a single center...
February 21, 2018: Journal of Thoracic and Cardiovascular Surgery
François Huchet, Fanny d'Acremont, Vincent Letocart, Patrice Guerin, Gael Grimandi, Thibaut Manigold
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has revolutionized the prognosis of inoperable patients with severe aortic valve stenosis. Yet, the implantation of expensive prostheses in patients with comorbidities may be questionable in an era when healthcare costs are becoming a major concern. AIM: The objective of this study was to assess whether the TAVR procedure is profitable in a high-volume French hospital. METHODS: Consecutive patients eligible for transfemoral TAVR using the SAPIEN bioprostheses (Edwards Lifesciences, Irvine, CA, USA) were included retrospectively in this single-centre study between September 2014 and December 2015...
March 15, 2018: Archives of Cardiovascular Diseases
Guson Kang, Juyong Brian Kim
Since the first-in-man transcatheter delivery of an aortic valve prosthesis in 2002, the landscape of aortic stenosis therapeutics has shifted dramatically. While initially restricted to non-surgical cases, progressive advances in transcatheter aortic valve replacement and our understanding of its safety and efficacy have expanded its use in intermediate and possibly low surgical risk patients. In this review, we explore the past, present, and future of transcatheter aortic valve replacement.
March 20, 2018: Korean Journal of Internal Medicine
Hui Li, Miguel Castro, Pascal Haigron, Jean-Philippe Verhoye, Vito Giovanni Ruggieri
PURPOSE: Minimally invasive aortic valve replacement (MIAVR) procedures remain more complex and technically challenging compared to conventional full sternotomy surgery. This technique involves a restricted surgical field and a limited workspace, which is, at present, strictly reserved for the most experienced surgeons. The MIAVR clinical outcomes are strongly dependent on the appropriate choice of the thoracic incision. This work presents a decision support system to optimize, through an interactive visualization interface, the exposure of the target structure in a limited field of view...
March 17, 2018: International Journal of Computer Assisted Radiology and Surgery
Thomas Ratschiller, Sames-Dolzer Eva, Wolfgang Schimetta, Patrick Paulus, Hannes Müller, Andreas Zierer, Rudolf Mair
OBJECTIVE: Autograft dilatation is the main long-term complication following the Ross procedure using the freestanding root replacement technique. We reviewed our 25-year experience with the Ross procedure with a special emphasis on valve-sparing reoperations. METHODS: From 1991 to 2016, 153 patients (29.6 ± 16.6 years; 29.4% pediatric) underwent a Ross operation at our institution with implantation of the autograft as freestanding root replacement. The follow-up is 98...
February 20, 2018: Journal of Thoracic and Cardiovascular Surgery
Divyanshu Mohananey, Kesavan Sankaramangalam, Arnav Kumar, Yash Jobanputra, Pedro Villablanca, Amar Krishnaswamy, Stephanie Mick, Lars G Svensson, E Murat Tuzcu, Samir R Kapadia
BACKGROUND: Stroke after transcatheter aortic valve replacement (TAVR) occurs with an incidence of 4-11% and is a particularly devastating adverse event associated with the procedure. Several cerebral protection devices (CPD) have been developed to prevent cerebrovascular events during TAVR. While most studies have shown CPD to be associated with decreased number and volume of lesions on diffusion weighted magnetic resonance imaging, the clinical benefit of these devices remains uncertain...
February 16, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Marta Obremska, Maria Boratyńska, Maciej Szymczak, Dorota Zyśko, Tomasz Płonek, Anna Goździk, Marian Klinger
INTRODUCTION    The dilatation of aortic root (AoR) correlates with cardiac damage and higher cardiovascular risk. The cardiovascular disease is the most common cause of death in patient after kidney transplantation ( KTX). OBJECTIVES    The aim of this study was to assess the prevalence of enlarged AoR diameter in patient after KTX. Patients with  bicuspid aortic valve, significant valvular disease or evidence of connective tissue disorder were excluded. PATIENTS AND METHODS    The all 87 patients after KTX were divided into 2 groups depend on immunosuppressive regimen :mTORi group: 41 patients treated with mammalian target of rapamycin inhibitors  and CNI group: 46 with calcineurin inhibitors...
March 17, 2018: Polish Archives of Internal Medicine
John M Trahanas, Benjamin S Van Boxtel, Steven E Miller, Christopher Irobunda, Susheel K Kodali, Isaac George
There are few case reports in the literature of transcatheter aortic valve replacement used as emergent therapy for aortic insufficiency. We present a case in which transcatheter aortic valve replacement was implemented successfully as a salvage therapy in a hemodynamically unstable patient experiencing aortic insufficiency as a result of a torn bio-prosthetic leaflet during an unrelated abdominal operation. The successful use of this technique in a non-cardiac operating room allowed the patient to be placed on extracorporeal support and ultimately to be discharged home...
March 13, 2018: Annals of Thoracic Surgery
Michel Carrier
No abstract text is available yet for this article.
February 24, 2018: Journal of Thoracic and Cardiovascular Surgery
Suk Ho Sohn, Myoung-Jin Jang, Ho Young Hwang, Kyung Hwan Kim
OBJECTIVES: This meta-analysis was conducted to compare the early and follow-up outcomes of aortic valve replacement using rapid deployment or sutureless (RD) valves (RDAVR group) with aortic valve replacement using conventional bioprostheses (CAVR group). METHODS: A literature search of 5 online databases was conducted. The primary outcomes were postoperative complications and the secondary outcomes included the aortic cross-clamp (ACC) and cardiopulmonary bypass (CPB) times and early mortality and all-cause mortality during follow-up...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Dan Rusinaru, Yohann Bohbot, Anne Ringle, Sylvestre Maréchaux, Momar Diouf, Christophe Tribouilloy
Aims: In patients with severe aortic stenosis (AS) and preserved left ventricular ejection fraction (LVEF), low flow (LF) is currently defined using Doppler-echocardiography by a stroke volume index (SVi)<35 mL/m2. However, the relationship between LF and outcome remains unclear as data on normal reference values defining LF are scarce, and previous studies did not explore the risk associated with other SVi cut-points. We analysed the relationship between LF and mortality in severe AS to establish prognostic LF values associated with mortality risk...
March 13, 2018: European Heart Journal
Konstadinos Plestis, Oleg Orlov, Vishal N Shah, Joshua Wong, Matthew Thomas, Alon Aharon, Cinthia Orlov, Georgia Panagopoulos, Scott Goldman
OBJECTIVES: Minimally invasive aortic valve replacement (MIAVR) can be technically demanding and may lead to prolonged operative time. We evaluated the intraoperative and postoperative patient outcomes following implementation of 2 facilitating technologies (FT) in MIAVR: the Cor-Knot titanium fastener and Custodiol-histidine-tryptophan-ketoglutarate solution. METHODS: A total of 299 patients underwent MIAVR from 2008 to 2016; 172 (57.5%) patients were included in the FT group and 127 (42...
March 14, 2018: Interactive Cardiovascular and Thoracic Surgery
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