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Percutaneous aortic valve replacement

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https://www.readbyqxmd.com/read/29105330/pvl-closure-after-tavr-yes-we-can-do-it
#1
EDITORIAL
Mehmet Cilingiroglu, Andre Paixao
Paravalvular leak (PVL) remains a significant problem after transcatheter aortic valve replacement. PVL is associated with long-term morbidity and mortality. Percutaneous management of post-TAVR PVL seems to be feasible and should be adopted by the structural heart interventionalist.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29102344/clinical-outcomes-of-coronary-occlusion-following-transcatheter-aortic-valve-replacement-a-systematic-review
#2
REVIEW
Oluwaseun A Akinseye, Sunil K Jha, Uzoma N Ibebuogu
BACKGROUND: Coronary occlusion (CO) is a rare but serious complication following transcatheter aortic valve replacement (TAVR) with limited published data. We sought to evaluate the immediate and short-term outcomes of CO complicating TAVR. METHODS: Studies, including case reports, case series and original articles published from 2002 to 2016 describing CO following TAVR were identified with a systematic electronic search using the PRISMA Statement. Only studies reporting data on demographic and procedural characteristics, management and follow up outcomes were analyzed...
September 12, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29101953/catheterization-laboratory-structural-heart-disease-devices-and-transcatheter-aortic-valve-replacement
#3
REVIEW
Paul N Fiorilli, Saif Anwaruddin, Elizabeth Zhou, Ronak Shah
The cardiac catheterization laboratory is advancing medicine by performing procedures on patients who would usually require sternotomy and cardiopulmonary bypass. These procedures are done percutaneously, allowing them to be performed on patients considered inoperable. Patients have compromised cardiovascular function or advanced age. An anesthesiologist is essential for these procedures in case of hemodynamic compromise. Interventionalists are becoming more familiar with transcatheter aortic valve replacement and the device has become smaller, both contributing to less complications...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29081473/acute-heart-failure-in-patients-with-severe-aortic-stenosis%C3%A3-insights-from-the-current-as-registry
#4
Kazuya Nagao, Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Naritatsu Saito, Kenji Minatoya, Takeshi Kimura
BACKGROUND: Clinical profiles of acute heart failure (AHF) complicating severe aortic stenosis (AS) remain unclear.Methods and Results:From a Japanese multicenter registry enrolling consecutive patients with severe AS, 3,813 patients were categorized into the 3 groups according to the symptom of heart failure (HF); No HF (n=2,210), chronic HF (CHF) (n=813) and AHF defined as hospitalized HF at enrolment (n=790). Median follow-up was 1,123 days with 93% follow-up rate at 2 years. Risk factors for developing AHF included age, female sex, lower body mass index, untreated coronary artery stenosis, anemia, history of HF, left ventricular ejection fraction <50%, presence of any combined valvular disease, peak aortic jet velocity ≥5 m/s and tricuspid regurgitation pressure gradient ≥40 mmHg, and negative risk factors included dyslipidemia, history of percutaneous coronary intervention and hemodialysis...
October 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29077586/aorto-atrial-fistulas-a-contemporary-review
#5
Elizabeth Fierro, Rutuja R Sikachi, Abhinav Agrawal, Isha Verma, Marcin Ojrzanowski, Sonu Sahni
Aorto-atrial fistulas are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. Aorto-atrial fistulas are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Secondary causes incite local deterioration of cardiac wall integrity leading to formation of fistulous connections, while iatrogenic causes are more traumatic in nature...
October 25, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/29068128/percutaneous-axillary-arteriotomy-closure-during-transcatheter-aortic-valve-replacement-using-the-manta-device
#6
Rodney De Palma, Andreas Rück, Magnus Settergren, Nawzad Saleh
Percutaneous aortic valve replacement is performed predominantly via the transfemoral approach. The transaxillary (subclavian) approach may be utilized if an alternative route access is required. Conventional access and closure for this approach necessitates open surgical techniques. We report a nonsurgical fully percutaneous axillary TAVR using a collagen-based vascular closure device.
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29068124/percutaneous-transcatheter-aortic-valve-replacement-induces-femoral-artery-shrinkage-angiographic-evidence-and-predictors-for-a-new-side-effect
#7
Osama Shoeib, Francesco Burzotta, Cristina Aurigemma, Lazzaro Paraggio, Fausta Viccaro, Italo Porto, Antonio Maria Leone, Piergiorgio Bruno, Carlo Trani
OBJECTIVES: We sought to investigate the possible impact of transaortic valve replacement (TAVR) on common femoral artery (CFA) integrity as assessed by angiography. BACKGROUND: CFA represents the most adopted access for TAVR but various degrees of vascular damage may be induced by the procedure. METHODS: Patients underwent percutaneous transfemoral TAVR who had both pre- and post-TAVR access-site angiography were retrospectively selected...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29024382/comparison-of-outcomes-with-surgical-cut-down-versus-percutaneous-transfemoral-transcatheter-aortic-valve-replacement-tavr-transfemoral-access-comparisons-between-surgical-cut-down-and-percutaneous-approach
#8
Brandon C Drafts, Charles H Choi, Kunal Sangal, Michael W Cammarata, Robert J Applegate, Sanjay K Gandhi, Edward H Kincaid, Neal Kon, David X Zhao
OBJECTIVES: The objective is to compare the short-term (30 days) and late (12 months) vascular adverse events in patients undergoing transfemoral (TF)-transcatheter aortic valve replacement (TAVR) by surgical cut-down (SC) vs. percutaneous (PC) approaches. BACKGROUND: Programs continue to utilize both approaches in TF-TAVR. There are limited data comparing outcomes by SC vs. PC approaches and long-term effects of endovascular intervention facilitated hemostasis on late vascular adverse events...
October 10, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28988450/feasibility-of-coronary-angiography-and-percutaneous-coronary-intervention-after-transcatheter-aortic-valve-replacement-using-a-medtronic%C3%A2-self-expandable-bioprosthetic-valve
#9
Wah Wah Htun, Cindy Grines, Theodore Schreiber
BACKGROUND AND OBJECTIVE: With aging, the progression of atherosclerosis in the coronary arteries is expected. The Medtronic™ self-expandable aortic bioprosthetic valve is deployed in the supra-annular position, and it has been challenging to selectively engage coronary arteries post-transcatheter aortic valve replacement (TAVR) even though there are diamond-shaped spaces in the mesh frame within the valve. Given the scarcity of data, we analyzed angiographic and clinical data from all patients requiring coronary angiography (CA) or intervention post-TAVR...
October 8, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28969897/current-status-of-endovascular-training-for-cardiothoracic-surgery-residents-in-the-united-states
#10
COMPARATIVE STUDY
Panos N Vardas, Ada C Stefanescu Schmidt, Xiaoying Lou, Andrew B Goldstone, Gregory Pattakos, Amy G Fiedler, Elizabeth H Stephens, Vakhtang Tchantchaleishvili
BACKGROUND: Endovascular interventions for cardiovascular pathology are becoming increasingly relevant to cardiothoracic surgery. This study assessed the perceived prevalence and efficacy of endovascular skills training and identified differences among training paradigms. METHODS: Trainee responses to questions in the 2016 In-Service Training Examination survey regarding endovascular training were analyzed based on the four different cardiothoracic surgery training pathways: traditional 2- and 3-year thoracic, integrated 6-year, and combined 4+3 general and thoracic residency programs...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28950325/management-of-tricuspid-valve-regurgitation-position-statement-of-the-european-society-of-cardiology-working-groups-of-cardiovascular-surgery-and-valvular-heart-disease
#11
Manuel J Antunes, José Rodríguez-Palomares, Bernard Prendergast, Michele De Bonis, Raphael Rosenhek, Nawwar Al-Attar, Fabio Barili, Filip Casselman, Thierry Folliguet, Bernard Iung, Patrizio Lancellotti, Claudio Muneretto, Jean-François Obadia, Luc Pierard, Piotr Suwalski, Pepe Zamorano
Tricuspid regurgitation (TR) is a very frequent manifestation of valvular heart disease. It may be due to the primary involvement of the valve or secondary to pulmonary hypertension or to the left-sided heart valve disease (most commonly rheumatic and involving the mitral valve). The pathophysiology of secondary TR is complex and is intrinsically connected to the anatomy and function of the right ventricle. A systematic multimodality approach to diagnosis and assessment (based not only on the severity of the TR but also on the assessment of annular size, RV function and degree of pulmonary hypertension) is, therefore, essential...
December 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28941149/management-of-left-main-coronary-artery-obstruction-after-transcatheter-aortic-valve-replacement-utilizing-a-periscope-approach
#12
Todd Drexel, Gregory Helmer, Santiago Garcia, Ganesh Raveendran
Coronary obstruction is a rare but potentially fatal complication of transcatheter aortic valve replacement (TAVR). It can result from native leaflet or stent frame obstruction of the coronary ostia. There are reports detailing the difficulty of percutaneous coronary intervention following TAVR, but none that describe a periscope approach to access the left main ostia in the presence of a braided nitinol frame. This report describes an alternative approach to access a coronary artery when the valve stent struts are prohibitive to equipment delivery...
September 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28920637/bypassing-a-bypass-transcatheter-aortic-valve-replacement-and-percutaneous-closure-of-a-regurgitant-apical-aortic-conduit
#13
Andrew M Goldsweig
No abstract text is available yet for this article.
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28914661/percutaneous-aortic-leak-closure-in-a-small-and-frail-annulus-after-double-heart-valve-replacement
#14
Guglielmo Saitto, Paolo Nardi, Gian P Ussia, Domenico Sergi, Paolo Prati, Marco Russo, Francesco Romeo, Giovanni Ruvolo
: Paravalvular leak (PVL) is an uncommon but serious complication associated with the implantation of prosthetic valves. Following aortic valve replacement, up to 5% of patients affected by PVL develop clinical symptoms of heart failure, hemolysis or both. Percutaneous treatment of PVL has emerged instead of conventional surgery, as a well tolerated and less invasive procedure but remains a challenge. We present the case of a young woman with mechanical aortic and mitral prostheses, who presented surgical aortic PVL caused by a serious frailty of native annulus, became symptomatic after 5 months and was successfully percutaneously treated with an Amplatzer Duct Occluder device...
September 12, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28898453/echocardiographic-guidance-and-monitoring-of-left-atrial-appendage-closure-with-atriclip-during-open-chest-cardiac-surgery
#15
Rachele Contri, Sara Clivio, Tiziano Torre, Tiziano Cassina
Left atrial appendage (LAA) closure prevents thromboembolic risk and avoids lifelong anticoagulation due to atrial fibrillation (AF). Nowadays, AtriClip, a modern epicardial device approved in June 2010, allows external and safe closure of LAA in patients undergoing cardiac surgery during other open-chest cardiac surgical procedures. Such a surgical approach and its epicardial deployment differentiates LAA closure with AtriClip from percutaneous closure techniques such as Watchman (Boston Scientific, Marlborough, MA, USA), Lariat (SentreHEART Inc...
October 2017: Echocardiography
https://www.readbyqxmd.com/read/28895061/valvular-heart-disease-in-women-differential-remodeling-and-response-to-new-therapies
#16
REVIEW
Jaya Chandrasekhar, George Dangas, Roxana Mehran
In the United States, valvular heart disease (VHD) has a prevalence of 2.5%, most commonly presenting as aortic stenosis (AS) or mitral valve regurgitation (MR) and increasingly observed to be of a degenerative etiology. Women frequently have latent symptoms despite significant disease, and it is therefore pertinent to consider both clinical symptoms and imaging findings for decision-making on treatment. Indeed, significant advances have been made in noninvasive imaging allowing for more accurate diagnosis and disease prognostication...
September 11, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28879526/intracardiac-echocardiography-for-structural-heart-and-electrophysiological-interventions
#17
REVIEW
Craig Basman, Yuvrajsinh J Parmar, Itzhak Kronzon
PURPOSE OF REVIEW: With an increasing number of interventional procedures performed for structural heart disease and cardiac arrhythmias each year, echocardiographic guidance is necessary for safe and efficient results. The purpose of this review article is to overview the principles of intracardiac echocardiography (ICE) and describes the peri-interventional role of ICE in a variety of structural heart disease and electrophysiological interventions. RECENT FINDINGS: Both transthoracic (TTE) and transesophageal echocardiography have limitations...
September 6, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28864443/conscious-sedation-versus-general-anesthesia-for-transcatheter-aortic-valve-replacement-insights-from-the-ncdr%C3%A2-sts-acc-tvt-registry
#18
Matthew C Hyman, Sreekanth Vemulapalli, Wilson Y Szeto, Amanda Stebbins, Prakash A Patel, Roland A Matsouaka, Howard C Herrmann, Saif Anwaruddin, Taisei Kobayashi, Nimesh D Desai, Prashanth Vallabhajosyula, Fenton H McCarthy, Robert Li, Joseph E Bavaria, Jay Giri
Background -Conscious sedation is used during transcatheter aortic valve replacement (TAVR) with limited evidence as to the safety and efficacy of this practice. Methods -The NCDR STS/ACC TVT Registry was used to characterize the anesthesia choice and clinical outcomes of all U.S. patients undergoing elective percutaneous transfemoral TAVR between April 1, 2014 and June 30, 2015. Raw and inverse probability of treatment weighted (IPTW) analyses were performed to compare general anesthesia patients with conscious sedation patients on an intention-to-treat basis for the primary outcome of in-hospital mortality, and secondary outcomes including 30-day mortality, in-hospital and 30-day death/stroke, procedural success, ICU and hospital length-of-stay, and rates of discharge to home...
September 1, 2017: Circulation
https://www.readbyqxmd.com/read/28862381/a-systematic-review-of-reported-cases-of-combined-transcatheter-aortic-and-mitral-valve-interventions
#19
Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Tesfaye Telila, David P Slovut, Luis Afonso, Cindy L Grines, Theodore Schreiber
OBJECTIVES: To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI). BACKGROUND: CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28844511/prognostic-significance-of-change-in-the-left-ventricular-ejection-fraction-after-transcatheter-aortic-valve-implantation-in-patients-with-severe-aortic-stenosis-and-left-ventricular-dysfunction
#20
Marco Angelillis, Cristina Giannini, Marco De Carlo, Marianna Adamo, Matilde Nardi, Antonio Colombo, Alaide Chieffo, Francesco Bedogni, Nedy Brambilla, Corrado Tamburino, Marco Barbanti, Giuseppe Bruschi, Paola Colombo, Arnaldo Poli, Paola Martina, Roberto Violini, Patrizia Presbitero, Anna Sonia Petronio
Patients with severe aortic stenosis and reduced left ventricular ejection fraction (LVEF) have a poor prognosis compared with patients with preserved LVEF. To evaluate the impact of early LVEF recovery in patients with baseline dysfunction on clinical outcomes after transcatheter aortic valve implantation (TAVI), we included all consecutive patients who underwent TAVI from the Italian ClinicalService registry with an LVEF of ≤45% at baseline who had 1-month LVEF data. Patients who experienced a previous coronary artery bypass graft, a previous valve replacement, or a previous myocardial infarction were excluded from the analysis...
November 1, 2017: American Journal of Cardiology
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