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Percutaneous aortic valve replacement

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https://www.readbyqxmd.com/read/28544828/acute-aortic-regurgitation-in-the-current-era-of-percutaneous-treatment-pathophysiology-and-hemodynamics
#1
Baris Bugan, Erkan Yildirim, Murat Celik, Uygar Cagdas Yuksel
Aortic regurgitation (AR) is characterized by the backflow of blood from the aorta to the left ventricle. Acute AR typically causes severe pulmonary edema and hypotension, and is a surgical emergency. In chronic AR, however, compensatory mechanisms can clinically compensate for years, with normal left ventricular function and no symptoms. While the hemodynamic mechanisms of chronic AR on the left ventricle are well described, the hemodynamic mechanisms of acute AR are not clear. Most of the literature on acute AR includes either small series or case reports...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28544825/leaflet-hypomobility-after-transcatheter-aortic-valve-replacement-thrombosis-or-mechanical-factors-a-possible-pathophysiological-pattern
#2
Michele Gallo, Stefanos Demertzis, Gino Gerosa, Enrico Ferrari
Transcatheter heart valve replacement is an emerging technology in the treatment of valvular disease. During recent years, the opportunity to replace a heart valve via percutaneous access or via a miniinvasive access without the use of cardiopulmonary bypass has revolutionized the approach to this pathology. The different designs of transcatheter valves have also altered the spectrum of possible complications, with the unexpected occurrence of leaflet hypomobility after valve deployment. Here, the pathophysiological pattern of this complication is categorized, and an analysis provided of recently reported clinical evidences...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28535962/predictors-of-paravalvular-regurgitation-after-implantation-of-the-fully-repositionable-and-retrievable-lotus-transcatheter-aortic-valve-from-the-reprise-ii-trial-extended-cohort
#3
Daniel J Blackman, Ian T Meredith, Nicolas Dumonteil, Didier Tchétché, David Hildick-Smith, Mark S Spence, Darren L Walters, Jan Harnek, Stephen G Worthley, Gilles Rioufol, Thierry Lefèvre, Vicki M Houle, Dominic J Allocco, Keith D Dawkins
Paravalvular leak (PVL) after transcatheter aortic valve replacement is associated with worse long-term outcomes. The Lotus Valve incorporates an innovative Adaptive Seal designed to minimize PVL. This analysis evaluated the incidence and predictors of PVL after implantation of the Lotus transcatheter aortic valve. The REPRISE II (REpositionable Percutaneous Replacement of Stenotic Aortic Valve through Implantation of Lotus Valve System - Evaluation of Safety and Performance) Study With Extended Cohort enrolled 250 high-surgical risk patients with severe symptomatic aortic stenosis...
April 27, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28500739/feasibility-and-safety-of-transfemoral-sheathless-portico-aortic-valve-implantation-preliminary-results-in-a-single-center-experience
#4
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28494713/vascular-complications-associated-with-transcatheter-aortic-valve-replacement
#5
M Rizwan Sardar, Andrew M Goldsweig, J Dawn Abbott, Barry L Sharaf, Paul C Gordon, Afshin Ehsan, Herbert D Aronow
Transcatheter aortic valve replacement (TAVR) is now an accepted pathway for aortic valve replacement for patients who are at prohibitive, severe and intermediate risk for traditional aortic valve surgery. However, with this rising uptrend and adaptation of this new technology, vascular complications and their management remain an Achilles heel for percutaneous aortic valve replacement. The vascular complications are an independent predictor of mortality for patients undergoing TAVR. Early recognition of these complications and appropriate management is paramount...
June 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28475802/complete-fusion-of-a-percutaneous-aortic-valve-placed-after-ventricular-assist-device
#6
Stephen L Derryberry, Renaldo D Williams, Joseph L Fredi, Stephen K Ball
Severe aortic insufficiency following continuous flow left ventricular assist device (LVAD) placement requires intervention. Conventional corrective approaches are varied and morbid. Increasingly, percutaneous solutions, such as transcatheter aortic valve replacement (TAVR), have been used to rescue these patients. The unique flow characteristics in the aortic root following LVAD implantation may have unintended consequences to the TAVR leaflets. We describe the premature fusion of TAVR leaflets following 159 days of LVAD support...
May 4, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28461798/transcatheter-aortic-valve-implantation-in-a-patient-with-unicuspid-aortic-valve
#7
Angelo Nascimbene, Pranav Loyalka, Igor D Gregoric, Ricardo Bellera, Maan Malahfji, Marija Petrovic, Biswajit Kar
Transcatheter aortic valve replacement (TAVR) in patients with bicuspid aortic valves has been successfully performed, but there is a lack of published experience in percutaneous treatment of patients with unicuspid valves and severe aortic stenosis. We describe a case of TAVR in such a patient. A 31-year-old woman with Turner syndrome-who had undergone coarctation repair via subclavian flap at age 7 days and an aortic valvotomy at age 6 weeks-presented with severe symptomatic aortic stenosis. She was deemed inoperable because of her severe pulmonary hypertension and numerous comorbidities; consequently, a 20-mm Edwards Sapien 3 Transcatheter Heart Valve was offered for compassionate use...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#8
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28396989/cardiac-surgery-2016-reviewed
#9
REVIEW
Torsten Doenst, Yasin Essa, Khalil Jacoub, Alexandros Moschovas, David Gonzalez-Lopez, Hristo Kirov, Mahmoud Diab, Steffen Bargenda, Gloria Faerber
For the year 2016, more than 20,000 published references can be found in Pubmed when entering the search term "cardiac surgery". Publications last year have helped to more clearly delineate the fields where classic surgery and modern interventional techniques overlap. The field of coronary bypass surgery (partially compared to percutaneous coronary intervention) was enriched by five large prospective randomized trials. The value of CABG for complex coronary disease was reconfirmed and for less complex main stem lesions, PCI was found potentially equal...
April 10, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28386811/left-main-coronary-malperfusion-from-acute-non-communicating-aortic-dissection
#10
Mototsugu Tamaki, Hideki Kitamura, Yutaka Koyama, Arishige Kimura, Yasuhide Okawa
A 64-year-old man was admitted with sudden back and chest pain. He had undergone aortic valve replacement 5 years earlier. Enhanced computed tomography showed acute type A non-communicating aortic dissection. He was initially treated with supportive medical therapy. Since he was restless, he was placed on a respirator. He went into sudden shock 6 h after onset. Percutaneous cardiopulmonary support was administered, and coronary arteriography showed progression of the dissection to the left main trunk. Percutaneous coronary intervention was performed...
April 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28383864/-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-with-severe-symptomatic-aortic-stenosis
#11
REVIEW
P Lancellotti, H Kulbertus
Aortic valve stenosis (AS) is the most commonly operated valvular heart disease in developed countries. Aortic valve replacement is the sole effective treatment of symptomatic patients. PARTNER-1 (Placement of AoRtic TraNscathetER Valves) has recently proved the efficacy of percutaneous aortic valve replacement (TAVI : Transcatheter Aortic Valve Implantation) in patients at high surgical risk, or inoperable. In the present article, we report and discuss the results of the PARTNER-2 study in intermediate risk patients...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28380656/early-results-of-surgical-simultaneous-therapy-for-significant-carotid-artery-stenosis-and-heart-disease
#12
Marc Irqsusi, Alessandro Vannucchi, Julius Beckers, Stefan Kasseckert, Stefan Waldhans, Sebastian Vogt, Rainer G H Moosdorf
Background The purpose of this single-center, retrospective study was to review the early outcome with defined endpoints of myocardial infarction, brain injury, and death after coronary bypass grafting and simultaneous carotid endarterectomy with or without combined valve replacement. Methods During the preoperative investigation 52 (44 males, 8 females) patients were examined by cardiac catheterization within the scope of their coronary status. In addition, all patients underwent echocardiography, CT angiography of the supra-aortic vessels, and full description of their neurologic status...
April 5, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28374279/design-analysis-and-testing-of-a-novel-mitral-valve-for-transcatheter-implantation
#13
Selim Bozkurt, Georgia L Preston-Maher, Ryo Torii, Gaetano Burriesci
Mitral regurgitation is a common mitral valve dysfunction which may lead to heart failure. Because of the rapid aging of the population, conventional surgical repair and replacement of the pathological valve are often unsuitable for about half of symptomatic patients, who are judged high-risk. Transcatheter valve implantation could represent an effective solution. However, currently available aortic valve devices are inapt for the mitral position. This paper presents the design, development and hydrodynamic assessment of a novel bi-leaflet mitral valve suitable for transcatheter implantation...
April 3, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28369578/sutureless-aortic-bioprosthesis
#14
José Martínez-Comendador, Mario Castaño, Javier Gualis, Elio Martín, Pasquale Maiorano, Javier Otero
Aortic valve replacement (AVR) is the treatment of choice for aortic valve disease, with excellent results reported in the short- and long-term follow-up. Due to the increasing number of patient comorbidities and older age, various technical alternatives have been developed such as transcatheter aortic valve implantation and, more recently, sutureless valve bioprostheses. For patients with very high surgical risk, transcatheter implantation is becoming the top therapeutic option. However, the percutaneous technique still has major disadvantages including those related to implantation without excision of the diseased native valve without direct view of the annulus, which increases the probability of developing perivalvular leaks and a high percentage of atrioventricular block...
March 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28336789/percutaneous-therapy-for-tricuspid-regurgitation-a-new-frontier-for-interventional-cardiology
#15
EDITORIAL
Samir Kapadia, Amar Krishnaswamy, E Murat Tuzcu
No abstract text is available yet for this article.
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28336114/paradoxical-aortic-stenosis-a-systematic-review
#16
Rita Cavaca, Rogério Teixeira, Maria João Vieira, Lino Gonçalves
Aortic stenosis (AS) is a complex systemic valvular and vascular disease with a high prevalence in developed countries. The new entity "paradoxical low-flow, low-gradient aortic stenosis" refers to cases in which patients have severe AS based on assessment of aortic valve area (AVA) (≤1 cm(2)) or indexed AVA (≤0.6 cm(2)/m(2)), but paradoxically have a low mean transvalvular gradient (<40 mmHg) and a low stroke volume index (≤35 ml/m(2)), despite preserved left ventricular ejection fraction (≥50%)...
April 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28335899/percutaneous-plug-based-arteriotomy-closure-device-for-large-bore-access-a-multicenter-prospective-study
#17
Nicolas M Van Mieghem, Azeem Latib, Jan van der Heyden, Lennart van Gils, Joost Daemen, Todd Sorzano, Jurgen Ligthart, Karin Witberg, Thom de Kroon, Nathaniel Maor, Antonio Mangieri, Matteo Montorfano, Peter P de Jaegere, Antonio Colombo, Gary Roubin
OBJECTIVES: The authors sought to study the safety and efficacy of the MANTA Vascular Closure Device (VCD), a novel collagen-based technology dedicated to closure of large-bore arteriotomies. BACKGROUND: Novel transfemoral therapeutic interventions requiring large-bore catheters have become valid minimally invasive options but have inherent access management challenges. To date, no dedicated vascular closure devices exist for large arteriotomies. METHODS: A prospective, single-arm clinical investigation enrolling patients who underwent elective percutaneous interventions with large-bore catheters and planned percutaneous arteriotomy closure in 3 European institutions...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#18
Ana Rita G Francisco, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Cláudia Jorge, Doroteia Silva, Eduardo Infante de Oliveira, Fausto J Pinto, Pedro Canas da Silva
INTRODUCTION: Percutaneous balloon aortic valvuloplasty (BAV) has been limited by the risk of complications and restenosis. However, growing use of transcatheter aortic valve implantation (TAVI) has revived interest in this technique. We analyzed the current indications for BAV and outcomes in a single center. METHODS: Acute results and long-term outcomes were analyzed in a retrospective single-center registry of patients undergoing BAV between January 2013 and January 2016...
April 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#19
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28296026/bioprosthetic-mitral-valve-paravalvular-leak-closure-using-intracardiac-echocardiography-guided-three-dimensional-electroanatomic-mapping
#20
Subhi J Al'Aref, Richard B Devereux, Jim W Cheung, Geoffrey Bergman
The development of paravalvular leak (PVL) following surgical replacement of an aortic or mitral valve is an uncommon complication with significant morbidity and mortality. Surgical or percutaneous repair of PVL can be technically challenging. We describe the application of intracardiac echocardiography guided 3-dimensional electroanatomic mapping to facilitate PVL closure in a symptomatic patient with a previously placed bioprosthetic mitral valve. © 2017 Wiley Periodicals, Inc.
March 15, 2017: Catheterization and Cardiovascular Interventions
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