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Patient Prosthesis mismatch

Vlad Ciobotaru, Nicolas Combes, Claire A Martin, Eloi Marijon, Eric Maupas, Augustin Bortone, Eric Bruguière, Jean-Benoit Thambo, Emmanuel Teiger, Pénélope Pujadas-Berthault, Julien Ternacle, Xavier Iriart
AIMS: To assess the predictive value of simulation based on 3D-printed models before left atrial appendage occlusion (LAAO) for peri-device leaks (PDL) and the impact on procedural outcomes compared to conventional imaging. METHODS AND RESULTS: 76 patients referred for LAAO with double disc device underwent construction of a 3D-printed LA model using flexible photopolymer resin. An implant simulation was performed retrospectively in Group 1 (55 patients), blinded to implanted device size, and prospectively in Group 2 (21 patients)...
March 13, 2018: EuroIntervention
Christopher Young, Günther Laufer, Alfred Kocher, Marco Solinas, Francesco Alamanni, Gianluca Polvani, Bruno K Podesser, Jose Ignacio Aramendi, Jose Arribas, Olivier Bouchot, Ugolino Livi, Massimo Massetti, Kim Terp, Christophe Giot, Mattia Glauber
OBJECTIVE: The goals of rapid-deployment aortic valve replacement include facilitation of minimally invasive surgery and reduced aortic crossclamp time. We report the short-term outcomes of a series of 493 patients undergoing rapid-deployment aortic valve replacement with the EDWARDS INTUITY valve system (Edwards Lifesciences, LLC, Irvine, Calif). METHODS: Assessing Standard oF Care and Clinical Outcomes UsiNg the EDWARDS INTUITY VAlve SysTem in a European multI-center, Active, pOst-market surveillaNce Study was a prospective, multicenter (n = 26) European registry designed to evaluate the safety and performance of the valve system...
February 2018: Journal of Thoracic and Cardiovascular Surgery
Sleiman Sebastian Aboul-Hassan, Tomasz Stankowski, Jakub Marczak, Romuald Cichon
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether patient-prosthesis mismatch (PPM) has a negative impact on patients undergoing mitral valve replacement in terms of postoperative mortality, incidence of postoperative pulmonary hypertension (PH) and higher transmitral gradients. Altogether 103 papers were found using the reported search, 18 of which represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
January 22, 2018: Interactive Cardiovascular and Thoracic Surgery
Abdallah El Sabbagh, Mackram F Eleid, Jane M Matsumoto, Nandan S Anavekar, Mohammed A Al-Hijji, Sameh M Said, Vuyisile T Nkomo, David R Holmes, Charanjit S Rihal, Thomas A Foley
INTRODUCTION: Three-dimensional (3D) prototyping is a novel technology which can be used to plan and guide complex procedures such as transcatheter mitral valve replacement (TMVR). METHODS: Eight patients with severe mitral annular calcification (MAC) underwent TMVR. 3D digital models with digital balloon expandable valves were created from pre-procedure CT scans using dedicated software. Five models were printed. These models were used to assess prosthesis sizing, anchoring, expansion, paravalvular gaps, left ventricular outflow tract (LVOT) obstruction, and other potential procedure pitfalls...
January 23, 2018: Catheterization and Cardiovascular Interventions
Sabine Bleiziffer, Magdalena Erlebach, Matheus Simonato, Philippe Pibarot, John Webb, Lukas Capek, Stephan Windecker, Isaac George, Jan-Malte Sinning, Eric Horlick, Massimo Napodano, David M Holzhey, Petur Petursson, Alfredo Cerillo, Nikolaos Bonaros, Enrico Ferrari, Mauricio G Cohen, Giselle Baquero, Tara L Jones, Ankur Kalra, Michael J Reardon, Adnan Chhatriwalla, Vasco Gama Ribeiro, Sami Alnasser, Nicolas M Van Mieghem, Christian Jörg Rustenbach, Joachim Schofer, Santiago Garcia, Tobias Zeus, Didier Champagnac, Raffi Bekeredjian, Ran Kornowski, Rüdiger Lange, Danny Dvir
OBJECTIVE: We aimed to analyse the incidence of prosthesis-patient mismatch (PPM) and elevated gradients after aortic valve in valve (ViV), and to evaluate predictors and associations with clinical outcomes of this adverse event. METHODS: A total of 910 aortic ViV patients were investigated. Elevated residual gradients were defined as ≥20 mm Hg. PPM was identified based on the indexed effective orifice area (EOA), measured by echocardiography, and patient body mass index (BMI)...
January 19, 2018: Heart: Official Journal of the British Cardiac Society
Philippe Pibarot, Matheus Simonato, Marco Barbanti, Axel Linke, Ran Kornowski, Tanja Rudolph, Mark Spence, Neil Moat, Gabriel Aldea, Marco Mennuni, Alessandro Iadanza, Hafid Amrane, Diego Gaia, Won-Keun Kim, Massimo Napodano, Hardy Baumbach, Ariel Finkelstein, Junjiro Kobayashi, Stephen Brecker, Creighton Don, Alfredo Cerillo, Axel Unbehaun, David Attias, Mohammed Nejjari, Noah Jones, Claudia Fiorina, Didier Tchetche, Raphael Philippart, Konstantinos Spargias, Jose-Maria Hernandez, Azeem Latib, Danny Dvir
OBJECTIVES: The aim of this study was to determine whether the association of small label size of the surgical valve with increased mortality after transcatheter valve-in-valve (ViV) implantation is, at least in part, related to pre-existing prosthesis-patient mismatch (PPM) (i.e., a bioprosthesis that is too small in relation to body size). BACKGROUND: Transcatheter ViV implantation is an alternative for the treatment of patients with degenerated bioprostheses...
January 22, 2018: JACC. Cardiovascular Interventions
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
Jayendrakumar S Patel, Amar Krishnaswamy, Jonathon White, Stephanie Mick, Jose Navia, Anand Mehta, Faisal Bakaeen, Zoran Popovic, Lars Svensson, Samir R Kapadia
OBJECTIVE: To demonstrate the feasibility of achieving good hemodynamic results with valve-in-valve transcatheter aortic valve replacement (ViV TAVR) for degenerated 19 mm surgical bioprosthetic valves. BACKGROUND: Considerable controversy exists regarding ViV TAVR within 19mm surgical prostheses due to concerns of elevated valve gradients and mortality. METHODS: Among all patient undergoing ViV TAVR between 7/2016 and 4/2017 for symptomatic severe bioprosthetic aortic stenosis (AS), five had a 19 mm surgical valve in place and were included in this publication...
December 11, 2017: Catheterization and Cardiovascular Interventions
Sreekanth Vemulapalli, David R Holmes, David Dai, Roland Matsouaka, Michael J Mack, Fred L Grover, Raj R Makkar, Vinod H Thourani, Pamela S Douglas
BACKGROUND: Recent reports of leaflet abnormalities (detected using advanced imaging) have raised questions regarding transcatheter aortic valve replacement (TAVR) durability. We sought to determine the incidence of valve hemodynamic deterioration (VHD) and its association with cardiovascular outcomes. METHODS AND RESULTS: Consecutive cases with paired postimplant and follow-up echocardiograms from November 2011 to March 2015 in the STS/ACC TVT Registry were allocated into 2 overlapping cohorts: early (paired echocardiograms at 0 and 30 days) and late (paired echocardiograms at 30 days and 1 year)...
January 2018: American Heart Journal
Alberto Repossini, Theodor Fischlein, Marco Solinas, Lorenzo DI Bacco, Bruno Passaretti, Herko Grubitzsch, Thierry Folliguet, Giuseppe Santarpino, Roberto DI Bartolomeo, François Laborde, Claudio Muneretto
BACKGROUND: Stentless aortic valves have been developed to overcome obstructive limitations associated with stented bioprostheses. A new concept of surgical sutureless (SU) bioprosthesis has been developed in the last decade. In this multi-institutional study we sought to compare hemodynamics of different bioprosthesis concept as transcatheter (TAVR), Livanova Perceval S sutureless valve and Freedom Solo Stentless (FS) valve in patients undergoing aortic valve replacement (sAVR). METHODS: From 2010 to 2016, 478 patients underwent sAVR with FS, 518 Perceval S and 367 patients underwent TAVR...
November 20, 2017: Minerva Cardioangiologica
Nathaniel W Taggart, Allison K Cabalka, Andreas Eicken, Jamil A Aboulhosn, John D R Thomson, Brian Whisenant, Martin L Bocks, Stephan Schubert, Thomas K Jones, Jeremy D Asnes, Thomas E Fagan, Jeffery Meadows, Mark Hoyer, Mary H Martin, Frank F Ing, Daniel R Turner, Azeem Latib, Aphrodite Tzifa, Stephan Windecker, Bryan H Goldstein, Jeffrey W Delaney, James A Kuo, Susan Foerster, Matthew Gillespie, Gianfranco Butera, Shabana Shahanavaz, Eric Horlick, Younes Boudjemline, Daniel Dvir, Doff B McElhinney
We sought to describe the acute results and short- to medium-term durability of transcatheter tricuspid valve-in-valve (TVIV) implantation within surgical bioprostheses among patients with Ebstein anomaly (EA). Cases were identified from a voluntary, multicenter, international registry of 29 institutions that perform TVIV. Demographic, clinical, procedural, and follow-up data were analyzed. Eighty-one patients with EA underwent TVIV from 2008 to 2016. Thirty-four patients (42%) were New York Heart Association (NYHA) class 3/4 at time of TVIV...
January 15, 2018: American Journal of Cardiology
Sina Stock, Hans-Hinrich Sievers, Doreen Richardt, Michael Scharfschwerdt
OBJECTIVES: Heart valve replacement with a bioprosthesis is one of the most frequently performed procedures in cardiac surgery and represents a highly effective therapy to relieve diseased heart valves. Nevertheless, as postoperatively elevated transvalvular gradients and prosthesis-patient mismatch are reported as shortcomings of the procedure or of the currently used devices, there is a need for novel bioprostheses with improved haemodynamics. This study presents preclinical haemodynamic results after mitral valve replacement with the novel TRIBIO bioprosthesis (TRIBIO) compared with an established bioprosthesis in a sheep model...
November 15, 2017: Interactive Cardiovascular and Thoracic Surgery
Parwis B Rahmanian, Süreyya Kaya, Kaveh Eghbalzadeh, Hruy Menghesha, Navid Madershahian, Thorsten Wahlers
BACKGROUND: The aim of this study was to evaluate the effects of rapid deployment aortic valve replacement (RDAVR) on surgical outcome and hemodynamics compared with standard aortic valve replacement (AVR). METHODS: One hundred sixty-three RDAVR patients (isolated, n = 67; combined with coronary artery bypass graft surgery [CABG], n = 96) were compared with a propensity matched control group (n = 163). Primary endpoints included association between valve type and procedure times, prosthesis size, transvalvular gradient, and indexed effective orifice area...
January 2018: Annals of Thoracic Surgery
Yan-Biao Liao, Yi-Jian Li, Li Jun-Li, Zhen-Gang Zhao, Xin Wei, Jiay-Yu Tsauo, Tian-Yuan Xiong, Yuan-Ning Xu, Yuan Feng, Mao Chen
The aim of this study was to investigate the incidence, predictors and outcome of prosthesis-patient mismatch (PPM) following transcatheter aortic valve replacement (TAVR). A total of 30 articles incorporating 4,691 patients were identified. The pooled incidences of overall, moderate and severe PPM following TAVR were 33.0%, 25.0% and 11.0% respectively. Medtronic CoreValve (MCV) had lower incidence of overall (32% vs: 40%, P < 0.0001) and moderate (23% vs 32%, P < 0.0001) than Edwards Sapien (ESV)...
November 8, 2017: Scientific Reports
Carlo Bassano, Valentina Gislao, Emanuele Bovio, Sonia Melino, Ilaria Tropea, Guglielmo Saitto, Marta Pugliese, Dionisio F Colella, Antonio Scafuri, Giovanni Ruvolo
BACKGROUND: An alarming rate of early failure has been recently reported for the LivaNova (previously Sorin) Mitroflow (LivaNova, London, UK) bioprosthesis. Here, we aimed at verifying if this possible underperformance is confirmed in a large, single-center experience and identifying the risk factors associated with early deterioration. METHODS: In all, 459 Mitroflow valves have been implanted from July 2009 to December 2013 (patients' mean age 73 years; 204 women)...
November 1, 2017: Annals of Thoracic Surgery
Iñaki Cercadillo-Ibarguren, Alba Sánchez-Torres, Rui Figueiredo, Eduard Valmaseda-Castellón
AIM: To describe a bimaxillary simultaneous immediate loading protocol with full-arch implant-supported fixed prostheses. MATERIAL AND METHODS: A prospective case series of 8 patients who required full-arch rehabilitation was conducted. The main inclusion criteria were patients with teeth that required extraction. At least 1 molar per arch was temporarily employed to stabilize the surgical template and the provisional prosthesis during intraoral relining. RESULTS: Two upper implants failed in 1 patient...
September 2017: Journal of Clinical and Experimental Dentistry
Antonino S Rubino, Fausto Biancari, Vincenzo Caruso, Vincenzo Lavanco, Fiorella Privitera, Ivana Rinaldi, Maria Sanfilippo, Giovanni Millan, Lucia V D'Urso, Sergio Castorina, Carmelo Mignosa
OBJECTIVES: The aim of this study was to evaluate the hemodynamic performance of a sutureless bioprosthesis under high workload at mid-term follow-up. METHODS: Thirty-two patients who underwent isolated aortic valve replacement with a Perceval sutureless bioprosthesis with a minimum follow-up of 1 year were enrolled in this study. S size prosthesis was deployed in 10 patients (31.3%), M size in 9 (28.1%), L size in 8 (25%) and XL size in 5 (15.6%). Effective orifice area (EOA), EOA index (EOAi), and transvalvular gradients were assessed at rest and during dobutamine stress echocardiography (DSE) a median of 19...
October 26, 2017: Echocardiography
Y Hisata, S Yokose, S Hazama, I Matsumaru, K Eishi
OBJECTIVES: Asians are smaller than Europeans and North Americans, but aortic valve replacement (AVR) in small patients has not been examined. We aimed to compare short- and mid-term outcomes of AVR between small and non-small patients. METHODS: We retrospectively divided 173 patients who underwent AVR into small (S, n = 95) and non-small (NS, n = 78) groups according to body surface area (≤1.6 in men, ≤1.5 in women) and analyzed differences in baseline characteristics, procedural and post-procedural variables, and survival...
October 11, 2017: Asian Journal of Surgery
Miroslaw Gozdek, Giuseppe Maria Raffa, Piotr Suwalski, Michalina Kolodziejczak, Lech Anisimowicz, Jacek Kubica, Eliano Pio Navarese, Mariusz Kowalewski
The objective of this report was to directly compare, by means of a systematic review and meta-analysis, redo surgical aortic valve replacement (re-sAVR) with valve-in-valve transcatheter aortic valve implantation (ViV TAVI) for patients with failed degenerated aortic bioprostheses. Multiple databases were screened for all available reports comparing ViV TAVI with re-sAVR in patients with failing degenerated aortic bioprostheses. The primary outcome was all-cause mortality determined from the longest available survival data...
September 8, 2017: European Journal of Cardio-thoracic Surgery
Seung Hyun Lee, Byung Chul Chang, Young-Nam Youn, Hyun Chel Joo, Kyung-Jong Yoo, Sak Lee
BACKGROUND: Prosthesis-patient mismatch (PPM) is characterised by the effects of inadequate prosthesis size relative to body surface area (BSA).The purpose of this study was to determine the impact of PPM on late clinical outcomes after mitral valve replacement (MVR) in rheumatic population. METHODS: From 2000 to 2013, a total of 445 patients (mean age 54.2 ± 11.7 years) underwent isolated MVR (±tricuspid annuloplasty) for rheumatic disease were investigated...
October 10, 2017: Journal of Cardiothoracic Surgery
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