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https://www.readbyqxmd.com/read/29329825/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-in-patients-with-pure-aortic-regurgitation-and-advanced-heart-failure
#1
Gabriele Pesarini, Mattia Lunardi, Anna Piccoli, Leonardo Gottin, Daniele Prati, Valeria Ferrero, Roberto Scarsini, Aldo Milano, Alberto Forni, Giuseppe Faggian, Flavio Ribichini
Results of transcatheter aortic valve implantation (TAVI) for treatment of severe noncalcific isolated aortic regurgitation (AR) complicated by advanced heart failure or cardiogenic shock has been previously reported only in isolated case reports. Current self-expanding transcatheter aortic valves are designed to treat aortic valve stenosis, and have also been implanted in cases of severe AR due to degenerated bioprosthesis and in very few cases of native aortic valves. We report 13 consecutive inoperable patients with noncalcific, pure AR, and advanced heart failure treated with emergency percutaneous transfemoral implantation with self-expandable CoreValves at our institution between July 2012 and September 2017...
December 11, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29322433/biological-aortic-valve-replacement-advantages-and-optimal-indications-of-stentless-compared-to-stented-valve-substitutes-a-review
#2
REVIEW
Reza Tavakoli, Pichoy Danial, Ahmed Hamid Oudjana, Peiman Jamshidi, Max Gassmann, Pascal Leprince, Guillaume Lebreton
Controversy still surrounds the optimal biological valve substitute for aortic valve replacement. In light of the current literature, we review advantages and optimal indications of stentless compared to stented aortic bio-prostheses. Recent meta-analyses, prospective randomized controlled trials and retrospective studies comparing the most frequently used stentless and stented aortic bio-prostheses were analyzed. In the present review, the types and implantation techniques of the bio-prosthesis that are seldom taken into account by most studies and reviews were integrated in the interpretation of the relevant reports...
January 10, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29276106/natural-history-of-the-proximal-aorta-in-patients-with-descending-thoracic-aortic-disease
#3
Paul C Tang, Paul D DiMusto, Nilto C De Oliveira, Brooks L Rademacher, Jennifer L Philip, Shahab A Akhter, Charles W Acher
OBJECTIVE: This study investigated the growth and behavior of the ascending aorta in patients with descending thoracic aortic disease. METHODS: We examined 200 patients with descending thoracic aortic disease including acute type B dissection (n = 95), chronic type B dissection (n = 38), intramural hematoma (n = 23), and thoracoabdominal aortic aneurysms (n = 44). Images from computed tomography and magnetic resonance imaging were evaluated after three-dimensional reconstruction to examine the growth rate in those with >1 year of imaging follow-up (n = 108)...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29193671/percutaneous-transcatheter-pulmonary-valve-replacement-in-children-weighing-less-than-20-kg
#4
Mary Hunt Martin, Shabana Shahanavaz, Lynn F Peng, Jeremy D Asnes, Michelle Riley, William E Hellenbrand, David T Balzer, Robert G Gray, Doff B McElhinney
BACKGROUND: Since FDA approval of the Melody valve, transcatheter pulmonary valve replacement (TPVR) has been offered to an expanding population. Limited data exist regarding the safety and feasibility of TPVR in smaller patients. METHODS: All patients weighing <20 kg who underwent catheterization for percutaneous TPVR at four centers were reviewed. RESULTS: Of the 51 patients reviewed, 43 (84%) had successful valve implantation and 8 (16%) were found not to be candidates due to access veins too small (n = 3), coronary artery/aortic root compression (n = 3), and RVOT too large (n = 2)...
November 29, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29049549/transapical-cardioscopic-mitral-annuloplasty-a-short-term-survival-study-in-a-porcine-model
#5
Thang Duc Vu, Min Zin Oo, Duc-Viet Nguyen, Ervin Marquez Ocampo, Yilin Ong, Suganya Cheyyatraivendran-Arularasu, Lian-Kah Ti, Mark A Richards, Theo Kofidis
OBJECTIVES: The transapical approach provides concurrent surgical access to the mitral and the aortic valves, the root of the aorta and the left atrium. We previously showed the feasibility of transapical cardioscopic (TAC) surgery in a non-survival porcine model. However, reproducibility and feasibility of ring implantation using TAC have not been reported. Therefore, in this study, we hypothesized that implantation of a mitral annuloplasty ring can be feasibly and safely carried out endoscopically via the apex of the heart...
August 30, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28962499/valve-sparing-aortic-root-replacement-in-a-bicuspid-aortic-valve-with-papillary-fibroelastoma
#6
Stoyan Kondov, Fabian Alexander Kari, Martin Czerny, Matthias Siepe
We present our surgical strategy in a patient with a bicuspid aortic valve Type I (R/N), aortic root aneurysm and papillary fibroelastoma on the aortic valve's cusp. He underwent valve-sparing aortic root replacement (David V Procedure); we also removed the papillary fibroelastoma from the fused right- and non-coronary cusp. In this case, we used a 34-mm straight Dacron graft for root replacement and an aortic annulus downsized to 30 mm. We use Hegar dilatators for the intraoperative measurement of the aortic annulus...
October 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28736387/effect-of-pregnancy-on-ventricular-and-aortic-dimensions-in-repaired-tetralogy-of-fallot
#7
Matthew Cauldwell, Michael A Quail, Gillian S Smith, Ee Ling Heng, Sarah Ghonim, Anselm Uebing, Lorna Swan, Wei Li, Roshni R Patel, Dudley J Pennell, Philip J Steer, Mark R Johnson, Michael A Gatzoulis, Sonya V Babu-Narayan
BACKGROUND: The aim was to assess whether cardiovascular adaptation to pregnancy in women with repaired tetralogy of Fallot (TOF) adversely affects hemodynamic stability, in particular with respect to right ventricular (RV) dilatation, pulmonary regurgitation, or aortic root dilatation. METHODS AND RESULTS: This was a retrospective cohort study of women with repaired TOF with paired cardiovascular magnetic resonance scans before and after their first pregnancy (baseline RV end systolic volume index 49 mL/m(2) and RV end diastolic volume index 118 mL/m(2)) matched with a comparison group of nulliparous women with TOF...
July 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28720378/a-novel-technique-carbon-dioxide-gas-assisted-total-peritonectomy-diaphragm-and-intestinal-meso-stripping-in-open-surgery-for-advanced-ovarian-cancer-%C3%A3-ukurova-technique
#8
Ghanim Khatib, Ahmet Baris Guzel, Umran Kucukgoz Gulec, Mehmet Ali Vardar
OBJECTIVE: Most of the ovarian cancers are diagnosed at advanced stages. As peritoneal carcinomatosis increases, especially when it extends to the diaphragm and intestinal mesos, probability of obtaining complete cytoreduction is reduced. Complete cytoreduction (residue zero: R0) is one of the main factors affecting survival [1-3]. Here we present a novel technique of stripping the peritoneal surfaces as a part of cytoreductive surgery in such cases. METHODS: A 55year-old woman diagnosed with peritoneal carcinomatosis was considered appropriate for primary cytoreduction after assessment of her thorax-abdominopelvic tomography, which revealed resectable intra-abdominal disease...
September 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28708846/sex-pregnancy-and-aortic-disease-in-marfan-syndrome
#9
Marjolijn Renard, Laura Muiño-Mosquera, Elise C Manalo, Sara Tufa, Eric J Carlson, Douglas R Keene, Julie De Backer, Lynn Y Sakai
BACKGROUND: Sex-related differences as well as the adverse effect of pregnancy on aortic disease outcome are well-established phenomena in humans with Marfan syndrome (MFS). The underlying mechanisms of these observations are largely unknown. OBJECTIVES: In an initial (pilot) step we aimed to confirm the differences between male and female MFS patients as well as between females with and without previous pregnancy. We then sought to evaluate whether these findings are recapitulated in a pre-clinical model and performed in-depth cardiovascular phenotyping of mutant male and both nulliparous and multiparous female Marfan mice...
2017: PloS One
https://www.readbyqxmd.com/read/28655533/a-unique-hybrid-approach-to-complex-re-do-aortic-root-surgery
#10
Fiona Doig, Rishen Naidoo, Vinod Sharma, Peter Tesar
BACKGROUND: We present the case of a 23-year-old male with ventriculo-aortic dehiscence and a retrosternal false aneurysm communicating to the left ventricular outflow tract (LVOT) and ascending aorta. His history included aortic valve replacement (AVR) and mitral valve (MV) repair remotely, followed by two further operations for endocarditis and aortic root abscess. METHODS: The risk associated with the redo surgery required detailed planning and innovative techniques to allow it to be performed safely...
June 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28637199/first-ex-vivo-and-preliminary-sheep-model-results-of-the-new-tribio-aortic-valve-bioprosthesis-in-small-aortic-annuli
#11
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: Small aortic annuli are challenging in aortic valve replacement. Prosthesis-patient mismatch, accompanied by high transvalvular gradients and small orifice area, is an often faced problem impairing postoperative outcome. The new TRIBIO bioprosthesis aims to enable enhanced haemodynamics, being increasingly important with decreasing annular size. This study compares ex vivo hydrodynamics of TRIBIO with 2 established bioprostheses in small annuli at different stroke volumes, simulating 'rest' and 'exercise', and evaluates haemodynamics of TRIBIO in a sheep model...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28633278/radiopaque-marker-addition-during-aortic-root-replacement-with-the-use-of-a-freestyle-porcine-bioprosthesis
#12
Olivia M Crowley, John R Doty
Aortic root replacement is indicated for aortic root aneurysm, small aortic root, and most root abscesses. This report describes the placement of a radiopaque marker during aortic root replacement using a Freestyle porcine bioprosthesis. This marker is a useful landmark during fluoroscopy for transcatheter valve-in-valve aortic valve replacement in the event of bioprosthesis degeneration.
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616353/double-pseudoaneurysm-recurrent-subvalvular-aortic-membrane-and-small-left-ventricular-outflow-tract-in-the-same-patient-who-dares
#13
Rocío Díaz, Daniel Hernandez-Vaquero, Rubén Álvarez-Cabo, Isaac Pascual, Cecilia Corros, Alberto Alperi, Jose Rozado, Jacobo Silva, César Morís
Patients with pseudoaneurysm in the left ventricular outflow tract (LVOT) commonly present vague and nonspecific symptoms making the diagnosis difficult. We present the case of a 37-year-old patient with two subvalvular pseudoaneurysms in whom a combined resection surgery, enlargement of the LVOT, aortic valve replacement (AVR) and aortic root replacement were performed using the technique of Cabrol.
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28610543/does-diathermy-smoke-contaminate-processed-salvaged-blood-in-cardiac-surgery
#14
Katherine R Hulme, Jon van den Burg
INTRODUCTION: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28601639/tofacitinib-ameliorates-atherosclerosis-and-reduces-foam-cell-formation-in-apoe-deficient-mice
#15
Zaicun Wang, Shumei Wang, Zunzhe Wang, Tiantian Yun, Chenchen Wang, Huating Wang
Atherosclerosis is a chronic inflammatory cardiovascular disease with high mortality worldwide. Tofacitinib (CP-690,550), an oral small-molecule Janus kinase inhibitor, has been shown to be effective in the treatment of rheumatoid arthritis, autoimmune encephalomyelitis and ulcerative colitis. However, its protective effect against atherosclerosis remains poorly understood. The aim of the present study was to evaluate the effects of Tofacitinib on atherogenic diet (ATD)-induced atherosclerosis using apolipoprotein E deficient (apoE-/-) mice...
August 19, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28570525/full-root-aortic-valve-replacement-by-stentless-aortic-xenografts-in-patients-with-small-aortic-roots
#16
Reza Tavakoli, Peiman Jamshidi, Max Gassmann
In patients with small aortic roots who need an aortic valve replacement with biological valve substitutes, the implantation of the stented pericardial valve might not meet the functional needs. The implantation of a too-small stented pericardial valve, leading to an effective orifice area indexed to a body surface area less than 0.85 cm(2)/m(2), is regarded as prosthesis-patient mismatch (PPM). A PPM negatively affects the regression of left ventricular hypertrophy and thus the normalization of left ventricular function and the alleviation of symptoms...
May 21, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28516095/david-v-procedure-in-a-patient-with-aortic-dilation-and-competent-quadricuspid-aortic-valve-are-genetics-to-blame
#17
Katherine R Hebeler, John J Squiers, Heike Baumgarten, J Michael DiMaio, William T Brinkman
Quadricuspid aortic valves (QAVs) are extremely rare. In this case study, we report a David-V valve-sparing aortic root replacement with reimplantation of a native QAV in a patient with aortic dilation, normal valve function, and a family history of aortic dissection. Microscopic pathological examination of the excised section of the aorta revealed scattered small foci of cystic medical degeneration throughout. A genetic predisposition for aortic dilation may be present in patients with QAV, even in the setting of a competent valve...
October 2016: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28475560/hydrodynamic-and-geometric-behavior-of-two-pericardial-prostheses-implanted-in-small-aortic-roots
#18
Giordano Tasca, Gianfranco Beniamino Fiore, Paola Redaelli, Claudia Romagnoni, Alberto Redaelli, Amando Gamba, Carlo Antona, Riccardo Vismara
Hydrodynamic performance of stented bioprostheses is far below that of the native valve. One of the reasons is that the internal diameter of the prosthesis is usually smaller than that of the native valve. However, other valve characteristics are also important in generating the pressure drop. We aimed to assess, in an ex vivo pulsatile mock loop, the hydrodynamic behavior of two bioprostheses, Trifecta and Mitroflow, to ascertain which geometric terms are limiting factors in hydrodynamic performance. At stroke volumes between 30 and 60 ml, Trifecta showed lower pressure drop, energy dissipation and valve resistance, and greater effective orifice area...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28345211/3d-echocardiographic-analysis-of-aortic-annulus-for-transcatheter-aortic-valve-replacement-using-novel-aortic-valve-quantification-software-comparison-with-computed-tomography
#19
Anuj Mediratta, Karima Addetia, Diego Medvedofsky, Robert J Schneider, Eric Kruse, Atman P Shah, Sandeep Nathan, Jonathan D Paul, John E Blair, Takeyoshi Ota, Husam H Balkhy, Amit R Patel, Victor Mor-Avi, Roberto M Lang
BACKGROUND: With the increasing use of transcatheter aortic valve replacement (TAVR) in patients with aortic stenosis (AS), computed tomography (CT) remains the standard for annulus sizing. However, 3D transesophageal echocardiography (TEE) has been an alternative in patients with contraindications to CT. We sought to (1) test the feasibility, accuracy, and reproducibility of prototype 3DTEE analysis software (Philips) for aortic annular measurements and (2) compare the new approach to the existing echocardiographic techniques...
May 2017: Echocardiography
https://www.readbyqxmd.com/read/28302625/silencing-of-anticoagulant-protein-c-evokes-low-incident-but-spontaneous-atherothrombosis-in-apolipoprotein-e-deficient-mice-brief-report
#20
Amber B Ouweneel, Marco Heestermans, Robin A F Verwilligen, Marion J J Gijbels, Pieter H Reitsma, Miranda Van Eck, Bart J M van Vlijmen
OBJECTIVE: Murine atherosclerosis models do not spontaneously develop atherothrombotic complications. We investigated whether disruption of natural anticoagulation allows preexisting atherosclerotic plaques to progress toward an atherothrombotic phenotype. APPROACH AND RESULTS: On lowering of plasma protein C levels with small interfering RNA (siProc) in 8-week Western-type diet-fed atherosclerotic apolipoprotein E-deficient mice, 1 out of 4 mice displayed a large, organized, and fibrin- and leukocyte-rich thrombus on top of an advanced atherosclerotic plaque located in the aortic root...
May 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
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