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Aortic valvuloplasty

Shigeaki Aoyagi, Takeshi Oda, Kumiko Wada, Eiji Nakamura, Tomokazu Kosuga, Hiroshi Yasunaga
We report a case of aortic valve infective endocarditis (IE) in a 24-year-old man with atopic dermatitis (AD). He had a history of balloon valvuloplasty for a stenotic bicuspid aortic valve, and had dental caries but no invasive dental procedure before the onset of IE. On admission, skin lesions of AD with itching and scratches were found on the neck, trunk, and extremities. Echocardiography showed a vegetation on the aortic valve with mild steno-regurgitation, but extension of IE to the annulus was not detected...
March 20, 2018: International Heart Journal
Joseph D Kuebler, Jill Shivapour, Selcen Yaroglu Kazanci, Kimberlee Gauvreau, Steven D Colan, Doff B McElhinney, David W Brown
BACKGROUND: Aortic stenosis has been reported to manifest a slow rate of progression in mild disease, with a greater likelihood of progression in patients with moderate-severe disease. The natural history of the Doppler-estimated maximum gradient (DEMG) in patients after balloon aortic valvuloplasty (BAVP) has not previously been studied on a large scale. METHODS AND RESULTS: A retrospective review was performed of 360 patients from 1984 to 2012 with aortic stenosis, providing a total of 2059 echocardiograms both before and after BAVP...
March 2018: Circulation. Cardiovascular Imaging
Toshinari Onishi, Kaoruko Sengoku, Yasuhiro Ichibori, Isamu Mizote, Koichi Maeda, Toru Kuratani, Yoshiki Sawa, Yasushi Sakata
Transcatheter aortic valve implantation (TAVI) is an effective and less invasive treatment for the increasing population of individuals with severe aortic stenosis (AS). Echocardiography is crucial in the assessment of AS patients from pre- to post-procedure. Transthoracic echocardiography (TTE) may be used to assess patient suitability for TAVI, as well as evaluate the severity of AS, the aortic valve complex, aortic valve morphology, mitral regurgitation (MR), and left ventricular function. Transesophageal echocardiography (TEE) is usually used as an intra-procedural monitoring tool to provide feedback during the procedure, to assess prosthetic valve function, and to detect complications rapidly before and after balloon aortic valvuloplasty (BAV) or transcatheter heart valve (THV) deployment...
February 2018: Cardiovascular Diagnosis and Therapy
Gerlando Pilato, Claudia I Tamburino, Corrado Tamburino
No abstract text is available yet for this article.
February 2018: Journal of Cardiovascular Medicine
Peter Murin, Nicodème Sinzobahamvya, Antonia Schulz, Victoria Lorenzen, Stanislav Ovroutski, Felix Berger, Joachim Photiadis, Mi-Young Cho
OBJECTIVES: The technique of subcoronary autograft implantation for the Ross procedure has shown excellent durability of aortic valve function in adults. However, its use in children with hypoplastic aortic annulus or multilevel left ventricular outflow tract obstruction (LVOTO) was traditionally precluded. We combined this technique with a Konno incision and evaluated LVOTO relief and durability of the autograft function in growing patients. METHODS: Between January 2012 and January 2017, 13 patients with severe LVOTO and hypoplastic aortic annulus underwent Ross-Konno procedure with subcoronary autograft implantation...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
Giorgia M Bosi, Claudio Capelli, Mun Hong Cheang, Nicola Delahunty, Michael Mullen, Andrew M Taylor, Silvia Schievano
Patient-specific computational models are an established tool to support device development and test under clinically relevant boundary conditions. Potentially, such models could be used to aid the clinical decision-making process for percutaneous valve selection; however, their adoption in clinical practice is still limited to individual cases. To be fully informative, they should include patient-specific data on both anatomy and mechanics of the implantation site. In this work, fourteen patient-specific computational models for transcatheter aortic valve replacement (TAVR) with balloon-expandable Sapien XT devices were retrospectively developed to tune the material parameters of the implantation site mechanical model for the average TAVR population...
February 20, 2018: Journal of Biomechanics
Ilan A Marcuschamer, Aryeh Abelow, Ran Kornowski
The Impella is a mechanical circulatory support device that supports ventricular function. Since 2008, when the first Impella device received Food and Drug Administration clearance, its use has become increasingly prevalent. A variety of Impella devices are available, and are differentiated by size, power, and insertion techniques. These versions of the Impella have been used in a multitude of clinical scenarios, both emergent and elective, including high-risk coronary interventions, acute myocardial infarction complicated by cardiogenic shock, decompensated left and right heart failure, high-risk ventricular tachycardia ablations, and aortic valvuloplasty...
February 20, 2018: Coronary Artery Disease
Mark Webster, Sanjeevan Pasupati, Nigel Lever, Martin Stiles
OBJECTIVE: This first-in-human study evaluated the safety and technical feasibility of the Tempo temporary cardiac pacing lead (BioTrace Medical), which includes a novel fixation mechanism and soft tip. BACKGROUND: Complications of temporary pacing leads include dislodgment, arrhythmias, and ventricular perforation. Temporary pacing applications have increased with transcatheter aortic valve replacement (TAVR) growth, for rapid pacing during balloon valvuloplasty (BAV) and valve deployment, and for periprocedural bradyarrhythmia support...
February 15, 2018: Journal of Invasive Cardiology
Aaron R Prosnitz, Monika Drogosz, Audrey C Marshall, Louise E Wilkins-Haug, Carol B Benson, Lynn A Sleeper, Wayne Tworetzky, Kevin G Friedman
OBJECTIVE: To describe the early hemodynamic changes after fetal aortic valvuloplasty (FAV) for evolving hypoplastic left heart syndrome due to mid-gestational aortic stenosis and to assess whether these early changes predict biventricular (BiV) circulation at neonatal discharge. METHOD: We retrospectively reviewed all technically successful FAV cases resulting in live birth between 2000 and 2015 (n=93, 45% BiV circulation at neonatal discharge). Paired testing methods were used to compare pre- and post-intervention measures of left ventricular hemodynamics...
February 13, 2018: Prenatal Diagnosis
Emmanouil Chourdakis, Ioanna Koniari, Nicholas G Kounis, Dimitrios Velissaris, George Hahalis, Karl Eugen Hauptmann
No abstract text is available yet for this article.
January 2018: Journal of Geriatric Cardiology: JGC
Chawki ElZein, David Roberson, Nour Hammad, Michel Ilbawi
At present, aortic valvuloplasty is considered an effective procedure for treatment of aortic regurgitation in pediatric patients. It has encouraging mid- and long-term results. The improved outcome is primarily related to better understanding of the functional anatomy of the normal valve and the different factors that alter it. It is also related to the realization that outcome after valvuloplasty is dependent on comprehensive repair of all of the involved components of the aortic root. Refinement in preoperative diagnosis has helped identify these abnormal components and focus the surgical approach on the needed reconstruction...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Philippe J van Rosendael, Victoria Delgado, Jeroen J Bax
Aims: The incidence of new-onset conduction abnormalities requiring permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) with new-generation prostheses remains debated. This systematic review analyses the incidence of PPI after TAVI with new-generation devices and evaluates the electrical, anatomical, and procedural factors associated with PPI. In addition, the incidence of PPI after TAVI with early generation prostheses was reviewed for comparison...
February 6, 2018: European Heart Journal
Xianbao Liu, Yuxin He, Qifeng Zhu, Feng Gao, Wei He, Lei Yu, Qijing Zhou, Minjian Kong, Jian'an Wang
OBJECTIVES: To explore assessment of supra-annular structure for self-expanding transcatheter heart valve (THV) size selection in patients with bicuspid aortic stenosis (AS). BACKGROUND: Annulus-based device selection from CT measurement is the standard sizing strategy for tricuspid aortic valve before transcatheter aortic valve replacement (TAVR). Because of supra-annular deformity, device selection for bicuspid AS has not been systemically studied. METHODS: Twelve patients with bicuspid AS who underwent TAVR with self-expanding THVs were included in this study...
February 5, 2018: Catheterization and Cardiovascular Interventions
Marc Eugène, Marina Urena, Jérémie Abtan, José-Luis Carrasco, Walid Ghodbane, Patrick Nataf, Alec Vahanian, Dominique Himbert
The prognosis of patients with cardiogenic shock (CS) or refractory pulmonary edema because of severe aortic stenosis remains poor. The purpose of this study was to assess the outcomes of rescue percutaneous balloon aortic valvuloplasty (PBAV) in the transcatheter aortic valve implantation (TAVI) era. Patients were consecutively included between 2008 and 2016. CS was defined as ≥1 sign of systemic hypoperfusion and need of catecholamines. Refractory pulmonary edema was defined as not controlled by optimal medical treatment...
December 29, 2017: American Journal of Cardiology
Ankur Kalra, Raj R Makkar, Deepak L Bhatt, Sahil Khera, Neal S Kleiman, Michael J Reardon, Morton J Kern
Transcatheter aortic valve replacement (TAVR) has become the preferred therapy for treatment of severe aortic stenosis in patients at intermediate to high risk of perioperative mortality following surgical aortic valve replacement. Haemodynamic assessment is an integral part of the procedure, and it is crucial for the operator to have an in-depth understanding of the haemodynamic alterations that occur during balloon aortic valvuloplasty and transcatheter valve deployment. Comprehension of the haemodynamic tracings is also pivotal for early recognition of periprocedural complications...
2018: Open Heart
Yin-Yu Lin, Ming-Ren Chen
The use of balloon aortic valvuloplasty for congenital aortic valve stenosis was well established in literatures. However, balloon aortic valvuloplasty performed in low body weight neonates had been infrequently reported. Here we report a 5-day-old premature neonate diagnosed critical aortic valve stenosis. Balloon aortic valvuloplasty was performed as first-line therapy while the patient weighed only 1493 g. Balloon aortic valvuloplasty went successfully with transvalvular pressure gradient decreased from 80 mmHg to 44 mmHg...
January 2018: Acta Cardiologica Sinica
Akihiro Nakajima, Hiroyoshi Kawamoto, Tatsuya Nakao, Sunao Nakamura
Pseudoaneurysm is one of the complications after arterial cannulation. We report the case of a patient with ST-segment elevation myocardial infarction due to aortic pseudoaneurysm after surgical mitralvalvuloplasty. Careful evaluation should be performed in cases of ST-segment elevation myocardial infarction following cardiac surgery, even after several months.
January 16, 2018: European Journal of Cardio-thoracic Surgery
Valeria Cammalleri, Francesco Romeo, Massimo Marchei, Andrea Anceschi, Gianluca Massaro, Saverio Muscoli, Francesca De Persis, Massimiliano Macrini, Gian P Ussia
PURPOSE: The aim of our study was to assess the arterial cerebral blood flow variations in patients with aortic valve stenosis, immediately after the transcatheter aortic valve implantation (TAVI). METHODS: The study population includes 62 consecutive patients who underwent TAVI for aortic valve stenosis (95%) and sugical bioprosthesis degeneration (5%). Carotid Doppler examination was performed recording blood flow, systolic peak velocity, time average mean velocity and mean acceleration time at baseline, after balloon aortic valvuloplasty, and within 10 min after the device release...
January 17, 2018: Journal of Cardiovascular Medicine
Kevin G Friedman, Lynn A Sleeper, Raina N Fichorova, Taylor Weilnau, Wayne Tworetzky, Louise E Wilkins-Haug
OBJECTIVE: Fetal aortic stenosis (AS) imposes pressure load on the developing left ventricle (LV) and leads to derangements in myocardial structure and function via mechanisms that are not well characterized. METHODS: We compared amniotic fluid NT-BNP and troponin levels in fetuses with AS prior to fetal valvuloplasty and controls. We estimated correlations between NT-BNP and fetal echo parameters and identify NT-BNP cutoff associated with biventricular outcome RESULTS: Median NT-BNP level was higher in fetal AS than controls (3858 vs 1737 pg/mL, P < 0...
January 11, 2018: Prenatal Diagnosis
Monoj K Konda, Jagadeesh K Kalavakunta, Jerry W Pratt, David Martin, Vishal Gupta
An 88-year-old woman with a prior history of aortic stenosis and history of valvuloplasty presented with worsening symptoms of heart failure and dizziness. She underwent successful transcatheter aortic valve replacement (TAVR) without complications. Follow-up echocardiograms revealed a small fistula connecting aorta to the right ventricle. The patient was initially asymptomatic but 3 months later developed overload of the right ventricle and heart failure and chose to continue medical therapy. She died of progressive heart failure at 9 months from onset of fistula...
October 2017: Heart Views: the Official Journal of the Gulf Heart Association
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