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Percutaneous aortic valve replacement

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https://www.readbyqxmd.com/read/28633252/delayed-management-of-partial-aortic-valve-avulsion-after-transcatheter-aortic-valve-replacement
#1
Dimitri Sherev, Khalid Azizi, Nassir A Azimi, Susan Van Nordheim, Ricardo Moreno-Cabral
We report a case of delayed treatment of a partial aortic valve leaflet avulsion during transcatheter aortic valve replacement (TAVR) and its successful management by a percutaneous snare retrieval technique. Post-TAVR transesophogeal echocardiography showed an avulsed native valve leaflet. We deferred retrieval of the mass with anticoagulant agents. One month later, a 30-mm EN-Snare was used to snare the mass. This case report demonstrates that the management of an avulsed aortic valve leaflet can be safely deferred with the use of an anticoagulant agent...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28600091/transcatheter-aortic-valve-replacement-and-mitraclip-to-reverse-heart-failure
#2
REVIEW
Sukhdeep Basra, Molly Szerlip
Valvular heart diseases such as aortic stenosis and mitral regurgitation are often associated with heart failure, which in turn increases patients' Surgical Thoracic Society (STS) score. A high STS score means the patient is high risk for surgical aortic valve replacement and mitral valve repair/replacement. Transcatheter aortic valve replacement and percutaneous mitral valve repair offer a minimally invasive alternative for the treatment of valvular heart disease in patients with severe heart failure. We aim to review the current evidence on the safety, efficacy, and outcomes of these devices in patients with severe heart failure...
July 2017: Interventional cardiology clinics
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
#3
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/28583682/outcome-of-stent-graft-implantation-for-treatment-of-access-site-bleeding-after-transfemoral-transcatheter-aortic-valve-replacement
#4
Adi Segal, Moshe Y Flugelman, Nader Khader, Ronen Rubinshtein, Idit Lavi, Ron Karmeli, Ayman Jubran, Avinoam Shiran, Ronen Jaffe
Vascular complications are common after transcatheter aortic valve replacement (TAVR) and are associated with increased morbidity and mortality. Stent graft implantation enables percutaneous treatment of access site bleeding; however, the efficacy and durability and of this approach are unknown. We studied the immediate outcome of stent graft implantation for control of access site bleeding and the need for repeat vascular interventions after stenting, in a cohort of consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR...
May 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28579163/use-of-two-dimensional-ultrasonographically-guided-access-to-reduce-access-related-complications-for-transcatheter-aortic-valve-replacement
#5
Gabby Elbaz-Greener, Nevena Zivkovic, Yaron Arbel, Sam Radhakrishnan, Stephen E Fremes, Harindra C Wijeysundera
BACKGROUND: Major vascular complications have been associated with increased mortality and morbidity in patients undergoing transcatheter aortic valve replacement (TAVR). Our objective was to compare vascular and bleeding outcomes with the routine use of 2-dimensional ultrasonography (2D-US) guided femoral artery access in percutaneous transfemoral TAVR compared with traditional anatomic landmark palpation with angiographically-guided access. METHODS: This single-centre retrospective cohort study was conducted in Ontario, Canada...
April 4, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28570242/percutaneous-transaxillary-transcatheter-aortic-valve-replacement
#6
Rajiv Tayal, Amer Hawatmeh, Mohammad Thawabi, Bruce Haik, Najam Wasty, Mark Russo
The axillary artery is an alternative, large-caliber vessel that can be utilized in the presence of hostile aortoiliac segments. It can accommodate sheaths up to 18 Fr and is infrequently affected by atherosclerosis.
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28570233/sex-related-differences-in-outcomes-after-percutaneous-balloon-aortic-valvuloplasty
#7
Marzena Daniec, Artur Dziewierz, Danuta Sorysz, Paweł Kleczyński, Tomasz Rakowski, Łukasz Rzeszutko, Jarosław Trębacz, Marek Tomala, Bartłomiej Nawrotek, Krzysztof Żmudka, Dariusz Dudek
OBJECTIVES: We aimed to evaluate sex-related differences in short-term and long-term outcomes of patients undergoing balloon aortic valvuloplasty (BAV) for severe aortic stenosis (AS). METHODS: A total of 112 patients with severe AS underwent 114 BAV procedures as palliative procedure, bridge to definitive treatment, or before urgent non-cardiac surgery. Patients were followed for 24 months. RESULTS: Of the 112 patients, 70 (62.5%) were women...
June 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28549918/percutaneous-pulmonary-melody-%C3%A2-valve-implantation-in-small-conduits
#8
Myriam Bensemlali, Sophie Malekzadeh-Milani, Meriem Mostefa-Kara, Damien Bonnet, Younes Boudjemline
BACKGROUND: The Melody(®) pulmonary valve has received approval for the treatment of dysfunctional right ventricular (RV) outflow tract conduits ≥16mm. AIMS: To investigate technical and clinical outcomes in patients who underwent percutaneous pulmonary valve implantation (PPVI) in conduits ≤16mm. METHODS: Eleven patients were enrolled retrospectively between 2000 and 2015 in a cardiac referral centre. RESULTS: The PPVI indications were obstruction (n=5); regurgitation (n=1); and mixed lesions (n=5)...
May 23, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28544828/acute-aortic-regurgitation-in-the-current-era-of-percutaneous-treatment-pathophysiology-and-hemodynamics
#9
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
#10
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
#11
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...
July 15, 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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