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https://www.readbyqxmd.com/read/29743418/minimally-invasive-aortic-valve-replacement-following-root-enlargement-on-too-narrow-annulus-to-perform-transcatheter-aortic-valve-implantation
#1
Kosuke Sakamoto, Toshinori Totsugawa, Arudo Hiraoka, Kentaro Tamura, Hidenori Yoshitaka, Taichi Sakaguchi
An 88-year-old woman was diagnosed with aortic stenosis and an aortic annulus that was too narrow to perform transcatheter aortic valve implantation. Surgery was performed through a 7-cm right mini-thoracotomy at the fourth intercostal space. A 19-mm aortic valve bioprosthesis was implanted after root enlargement. The fourth intercostal space was a suitable site for aortic root enlargement because of the shorter skin-to-root distance and the detailed exposure of the aortic valve after cutting the aortic wall...
May 9, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29609994/refinement-of-anatomic-indications-for-the-nellix-system-for-endovascular-aneurysm-sealing-based-on-2-year-outcomes-from-the-evas-forward-ide-trial
#2
Jeffrey P Carpenter, John S Lane, Jose Trani, Sajjad Hussain, Christopher Healey, Clifford J Buckley, Homayoun Hashemi, Robert Cuff
BACKGROUND: The Nellix System (Endologix, Inc, Irvine, Calif) for endovascular aneurysm sealing (EVAS) is a novel approach to abdominal aortic aneurysm treatment and conceptually different from endovascular aneurysm repair, whereby polymer is employed to fill and actively manage the abdominal aortic aneurysm sac. One-year safety and effectiveness results of the Nellix pivotal trial demonstrated encouraging outcomes with very low morbidity and mortality and high procedural and treatment success...
March 30, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29572614/a-case-of-ruptured-aneurysm-of-coronary-pulmonary-artery-fistula-diagnosed-after-emergency-thoracotomy
#3
Madoka Kawano, Tomoyuki Wada, Hirofumi Anai, Takashi Shuto, Shinji Miyamoto
BACKGROUND: Coronary fistulae are occasionally detected using echocardiography or coronary angiography. We report a patient with cardiac tamponade because of a ruptured aneurysm of a coronary artery fistula. CASE PRESENTATION: A 60-year-old man was referred to our hospital with sudden onset of chest pain and unconsciousness. He was initially diagnosed with cardiac tamponade for type A acute aortic dissection, and an emergency operation was performed. A large amount of bleeding was seen in the pericardium, but aortic dissection around the arch was not observed...
March 23, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29571349/two-cases-of-surgical-management-of-supravalvular-aortic-stenosis-in-familial-hypercholesterolemia
#4
Takashi Kakuta, Tomoyuki Fujita, Satsuki Fukushima, Naonori Kawamoto, Yorihiko Matsumoto, Kizuku Yamashita, Yusuke Shimahara, Hatsue Ishibashi-Ueda, Mariko Harada-Shiba, Junjiro Kobayashi
Homozygous familial hypercholesterolemia is a rare autosomal dominant disorder caused by gene mutations of the low-density lipoprotein receptor, generally characterized by three major signs-hyper low-density lipoprotein cholesterolemia, tendon/skin xanthomas, and premature atherosclerosis disease-beginning in childhood and including supravalvular aortic stenosis. To the best of our knowledge, only a few successful surgical cases for supravalvular aortic stenosis in these patients have been reported. We report two cases of homozygous familial hypercholesterolemia with severe supravalvular aortic stenosis and coronary artery disease associated with very small aortic root, managed by aortic root replacement concomitant with coronary artery bypass graft surgery, which resulted in excellent postoperative outcomes...
April 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29530068/deregulated-microrna-and-mrna-expression-profiles-in-the-peripheral-blood-of-patients-with-marfan-syndrome
#5
Masood Abu-Halima, Mustafa Kahraman, Dominic Henn, Tanja Rädle-Hurst, Andreas Keller, Hashim Abdul-Khaliq, Eckart Meese
BACKGROUND: MicroRNAs (miRNAs) are small RNAs regulating gene expression post-transcriptionally. While acquired changes of miRNA and mRNA profiles in cancer have been extensively studied, little is known about expression changes of circulating miRNAs and messenger RNAs (mRNA) in monogenic constitutional anomalies affecting several organ systems, like Marfan syndrome (MFS). We performed integrated miRNA and mRNA expression profiling in blood samples of Marfan patients in order to investigate deregulated miRNA and mRNA networks in these patients which could serve as potential diagnostic and prognostic tools for MFS therapy...
March 12, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29488884/high-pressure-post-dilation-following-transcatheter-valve-in-valve-implantation-in-small-surgical-valves
#6
Tarun Chakravarty, Justin Cox, Yigal Abramowitz, Sharjeel Israr, Abhimanyu Uberoi, Sunghan Yoon, Damini Dey, Paya Zadeh, Wen Cheng, Raj R Makkar
AIMS: Residual gradients >20mmHg after transcatheter valve-in-valve (ViV) are associated with worse survival. This study evaluated the feasibility of high-pressure post-dilation with a non-compliant balloon after transcatheter ViV in small surgical valves to optimize hemodynamics. METHODS AND RESULTS: Thirty patients underwent ViV implantation in surgical valves with internal dimension ≤ 19mm. High-pressure post-dilation to 16-20 atmospheres with a non-compliant balloon was performed in 12 patients and 18 patients underwent ViV without post-dilation...
February 27, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29483481/-aortic-valve-repair-with-reimplantation-in-small-aortic-root
#7
Hiroshi Tanaka, Yutaka Okita
Annular fixation has an important role aortic valve repair for aortic regurgitation. We have used the reimplantation procedure as annular fixation combined with cusp repair rechniques for aortic valve repair even in small aortic root( <50 mm) since 2010. Freedom from aortic valve reoperation was 93% at 5 years and 79% at 8 years. Freedom from greater than moderate aortic regurgitation was 80% at 5 years and 71% at 8 years. Although the outcomes were not satisfactory and should be improved, this technique would be one of choices in selected patients, considering durability of bioprostheses and anticoagulation-related events in mechanical valves...
January 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29483475/-surgical-results-of-aortic-root-replacement-technical-modification-and-geometric-analysis-of-aortic-root-after-aortic-valve-sparing-procedure
#8
Tetsuro Uchida, Azumi Hamasaki, Yoshinori Kuroda, Masahiro Mizumoto, Atsushi Yamashita, Jun Hayashi, Shuto Hirooka, Ai Ishizawa, Kentaro Akabane, Mitsuaki Sadahiro
BACKGROUND: The Bentall procedure is a reliable treatment of various types of aortic root pathology. Furthermore, the aortic valve-sparing aortic root replacement also has been accepted as an ideal procedure especially in young patients. Recently, we have developed a simple valve-sparing operation focused on standardization and reproducibility. METHODS: From 2011 to 2017, 44 consecutive patients underwent aortic root replacement( Bentall 17, David 27)in our institution...
January 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29430429/extracardiac-conduit-fontan-operation-with-reduction-aortoplasty-for-left-pulmonary-artery-compression-after-a-norwood-procedure-in-a-patient-with-double-inlet-left-ventricle
#9
Jae Won Song, Woong Han Kim, Jae Gun Kwak, Ji Young Park
Patients with double-inlet left ventricle usually have a small ascending aorta. In the Norwood procedure, which involves a staged operation, a neoaorta is constructed with a homograft, and the pulmonary artery plays a role in the systemic circulation. Dilatation or aneurysmal changes can occur over time due to the exposure of the neoaorta to systemic pressure, which may induce adverse effects on adjacent structures. We report a rare case of surgical repair for neoaortic root dilataiton with aortic regurgitation, compressing the left pulmohary artery, in a patient who underwent the Norwood procedure...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29415164/suitability-of-the-porcine-aortic-model-for-transcatheter-aortic-root-repair
#10
Changtian Wang, Mario Lachat, Evelyn Regar, Ludwig Karl von Segesser, Francesco Maisano, Enrico Ferrari
OBJECTIVES: To treat aortic valve disease and concomitant root disease with transcatheter techniques, 'composite graft' implants are required. Our goal was to assess the suitability of the porcine aortic root for transcatheter root repair tests. METHODS: Eight pig hearts explanted from domestic pigs used in experimental surgery were compared to data from the literature on human hearts. The measured diameters included those of the annulus, sinuses of Valsalva, coronary ostia, sinotubular junction, ascending aorta, innominate artery and aortic arch...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29410328/modified-coronary-reimplantation-for-small-aortic-root-replacement-mismatch
#11
Marco Pocar, Davide Passolunghi, Maria Clemencia Araujo Dos Anjos, Alessandro Mazzola
Coronary reimplantation is a key step of aortic root replacement and may present special challenges under specific circumstances. Particularly in reoperations, mobilization of the coronary ostia can be hazardous and reattachment may require one or more interposition grafts to avoid tension, as originally described by Cabrol. We report a modified reimplantation technique of the coronary arteries that allows the creation of wide neo-ostia with minimal prosthetic material in case of a small aortic root.
May 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29338868/survival-and-reoperation-pattern-after-20-years-of-experience-with-aortic-valve-sparing-root-replacement-in-patients-with-tricuspid-and-bicuspid-valves
#12
Stefan Klotz, Sina Stock, Hans-Hinrich Sievers, Michael Diwoky, Michael Petersen, Ulrich Stierle, Doreen Richardt
OBJECTIVE: Remodeling or reimplantation are established operative techniques of aortic valve-sparing root replacement. Long-term follow-up is necessary comparing tricuspid and bicuspid aortic valves. METHODS: A total of 315 patients (tricuspid, n = 225, bicuspid, n = 89, quadricuspid, n = 1; remodeling, n = 101, reimplantation, n = 214) were evaluated. Mean follow-up was 10.1 ± 5.6 and 6.4 ± 4.2 years for the remodeling and reimplantation group, respectively...
April 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29338497/a-prospective-observational-study-comparing-cardiac-function-of-small-for-gestational-age-with-appropriate-for-gestational-age-babies-using-serial-echocardiographic-studies
#13
Manish Kumar, Sridhar Santhanam, Niranjan Thomas, Atanu Kumar Jana
BACKGROUND: Approximately 30% of babies born in India are low birth weight (LBW) and about 70% of LBW babies are small for gestational age (SGA). Though there are several trials that have evaluated cardiac function of intrauterine growth restricted (IUGR) babies in utero, there is limited data about postnatal cardiac function in SGA babies during early neonatal period. This study was conducted to evaluate the cardiac functions of SGA babies by serial echocardiographic measurements and compare this with appropriate for gestational age (AGA) babies during the early postnatal period...
January 31, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29329825/effectiveness-and-safety-of-transcatheter-aortic-valve-implantation-in-patients-with-pure-aortic-regurgitation-and-advanced-heart-failure
#14
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...
March 1, 2018: 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
#15
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
#16
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
#17
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)...
February 15, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29049549/transapical-cardioscopic-mitral-annuloplasty-a-short-term-survival-study-in-a-porcine-model
#18
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...
January 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28962499/valve-sparing-aortic-root-replacement-in-a-bicuspid-aortic-valve-with-papillary-fibroelastoma
#19
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
#20
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
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