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Percutaneous aortic valve replacement

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https://www.readbyqxmd.com/read/28219920/impact-of-coronary-artery-disease-severity-assessed-with-the-syntax-score-on-outcomes-following-transcatheter-aortic-valve-replacement
#1
Jean-Michel Paradis, Jonathon M White, Philippe Généreux, Marina Urena, Darshan Doshi, Tamim Nazif, Rebecca Hahn, Isaac George, Omar Khalique, Kishore Harjai, Laura Lasalle, Benoit M Labbé, Robert DeLarochellière, Daniel Doyle, Éric Dumont, Siamak Mohammadi, Martin B Leon, Josep Rodés-Cabau, Susheel Kodali
BACKGROUND: The influence of coronary artery disease (CAD) on clinical and echocardiographic outcomes after transcatheter aortic valve replacement (TAVR) is still controversial. We sought to evaluate the impact of CAD severity as measured by the SYNTAX score (SS) on patients undergoing TAVR. METHODS AND RESULTS: A total of 377 patients who underwent TAVR in 2 high-volume centers in North America were included in our retrospective analysis. A blinded angiographic core laboratory calculated the SS on all available coronary angiograms with the use of quantitative coronary analysis...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28163921/bioprosthetic-aortic-valve-replacement-12-years-after-percutaneous-aortic-valvuloplasty-in-a-young-female-adult-with-hope-of-pregnancy
#2
Hirohiko Akutsu, Yuichiro Kaminishi, Soki Kurumisawa, Yoshio Misawa
CASE: A 26-year-old woman who had congenital aortic valve stenosis presented with exertional dyspnea. She had undergone percutaneous balloon aortic valvuloplasty 12 years previously at the age of 14. When she was 20 years old, she delivered a neonate by elective cesarean section at the 31st week of gestation because the mean pressure between the left ventricle and the ascending aorta was 52 mmHg. OUTCOME: She successfully underwent aortic valve replacement with a bioprosthetic valve combined with replacement of the ascending aorta in order to make the next pregnancy possible...
October 2016: Acute Med Surg
https://www.readbyqxmd.com/read/28134010/noteworthy-cardiac-surgical-literature-2016
#3
Muhammad Aftab, Joseph C Cleveland, T Brett Reece
Cardiac surgical care of patients continued to evolve rapidly in 2016. In this article, 3 topics of considerable change are discussed based on recent publications. The first topic reviews the potential risks and benefits of newly instituted low-risk percutaneous aortic valve replacement. The second topic reviews the increasing utilization of more extensive arch replacements in acute type A dissection. The final topic reviews current trends and justification for changes in patterns of use of cardioplegia options...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28118931/safety-and-efficacy-of-the-percutaneous-transaxillary-access-for-transcatheter-aortic-valve-implantation-using-various-transcatheter-heart-valves-in-100-consecutive-patients
#4
U Schäfer, F Deuschl, N Schofer, C Frerker, T Schmidt, K H Kuck, F Kreidel, J Schirmer, I Mizote, H Reichenspurner, S Blankenberg, H Treede, L Conradi
OBJECTIVES: Transcatheter Aortic Valve Implantation (TAVI) can be performed via the transaxillary approach, but data about complications and procedural outcome is limited. INTRODUCTION: TAVI is an established treatment option for patients at high risk for conventional aortic valve replacement. Nowadays, the transfemoral approach is the most commonly used access for TAVI. Nevertheless, the transfemoral access is not suitable in many patients necessitating alternative approaches...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28116867/pass-the-rock-calcium-the-achilles-heel-of-transcatheter-valve-replacement
#5
EDITORIAL
James M McCabe, Larry S Dean
Increasing annular calcification portends more adverse outcomes and worse hemodynamic results following percutaneous structural heart interventions. Though the Direct Flow prosthesis did not appear to have significantly different post-procedural gradients based on aortic valve calcium burden in a selected group of patients, the average residual gradients were relatively high in all cases and the presence of a paravalvular leak was more common with increasing valvular calcification. It is unclear how the Direct Flow prosthesis fits into the armamentarium of TAVR prostheses...
January 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#6
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28100876/primary-percutaneous-coronary-intervention-followed-by-valve-surgery-for-acute-coronary-syndrome-at-left-main-trunk-complicated-with-severe-aortic-stenosis
#7
Akira Shikuma, Jun Shiraishi, Kazunari Okawa, Masaki Yashige, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Akiyuki Takahashi, Takahisa Sawada
An 89-year-old woman appeared to have acute coronary syndrome at the left main trunk (LMT) complicated with severe aortic stenosis, moderate-severe mitral regurgitation, depressed left ventricular (LV) function, and multivessel disease. Because of sustained hypotension even under intra-aortic balloon pumping support during emergency coronary angiograhy, we performed primary percutaneous coronary intervention solely for the LMT lesion using a bare metal stent, leading to recovery from the shock state. On the second hospital day, based on our heart-team consensus, we performed aortic valve replacement and coronary artery bypass grafting surgery, and added edge-to-edge repair (Alfieri stitch) of the mitral valve, resulting in complete revascularization and dramatically improved LV function...
February 7, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#8
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088437/safety-and-feasibility-of-pci-in-patients-undergoing-tavr-a-systematic-review-and-meta-analysis
#9
REVIEW
Anurag Bajaj, Samir Pancholy, Arjinder Sethi, Parul Rathor
We aimed to evaluate the safety and feasibility of PCI (percutaneous coronary intervention) for coronary artery disease (CAD) in patients undergoing transcatheter aortic valve replacement (TAVR) by performing a meta-analysis. A systemic search of the database was performed. Studies were included comparing TAVR versus TAVR with PCI for significant CAD in patients undergoing TAVR for severe aortic stenosis. The primary outcome was 30 day mortality and secondary outcomes were myocardial infarction, stroke, life threatening bleeding, major access site vascular complications and renal failure...
January 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28079661/femoral-neuropathy-following-spontaneous-retroperitoneal-hemorrhage-after-cardiac-surgery-a-case-report
#10
Dinah J White, F T Lytle
A woman underwent ascending aortic aneurysm repair, aortic root and valve replacement, and coronary artery bypass grafting. Her postoperative course was complicated by stroke and status epilepticus. With supportive care and antiepileptics, her neurologic status improved. Intravenous heparin and aspirin were initiated. On postoperative day 13, she developed a large retroperitoneal hematoma with femoral neuropathy. Because her hematoma was not amenable to percutaneous drainage or surgical evacuation, and considering her comorbidities, a conservative approach was elected...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#11
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28045671/bioprosthetic-aortic-paravalvular-leak-is-valve-in-valve-another-solution
#12
Anwar Tandar, David A Bull, Frederick G P Welt
Paravalvular leak (PVL) following aortic valve implantation is a rare complication but may cause potentially serious consequences. It occurs in 2%-10% of surgical aortic valve replacements and 7%-17% of surgical mitral valve replacements. Transcatheter valve replacement data show that significant PVL occurs in 6%-8% of cases. The management of significant PVL has traditionally involved repeat surgical repair. However, many of these patients are considered too high risk to undergo a repeat surgical procedure; hence, a percutaneous transcatheter approach has often been utilized to treat these patients...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28043783/pulmonary-homograft-stenosis-in-the-ross-procedure-incidence-clinical-impact-and-predictors-in-long-term-follow-up
#13
Laura Pardo González, Martin Ruiz Ortiz, Mónica Delgado, Dolores Mesa, Rafael Villalba, Sara Rodriguez, Francisco J Hidalgo, Pedro Alados, Jaime Casares, Jose Suarez de Lezo
BACKGROUND: The Ross procedure is used in the treatment of selected patients with aortic valve disease. Pulmonary graft stenosis can appear in the long-term follow-up after the Ross intervention, but the factors involved and its clinical implications are not fully known. AIM: To describe the incidence, clinical impact and predictors of homograft stenosis and reintervention after the Ross procedure in a prospective series in a tertiary referral hospital. METHODS: From 1997 to 2009, 107 patients underwent the Ross procedure (mean age: 30±11 years; 69% men; 21 aged<18 years), and were followed for echocardiographic homograft stenosis (peak gradient>36mmHg) and surgical or percutaneous homograft reintervention...
December 30, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28018817/transcatheter-valve-unable-to-cure-patient-prosthesis-mismatch-of-mosaic-bioprosthesis
#14
Daniela Serio, Andreas Zierer, Mirko Doss, Anton Moritz
Transcatheter aortic valve implantation (TAVI) has been recently established as a less invasive alternative to conventional aortic valve replacement (CAVR) in patients presenting with expected high procedural risk. The rapid technologic advances and the recent improvement of clinical outcomes with TAVI have made it possible to treat degenerated bioprosthesis using the valve-in-valve implantation concept (Walther T, Simon P, Dewey T, et al. Transapical minimally invasive aortic valve implantation: multicenter experience...
December 2016: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28008354/percutaneous-balloon-aortic-valvuloplasty-in-the-era-of-transcatheter-aortic-valve-implantation-a-narrative-review
#15
Thomas R Keeble, Arif Khokhar, Mohammed Majid Akhtar, Anthony Mathur, Roshan Weerackody, Simon Kennon
The role of percutaneous balloon aortic valvuloplasty (BAV) in the management of severe symptomatic aortic stenosis has come under the spotlight following the development of the transcatheter aortic valve implantation (TAVI) technique. Previous indications for BAV were limited to symptom palliation and as a bridge to definitive therapy for patients undergoing conventional surgical aortic valve replacement (AVR). In the TAVI era, BAV may also be undertaken to assess the 'therapeutic response' of a reduction in aortic gradient in borderline patients often with multiple comorbidities, to assess symptomatic improvement prior to consideration of definitive TAVI intervention...
2016: Open Heart
https://www.readbyqxmd.com/read/27994841/do-all-critical-aortic-stenosis-with-chest-pain-need-aortic-valve-replacement-a-case-report
#16
Munish Sharma, Daniel A N Mascarenhas
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27989885/transcaval-access-and-closure-for-transcatheter-aortic-valve-replacement-a%C3%A2-prospective-investigation
#17
Adam B Greenbaum, Vasilis C Babaliaros, Marcus Y Chen, Annette M Stine, Toby Rogers, William W O'Neill, Gaetano Paone, Vinod H Thourani, Kamran I Muhammad, Robert A Leonardi, Stephen Ramee, James F Troendle, Robert J Lederman
BACKGROUND: Transcaval access may enable fully percutaneous transcatheter aortic valve replacement (TAVR) without the hazards and discomfort of transthoracic (transapical or transaortic) access. OBJECTIVES: The authors performed a prospective, independently adjudicated, multicenter, single-arm trial of transcaval access for TAVR in patients who were ineligible for femoral artery access and had high or prohibitive risk of complications from transthoracic access...
February 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27989047/results-of-contemporary-valve-surgery-in-patients-with-carcinoid-heart-disease
#18
Thomas Kuntze, Tamer Owais, Maria-Anna Secknus, Daniel Kaemmerer, Richard Baum, Evaldas Girdauskas
BACKGROUND: Carcinoid tumor is a slow-growing type of neuroendocrine tumor, originating from enterochromaffin cells and secreting mainly serotonin. The diagnosis is based on clinical symptoms, hormone blood levels, radiological and nuclear imaging, and histological confirmation. However, most patients have metastases at the time of diagnosis because the clinical signs often remain unnoticed or are attributed to other abdominal conditions. In up to 50% of patients the endocardium is affected due to a hormonally active tumor profile...
May 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/27970127/tct-743-percutaneous-coronary-intervention-after-self-expanding-transcatheter-aortic-valve-replacement
#19
Stanley Chetcuti, Neal Kleiman, Ray Matthews, Jeffrey Popma
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970079/tct-697-comparison-of-outcomes-of-transcatheter-aortic-valve-replacement-plus-percutaneous-coronary-intervention-versus-transcatheter-aortic-valve-replacement-alone-in-the-united-states
#20
Vikas Singh, Badal Thakkar, Alexis Rodriguez, Nileshkumar Patel, Apurva Badheka, Carlos Alfonso, Mauricio Cohen, Igor Palacios, Ignacio Inglessis, Sammy Elmariah, William O'Neill
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
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