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Paravalvular regurgitation

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https://www.readbyqxmd.com/read/28521923/safety-and-efficacy-of-transcatheter-aortic-valve-replacement-in-the-treatment-of-pure-aortic-regurgitation-in-native-valves-and-failing-surgical-bioprostheses-results-from-an-international-registry-study
#1
Fadi J Sawaya, Marcus-André Deutsch, Moritz Seiffert, Sung-Han Yoon, Pablo Codner, Upul Wickramarachchi, Azeem Latib, A Sonia Petronio, Josep Rodés-Cabau, Maurizio Taramasso, Marco Spaziano, Johan Bosmans, Luigi Biasco, Darren Mylotte, Mikko Savontaus, Peter Gheeraert, Jason Chan, Troels H Jørgensen, Horst Sievert, Marco Mocetti, Thierry Lefèvre, Francesco Maisano, Antonio Mangieri, David Hildick-Smith, Ran Kornowski, Raj Makkar, Sabine Bleiziffer, Lars Søndergaard, Ole De Backer
OBJECTIVES: The aim of this study was to evaluate the use of transcatheter heart valves (THV) for the treatment of noncalcific pure native aortic valve regurgitation (NAVR) and failing bioprosthetic surgical heart valves (SHVs) with pure severe aortic regurgitation (AR). BACKGROUND: Limited data are available about the "off-label" use of transcatheter aortic valve replacement (TAVR) to treat pure severe AR. METHODS: The study population consisted of patients with pure severe AR treated by TAVR at 18 different centers...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28507571/transcatheter-paravalvular-leak-closure-and-hemolysis-a-prospective-registry
#2
Grzegorz Smolka, Piotr Pysz, Andrzej Ochała, Michał Kozłowski, Wojciech Zasada, Zofia Parma, Michał Tendera, Wojciech Wojakowski
INTRODUCTION: Paravalvular leak (PVL) related to a surgical prosthetic valve may be associated with clinically significant hemolysis. The influence of transcatheter PVL closure (TPVLC) on hemolysis remains uncertain. MATERIAL AND METHODS: The prospective registry included patients undergoing TPVLC due to PVL-related heart failure and/or hemolysis. Procedural data, laboratory markers of hemolysis and heart failure status were recorded at baseline, discharge and at 1- and 6-month follow-up...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28500739/feasibility-and-safety-of-transfemoral-sheathless-portico-aortic-valve-implantation-preliminary-results-in-a-single-center-experience
#3
Maurizio Taramasso, Andrea Denegri, Shingo Kuwata, Hans Rickli, Philipp K Haager, Gabor Sütsch, Hector Rodriguez Cetina Biefer, Jan Kottwitz, Fabian Nietlispach, Francesco Maisano
BACKGROUND: Feasibility of transfemoral (TF) transcathteter aortic valve replacement (TAVR) is limited by the smallest diameter, the calcification and tortuosity of the iliofemoral access vessels. The use of the Portico system without delivery sheath results in significantly lower profile delivery system compared to standard technique. We herein report our single center experience, feasibility and safety of such an approach. METHODS: The Portico valve was implanted sheathless in 81 high-risk patients with severe aortic stenosis utilizing percutaneous femoral access...
May 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28493389/contemporary-transcatheter-aortic-valve-replacement-with-third-generation-balloon-expandable-versus-self-expanding-devices
#4
Toby Rogers, Arie Steinvil, Kyle Buchanan, M Chadi Alraies, Edward Koifman, Jiaxiang Gai, Rebecca Torguson, Petros Okubagzi, Itsik Ben-Dor, Augusto Pichard, Lowell Satler, Ron Waksman
OBJECTIVES: To evaluate balloon-expandable and self-expanding third-generation transcatheter aortic valve replacement (TAVR) devices according to patient selection criteria and outcomes. BACKGROUND: Two competing third-generation TAVR technologies are currently commercially available in the US. There are no published head-to-head comparisons of the relative performance of these two devices. METHODS: 257 consecutive patients undergoing TAVR with a third-generation balloon-expandable (Edwards Sapien 3) or self-expanding device (Medtronic CoreValve Evolut R) at a single US medical center were included...
May 11, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28484830/insights-on-mid-term-tavr-performance-3-year-clinical-and-echocardiographic-results-from-the-corevalve-advance-study
#5
Sabine Bleiziffer, Johan Bosmans, Stephen Brecker, Ulrich Gerckens, Peter Wenaweser, Corrado Tamburino, Axel Linke
BACKGROUND: Extensive evidence relating to transcatheter aortic valve replacement (TAVR) has accumulated in recent years, but mid-term outcomes are less reported. We investigated 996 patients after implantation of the CoreValve prosthesis for severe aortic stenosis in a real-world setting. OBJECTIVE: To report clinical and echocardiographic 3-year results from the ADVANCE study. METHODS: ADVANCE is a prospective, multicenter, fully monitored, nonrandomized clinical study...
May 8, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28483264/transcatheter-aortic-valve-insertion-after-previous-mitral-valve-operation
#6
Kevin L Greason, Gurpreet S Sandhu, Vuyisile T Nkomo, Katherine S King, David L Joyce, Eric E Williamson, David R Holmes
OBJECTIVE: There are limited data on transcatheter aortic valve insertion after previous mitral valve operation. To better understand the associated procedural risks, we reviewed our single-center experience. METHODS: We retrospectively reviewed the records of 772 consecutive patients who received transcatheter aortic valve insertion from November 2008 through August 2016. There were 18 (2%) patients who had previous mitral valve operation that included valve repair in 4 patients (22%) and replacement in 14 (78%)...
April 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28475690/safety-effectiveness-and-haemodynamic-performance-of-a-new-stented-aortic-valve-bioprosthesis%C3%A2
#7
Robert J M Klautz, A Pieter Kappetein, Rüdiger Lange, Francois Dagenais, Louis Labrousse, Vinayak Bapat, Michael Moront, Martin Misfeld, Cathy Zeng, Joseph F Sabik Iii
OBJECTIVES: We assessed the safety, effectiveness and haemodynamic performance of a new bovine stented aortic valve bioprosthesis (Avalus™). METHODS: The PERIGON Pivotal Trial is a prospective, non-randomized, multicentre study. Subjects had symptomatic moderate or severe aortic stenosis or chronic, severe aortic regurgitation. Death, valve-related adverse events (AEs), functional recovery and haemodynamic performance were assessed at discharge, 3-6 months and 1 year...
May 4, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28473128/transcatheter-aortic-valve-implantation-within-degenerated-aortic-surgical-bioprostheses-partner-2-valve-in-valve-registry
#8
John G Webb, Michael J Mack, Jonathon M White, Danny Dvir, Philipp Blanke, Howard C Herrmann, Jonathon Leipsic, Susheel K Kodali, Raj Makkar, D Craig Miller, Philippe Pibarot, Augusto Pichard, Lowell F Satler, Lars Svensson, Maria C Alu, Rakesh M Suri, Martin B Leon
BACKGROUND: Early experience with transcatheter aortic valve replacement (TAVR) within failed bioprosthetic surgical aortic valves has shown that valve-in-valve (VIV) TAVR is a feasible therapeutic option with acceptable acute procedural results. OBJECTIVES: The authors examined 30-day and 1-year outcomes in a large cohort of high-risk patients undergoing VIV TAVR. METHODS: Patients with symptomatic degeneration of surgical aortic bioprostheses at high risk (≥50% major morbidity or mortality) for reoperative surgery were prospectively enrolled in the multicenter PARTNER (Placement of Aortic Transcatheter Valves) 2 VIV trial and continued access registries...
May 9, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28457950/practical-determination-of-aortic-valve-calcium-volume-score-on-contrast-enhanced-computed-tomography-prior-to-transcatheter-aortic-valve-replacement-and-impact-on-paravalvular-regurgitation-elucidating-optimal-threshold-cutoffs
#9
Nicolas Bettinger, Omar K Khalique, Joseph M Krepp, Nadira B Hamid, David J Bae, Todd C Pulerwitz, Ming Liao, Rebecca T Hahn, Torsten P Vahl, Tamim M Nazif, Isaac George, Martin B Leon, Andrew J Einstein, Susheel K Kodali
BACKGROUND: The threshold for the optimal computed tomography (CT) number in Hounsfield Units (HU) to quantify aortic valvular calcium on contrast-enhanced scans has not been standardized. Our aim was to find the most accurate threshold to predict paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). METHODS: 104 patients who underwent TAVR with the CoreValve prosthesis were studied retrospectively. Luminal attenuation (LA) in HU was measured at the level of the aortic annulus...
April 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28427598/computed-tomography-based-oversizing-degrees-and-incidence-of-paravalvular-regurgitation-of-a-new-generation-transcatheter-heart-valve
#10
Philipp Blanke, Philippe Pibarot, Rebecca Hahn, Neil Weissman, Susheel Kodali, Vinod Thourani, Rupa Parvataneni, Danny Dvir, Christopher Naoum, Bjarne L Nørgaard, Pamela Douglas, Wael Jaber, Omar K Khalique, Hasan Jilaihawi, Michael Mack, Craig Smith, Martin Leon, John Webb, Jonathon Leipsic
OBJECTIVES: The aim of the study was to investigate the influence of the extent of computed tomography (CT)-based area and perimeter oversizing on the incidence and severity of paravalvular aortic regurgitation (PAR) for the Edwards SAPIEN 3 (Edwards Lifesciences, Irvine, California) device, using CT data and echocardiographic outcome data of the PARTNER II (Placement of AoRTic TraNscathetER Valves Trial II) SAPIEN 3 intermediate-risk cohort. BACKGROUND: Transcatheter heart valve (THV) sizing algorithms are device specific, requiring refinements for new valve designs...
April 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28391002/paravalvular-regurgitation-after-transcatheter-aortic-valve-replacement-comparing-transthoracic-versus-transesophageal-echocardiographic-guidance
#11
Salim S Hayek, Frank E Corrigan, Jose F Condado, Shuang Lin, Sharon Howell, James P MacNamara, Shuai Zheng, Patricia Keegan, Vinod Thourani, Vasilis C Babaliaros, Stamatios Lerakis
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly being performed in cardiac catheterization laboratories using transthoracic echocardiography (TTE) to guide valve deployment. The risk of paravalvular regurgitation (PVR) remains a concern. METHODS: We retrospectively reviewed 454 consecutive patients (mean age, 82 ± 8; 58% male) who underwent transfemoral TAVR at Emory Healthcare from 2007 to 2014. Two hundred thirty-four patients underwent TAVR in the cardiac catheterization laboratory with TTE guidance (TTE-TAVR; mean Society of Thoracic Surgeons score, 10%), while 220 patients underwent the procedure in the hybrid operating room with transesophageal echocardiography (TEE) guidance (TEE-TAVR; mean Society of Thoracic Surgeons score, 11%)...
June 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28383864/-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-intermediate-risk-patients-with-severe-symptomatic-aortic-stenosis
#12
REVIEW
P Lancellotti, H Kulbertus
Aortic valve stenosis (AS) is the most commonly operated valvular heart disease in developed countries. Aortic valve replacement is the sole effective treatment of symptomatic patients. PARTNER-1 (Placement of AoRtic TraNscathetER Valves) has recently proved the efficacy of percutaneous aortic valve replacement (TAVI : Transcatheter Aortic Valve Implantation) in patients at high surgical risk, or inoperable. In the present article, we report and discuss the results of the PARTNER-2 study in intermediate risk patients...
June 2016: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28379513/five-year-echocardiographic-follow-up-after-tavi-structural-and-functional-changes-of-a-balloon-expandable-prosthetic-aortic-valve
#13
Manuela Muratori, Laura Fusini, Gloria Tamborini, Paola Gripari, Sarah Ghulam Ali, Massimo Mapelli, Franco Fabbiocchi, Piero Trabattoni, Maurizio Roberto, Marco Agrifoglio, Francesco Alamanni, Antonio L Bartorelli, Mauro Pepi
Aims: Scarce data are available on the long-term structural and functional changes of prosthetic valves after transcatheter aortic valve implantation (TAVI). The objective was to evaluate with echocardiography the long-term structural and functional changes of prosthetic valves after TAVI. Methods and results: Structural valve deterioration (SVD) was defined as leaflet thickening ≥3mm, presence of calcification and abnormal leaflet motion. Five-year echocardiographic follow-up was available in 96 out of 318 patients who underwent TAVI with a balloon-expandable device between April 2008 and December 2011...
March 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28379473/severe-aortic-regurgitation-after-implantation-of-a-sutureless-valve-prosthesis-using-an-automatic-knot-fastener-device
#14
Robert Balan, Christian Mogilansky, Axel-Lars Larsen, Parwis Massoudy
We report the case of severe aortic regurgitation 8 months after implantation of a 25-mm sutureless pericardial aortic valve prosthesis. On echocardiography, the regurgitation was suspected to be paravalvular. The sutureless prosthesis had been implanted using an automatic knot fastener device, which renders the suture tails less pliable because of the metal clip that is crimped around the suture.The patient was reoperated, a paravalvular leak was not observed. The sutureless prosthesis was explanted and a conventional biologic valve prosthesis was implanted instead...
March 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28379385/five-year-evolution-of-mild-aortic-regurgitation-following-transcatheter-aortic-valve-implantation-early-insights-from-a-single-centre-experience
#15
Nicola Buzzatti, Alessandro Castiglioni, Eustachio Agricola, Marta Barletta, Stefano Stella, Francesco Giannini, Damiano Regazzoli, Antonio Mangieri, Marco Ancona, Pietro Spagnolo, Alaide Chieffo, Matteo Montorfano, Ottavio Alfieri, Antonio Colombo, Azeem Latib
OBJECTIVES: To assess the follow-up evolution and impact of mild aortic regurgitation (1 + AR) following transcatheter aortic valve implantation (TAVI). METHODS: We evaluated the follow-up outcomes and AR evolution of 558 patients affected by native aortic stenosis who underwent TAVI with residual AR ≤ 1+. RESULTS: No residual AR was found in 294 (52.7%) patients, whereas 1 + AR was found in 264 (47.3%) patients. At 5.5 years, freedom from all-cause mortality (56...
March 31, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28374676/a-meta-analysis-on-clinical-outcomes-after-transaortic-transcatheter-aortic-valve-implantation-by-the-heart-team
#16
Hafid Amrane, Fabiano Porta, Ad J Van Boven, A Pieter Kappetein, Stuart J Head
AIMS: This study performed a meta-analysis on transaortic (TAo) transcatheter aortic valve implantation (TAVI), in order to gain more insight into the safety and efficacy of the approach in addition to the data available from selected centers with small numbers of patients. METHODS AND RESULTS: PubMed and EMBASE were searched on August 31st, 2016. The search yielded 251 studies, of which 16 studies with 1907 patients were included in the meta-analysis. All studies were observational, single-arm studies...
April 4, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28369303/transaortic-transcatheter-aortic-valve-implantation-as-a-first-line-choice-or-as-a-last-resort-an-analysis-based-on-the-route-registry
#17
Nikolaos Bonaros, Rainer Petzina, Riccardo Cocchieri, Dariusz Jagielak, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Vinayak Bapat, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Markus Kofler, Peter Bramlage, Cornelia Deutsch, Martin Thoenes, Derk Frank, Mauro Romano
OBJECTIVES: Transaortic transcatheter aortic valve implantation (TAo-TAVI) is a recently developed alternative to transapical (TA) or transfemoral (TF) TAVI. We aimed to analyse the effectiveness and safety of TAo-TAVI as a first line approach and to compare it to patients receiving TAo-TAVI as a last resort, which is current practice. METHODS: ROUTE is a prospective, multicentre registry to assess the clinical outcomes of TAo-TAVI. Patients without contraindications for TA- and TF-TAVI (TAo-first) were compared to patients with contraindications for both of these access routes (TAo-last)...
May 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28369223/severe-aortic-stenosis-with-low-aortic-valve-calcification-characteristics-and-outcome-following-transcatheter-aortic-valve-implantation
#18
Yigal Abramowitz, Hasan Jilaihawi, Philippe Pibarot, Tarun Chakravarty, Mohammad Kashif, Yoshio Kazuno, Yoshio Maeno, Hiroyuki Kawamori, Geeteshwar Mangat, John Friedman, Wen Cheng, Raj R Makkar
Aims: High aortic valve calcification (AVC) assessed with CT may be used to differentiate between severe and non-severe aortic stenosis (AS). Nonetheless, in some cases patients with low calcification are diagnosed with haemodynamically severe AS. The prevalence, mechanism of valve stenosis and implications for transcatheter aortic valve implantation (TAVI) of low AVC severe AS remain unclear. We assessed the clinical and haemodynamic characteristics and the outcome of patients with severe AS and low AVC that undergo TAVI...
June 1, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28361580/rapid-deployment-or-transcatheter-aortic-valves-in-intermediate-risk-patients
#19
Piergiorgio Bruno, Alessandro Di Cesare, Marialisa Nesta, Federico Cammertoni, Andrea Mazza, Lazzaro Paraggio, Raphael Rosenhek, Francesco Burzotta, Filippo Crea, Carlo Trani, Massimo Massetti
Background Transcatheter aortic valve implantation and rapid-deployment aortic valve replacement represent two emerging therapies for patients with intermediate surgical risk and severe aortic stenosis. However, head-to-head comparisons between such novel therapies are lacking. Methods Severe aortic stenosis patients with intermediate surgical risk treated with rapid-deployment valve replacement at our institution were identified and compared with a propensity-matched population of patients who underwent transcatheter aortic valve replacement...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28345243/dehiscence-of-a-pulmonary-bioprosthesis-with-a-focal-dissection-of-the-pulmonary-artery-in-a-patient-with-congenital-pulmonic-stenosis
#20
Evin Yucel, Ami Bhatt, Christos G Mihos, Brian B Ghoshhajra, Doreen DeFaria Yeh
Pulmonary valve replacement (PVR) is the most common adult congenital cardiac operation performed. Valve degeneration leading to prosthetic stenosis and/or regurgitation is a long-term risk in this population and may be associated with paravalvular leak (PVL). Complications involving the proximal pulmonary artery, including dissection, are less clearly defined. Herein, we report the case of a 30-year-old patient with a history of multiple pulmonary valve interventions secondary to congenital pulmonic stenosis, who developed dehiscence of a bioprosthetic PVR associated with significant paravalvular leak (PVL) and further complicated by a focal dissection of the proximal pulmonary artery...
March 27, 2017: Echocardiography
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