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Paravalvular regurgitation

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https://www.readbyqxmd.com/read/29774982/transcatheter-mitral-valve-implantation-in-rigid-mitral-annuloplasty-rings-potential-differences-between-complete-and-incomplete-rings
#1
Daisuke Hachinohe, Azeem Latib, Matteo Montorfano, Antonio Colombo
Transcatheter mitral valve implantation (TMVI) has been performed in high-risk and inoperable patients for degenerated mitral bioprostheses (TMVIinV) and failed annuloplasty rings (TMVIinR). TMVIinR is more challenging compared to TMVIinV because of the differences in dimensions, shapes, and contours between rings and valves. In this report, we present two clinical cases of TMVIinR that were treated by trans-septal implantation of a balloon-expandable prosthesis. In TMVI cases with an incomplete ring, the ring will be stretched out toward its anterior and commissural side, and the open side of the ring will increase in width...
May 18, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29762934/rescue-tavi-for-aortic-regurgitation-after-left-ventricular-assist-device-implantation-following-preoperative-impella%C3%A2-support
#2
Florian E M Herrmann, Petra Wellmann, Vera von Dossow, Steffen Massberg, Christian Hagl, René Schramm, Maximilian Pichlmaier
A patient presented with a decompensated cardiomyopathy requiring invasive hemodynamic support with an Impella® heart pump. Extracorporeal life support (ECLS) became necessary during the further course and the patient was bridged to left ventricular assist device (LVAD) implantation. Postoperatively, the patient did not improve as expected due to new aortic regurgitation (AR) that was most likely caused by the previously placed Impella. A SAPIEN 3 transcatheter aortic valve was implanted as a bail-out strategy; an additional valve-in-valve rescue was required due to paravalvular regurgitation...
September 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29743908/quantitative-estimation-of-aortic-valve-calcification-in-multislice-computed-tomography-in-predicting-the-development-of-paravalvular-leaks-following-transcatheter-aortic-valve-replacement
#3
Małgorzata Ryś, Tomasz Hryniewiecki, Ilona Michałowska, Patrycjusz Stokłosa, Monika Różewicz-Juraszek, Zbigniew Chmielak, Maciej Dąbrowski, Kryspin Mirota, Piotr Szymański
Introduction: Transcatheter aortic valve implantation (TAVI) improves prognosis in patients disqualified from surgical valve replacement. Calcifications of the aortic complex can lead to deformation of the prosthesis, resulting in paravalvular leaks (PVL). Aim: To evaluate the predictive value of quantitative estimation of volume/weight and geometric distribution of calcifications in multislice computed tomography, for the development of PVL. Material and methods: This was a retrospective, case-control study on patients with a CoreValve aortic prosthesis...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29741488/long-term-durability-and-hemodynamic-performance-of-a-self-expanding-transcatheter-heart-valve-beyond-5-years-after-implantation-a-prospective-observational-study-applying-the-standardized-definitions-of-structural-deterioration-and-valve-failure
#4
Erik W Holy, Julia Kebernik, Mohammad Abdelghani, Simon F Stämpfli, Jens Hellermann, Abdelhakim Allali, Mohamed El-Mawardy, Susanne Sachse, Thomas F Lüscher, Felix C Tanner, Gert Richardt, Mohamed Abdel-Wahab
AIMS: Long-term results of transcatheter aortic valve implantation (TAVI), in particular the incidence of bioprosthetic valve failure (BVF), are uncertain. METHODS AND RESULTS: The study prospectively included all 152 patients who had undergone TAVI with the self-expanding CoreValve™ up to December 2011 at the Heart Center, Bad Segeberg, Germany. Late BVF (>30 days) was defined as either: 1) Severe structural valve deterioration (trans-prosthetic mean pressure gradient ≥40 mmHg and/or ≥20 mmHg rise from baseline OR severe intra-prosthetic aortic regurgitation), OR 2) Bioprosthetic valve dysfunction leading to death or re-intervention...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29741486/computed-tomography-based-oversizing-and-incidence-of-para-valvular-aortic-regurgitation-and-permanent-pacemaker-implantation-with-a-new-generation-self-expanding-transcatheter-heart-valve
#5
Ung Kim, Philipp Blanke, Stephan Windecker, Albert M Kasel, Ulrich Schäfer, Darren Walters, Axel Linke, Herve Le Breton, Gerhard Schymik, Mark S Spence, Lars Sondergaard, Mohammed Abdel-Wahab, Stephen Worthley, Didier Tchetche, Hermann Reichenspurner, Mickael Ohana, Stephanie L Sellers, Jonathon A Leipsic
AIMS: We aimed to evaluate the relationship between CT-based annular perimeter oversizing and the incidence of paravalvular aortic regurgitation (PAR) and permanent pacemaker (PPM) implantation in patients treated with the new self-expanding CENTERA transcatheter heart valve (THV) for severe aortic stenosis. METHODS AND RESULTS: 198 patients in the CENTERA-EU trial were stratified priori into four groups based on the perimeter oversizing (2.5%-10%, 10-15%, 15-20% and >20%)...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29739021/prognosis-of-transcatheter-closure-compared-with-surgical-repair-of-paravalvular-leak-after-prosthetic-valve-replacement-a-retrospective-comparison
#6
Chun Yang, Yang Liu, Jiayou Tang, Ping Jin, Lanlan Li, Shiqiang Yu, Jian Yang
OBJECTIVE:  Paravalvular leak (PVL) after valve replacement remains clinically challenging. Percutaneous closure is an effective therapy for patients with PVLs because reoperation is associated with high rates of morbidity and mortality. The purpose of this study was to retrospectively compare the clinical outcome of transcatheter closure and surgical repair in patients with a PVL. METHODS:  From January 2000 to May 2016, 131 patients with PVL were treated at three major medical centers in China...
May 8, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29721704/workup-and-management-of-patients-with-paradoxical-low-flow-low-gradient-aortic-stenosis
#7
REVIEW
Mohamed-Salah Annabi, Marine Clisson, Marie-Annick Clavel, Philippe Pibarot
About 60% of patients with paradoxical low-flow, low-gradient (PLF-LG) aortic stenosis (AS) have a severe disease that justifies aortic valve replacement (AVR). The first step in patients with symptomatic PLF AS should be to rule out measurement errors and treat hypertension. The second step is to distinguish pseudo-severe from true severe AS (TSAS). The third step is to select the optimal treatment modality at the right time. Regarding the second step, projected aortic valve area calculated using stress echocardiography is superior to traditional severity criteria (AVA < 1...
May 2, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29696693/cardiovascular-magnetic-resonance-assessment-of-1st-generation-corevalve-and-2nd-generation-lotus-valves
#8
Tarique Al Musa, Akhlaque Uddin, Laura E Dobson, Peter P Swoboda, Pankaj Garg, James R J Foley, Christopher Malkin, Sven Plein, Daniel J Blackman, John P Greenwood
OBJECTIVES: We sought to compare using serial CMR, the quantity of AR and associated valve hemodynamics, following the first-generation CoreValve (Medtronic, Minneapolis, MN) and the second-generation Lotus valve (Boston Scientific, Natick, MA). BACKGROUND: Aortic regurgitation (AR) following Transcatheter Aortic Valve Replacement (TAVR) confers a worse prognosis and can be accurately quantified using cardiovascular magnetic resonance (CMR). Second generation valves have been specifically designed to reduce paravalvular AR and improve clinical outcomes...
April 25, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29680171/impact-of-balloon-predilatation-on-hemodynamics-and-outcomes-after-transcatheter-aortic-valve-implantation-with-the-self-expanding-corevalve-prosthesis
#9
Toby Rogers, Ron Waksman, J Kevin Harrison, G Michael Deeb, Angie Q Zhang, James B Hermiller, Jeffrey J Popma, Michael J Reardon
The impact of predilatation (Pre-Dil) on prosthesis hemodynamics and clinical outcomes of subjects who underwent transcatheter aortic valve implantation (TAVI) with a self-expanding prosthesis remains unclear. Two thousand seven hundred twenty-one subjects from the extreme- and high-risk CoreValve Continued Access Study (CAS) were included in the analysis. Subjects who underwent Pre-Dil before TAVI were compared with subjects who underwent TAVI without Pre-Dil. Clinical outcomes included death, stroke, myocardial infarction, acute kidney injury, and new permanent pacemaker implantation...
March 1, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29667013/predictors-of-paravalvular-regurgitation-and-permanent-pacemaker-implantation-after-tavr-with-a-next-generation-self-expanding-device
#10
Victor Mauri, Florian Deuschl, Thomas Frohn, Niklas Schofer, Matthias Linder, Elmar Kuhn, Andreas Schaefer, Volker Rudolph, Navid Madershahian, Lenard Conradi, Tanja K Rudolph, Ulrich Schäfer
AIMS: To identify predictors of paravalvular regurgitation (PVR) and permanent pacemaker implantation (PPI) following TAVR with a next-generation self-expanding device. METHODS AND RESULTS: Device landing zone (DLZ) calcification, angiographic implantation depth, and baseline and procedural characteristics were analyzed in 212 patients being treated with the ACURATE neo aortic bioprosthesis. PVR was none/trace in 57.1% and ≥ mild in 42.9% (37% mild, 6% moderate)...
April 17, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29627180/transatrial-implantation-of-a-transcatheter-heart-valve-for-severe-mitral-annular-calcification
#11
Fabien Praz, Omar K Khalique, Raymond Lee, Ramesh Veeragandham, Hyde Russell, Mayra Guerrero, Ashequl M Islam, David W Deaton, Tsuyoshi Kaneko, Susheel K Kodali, Martin B Leon, Vinayak Bapat, Hiroo Takayama, Michael A Borger, Isaac George
OBJECTIVE: To assess the outcomes of transatrial implantation of a transcatheter heart valve (THV) for the treatment of mitral valve disease with severe mitral annular calcification (MAC). METHODS: Implantation of a balloon-expandable THV was performed on cardiopulmonary bypass via left atrial exposure in patients considered at risk for left ventricular outflow tract obstruction. The anterior mitral valve leaflet was systematically resected and pledgeted sutures were placed to enhance stability and reduce paravalvular leak...
March 12, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29627110/comparison-of-outcomes-of-transfemoral-aortic-valve-implantation-in-patients-90-with-those-90-years-of-age
#12
Jeroen Vendrik, Martijn S van Mourik, Floortje van Kesteren, Marieke J Henstra, Jan J Piek, Jose P S Henriques, Joanna J Wykrzykowska, Robbert J de Winter, M Marije Vis, Karel T Koch, Jan Baan
In patients who underwent transcatheter aortic valve implantation (TAVI), postoperative mortality risk is commonly assessed with risk scores such as the Society of Thoracic Surgeons-Postoperative Risk of Mortality (STS-PROM) and EuroSCORE II, in which age plays a dominant role. However, we reason that in the naturally selected oldest-old patients (nonagenarians), this may not be completely justified and that therefore age should play a minor role in decision-making. The objective of this study was to compare procedural outcome and mid-term mortality of transfemoral (TF)-TAVI patients aged ≥90 years with patients aged <90 years...
March 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29622987/outcome-of-transcatheter-aortic-valve-implantation-in-high-risk-patients-with-severe-aortic-stenosis
#13
Hamdy Soliman, Khlid Alrabaat, Tarek Aboalaazm, Shaimaa Mostafa, Asaad Samy
Aim: To assess outcome of TAVI in high risk patients with severe symptomatic aortic stenosis. Patients and methods: 40 patients with symptomatic severe aortic stenosis and high risk underwent TAVI with implantation of either Sapien XT valve or Core Valve and followed for 6 months. Device success, cardiovascular mortality, myocardial infarction, stroke, life-threatening bleeding and vascular complications were defined according to Valve Academic Research Consortium definitions...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29622986/clinical-utility-of-a-predictive-model-for-paravalvular-aortic-regurgitation-after-transcatheter-aortic-valve-implantation-with-a-self-expandable-prosthesis
#14
Ahmad E Mostafa, Gert Richardt, Mohamed Abdel-Wahab
Background: A predictive model for Paravalvular aortic regurgitation (PAR) integrating the left ventricular outflow tract-to-ascending aorta angle (LVOT-AO) and depth to the non-coronary cusp (NCC) after TAVI with CoreValve prosthesis (MCP) was retrospectively identified (2 × ∠LVOT-AO + [depth to NCC-10]2; cutoff = 50). However, the validity and clinical utility of this model remain unknown. Methods: A total of 100 patients (79.6 ± 7 years, mean EuroScore 24...
December 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29617510/symptomatic-aortic-paravalvular-leak-percutaneous-treatment-with-amplatzer-vascular-plug-iii-device-as-an-alternative-to-surgery
#15
Gabriel E Pérez Baztarrica, Gastón Heredia, Juan Arellano, Juan Fernández, Rafael Porcile
A significant prosthetic paravalvular leak is an uncommon and severe postsurgical complication correlated to the occurrence of congestive heart failure and hemolytic anemia. Percutaneous treatment has become an attractive and effective proposal to relieve symptoms and reduce complications in patients whose high rate of morbidity/mortality precludes a new surgery. This is the case of an 81-year-old patient with a history of biological aortic valve replacement seeking medical help due to heart failure and hemolytic anemia, with a prosthetic paravalvular regurgitation jet and high surgical mortality according to EuroSCORE II...
January 2018: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29608814/impact-of-high-implantation-on-functionality-of-self-expandable-bioprosthesis-during-the-short-and-long-term-outcome-of-patients-who-undergo-tavi-is-high-implantation-beneficial
#16
Manolis Vavuranakis, Maria Kariori, Lilly Scott, Konstantinos Kalogeras, Gerasimos Siasos, Dimitrios Vrachatis, Maria Lavda, Charalampos Kalantzis, Michael Vavuranakis, Evangelia Bei, Carmen-Maria Moldovan, Evangelos Oikonomou, Christodoulos Stefanadis, Dimitrios Tousoulis
AIM: High position of the self-expandable bioprosthesis CoreValve/Evolut R has been proved to affect immediate hemodynamics of the valve. Whether this may have any impact on long-term procedural outcome has not been defined yet. The purpose of this study is to assess whether the final position of aortic bioprosthesis affects its long-term functionality. METHOD: Consecutive patients (pts) who underwent successful TAVI procedure were evaluated and separated into two groups according to the implantation depth (ID); Group I: pts with 4mm<ID≤13 mm, Group II: pts with ID≤4mm...
April 2, 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29590670/ct-adp-point-of-care-assay-predicts-30-day-paravalvular-aortic-regurgitation-and-bleeding-events-following-transcatheter-aortic-valve-replacement
#17
Marion Kibler, Benjamin Marchandot, Nathan Messas, Thibault Caspar, Flavien Vincent, Jean-Jacques Von Hunolstein, Lelia Grunebaum, Antje Reydel, Antoine Rauch, Ulun Crimizade, Michel Kindo, Tam Hoang Minh, Annie Trinh, Hélène Petit-Eisenmann, Fabien De Poli, Pierre Leddet, Laurence Jesel, Patrick Ohlmann, Sophie Susen, Eric Van Belle, Olivier Morel
BACKGROUND:  Paravalvular aortic regurgitation (PVAR) remains a frequent postprocedural concern following transcatheter aortic valve replacement (TAVR). Persistence of flow turbulence results in the cleavage of high-molecular-weight von Willebrand multimers, primary haemostasis dysfunction and may favour bleedings. Recent data have emphasized the value of a point-of-care measure of von Willebrand factor-dependent platelet function (closure time [CT] adenosine diphosphate [ADP]) in the monitoring of immediate PVAR...
March 28, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29570211/valve-in-valve-implantation-of-the-corevalve-evolut-r-in-degenerated-surgical-aortic-valves
#18
Marius Schwerg, Karl Stangl, Michael Laule, Verena Stangl, Henryk Dreger
BACKGROUND: The new CoreValve Evolut R has an improved design to minimize paravalvular leakage (PVL) and allows repositioning of the valve. For patients with degenerated bioprosthetic aortic valves, transcatheter aortic valve implantation (TAVI) represents a less invasive option. Herein reported are valve-in-valve (ViV) implantations of this new valve. METHODS: A total of 26 patients (mean age 79.4 ± 6.1 years, 17 males and 9 females) were treated for severe prosthesis stenosis (n = 9), severe regurgitation (n = 8) or severe combination of stenosis and regurgitation (n = 9)...
March 23, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29566812/transcatheter-aortic-valve-replacement-in-patients-with-low-flow-low-gradient-aortic-stenosis-the-topas-tavi-registry
#19
Henrique Barbosa Ribeiro, Stamatios Lerakis, Martine Gilard, João L Cavalcante, Raj Makkar, Howard C Herrmann, Stephan Windecker, Maurice Enriquez-Sarano, Asim N Cheema, Luis Nombela-Franco, Ignacio Amat-Santos, Antonio J Muñoz-García, Bruno Garcia Del Blanco, Alan Zajarias, John C Lisko, Salim Hayek, Vasilis Babaliaros, Florent Le Ven, Thomas G Gleason, Tarun Chakravarty, Wilson Y Szeto, Marie-Annick Clavel, Alberto de Agustin, Vicenç Serra, John T Schindler, Abdellaziz Dahou, Rishi Puri, Emilie Pelletier-Beaumont, Melanie Côté, Philippe Pibarot, Josep Rodés-Cabau
BACKGROUND: Few data exist on patients with low-flow, low-gradient aortic stenosis (LFLG-AS) undergoing transcatheter aortic valve replacement (TAVR). Also, very scarce data exist on the usefulness of dobutamine stress echocardiography (DSE) before TAVR in these patients. OBJECTIVES: The authors sought to evaluate clinical outcomes and changes in left ventricular ejection fraction (LVEF) following TAVR in patients with classical LFLG-AS. METHODS: This multicenter registry included 287 patients with LFLG-AS undergoing TAVR...
March 27, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29557590/what-are-the-remaining-limitations-of-tavi
#20
Chiara DE Biase, Antonios Mastrokostopoulos, Raphael Philippart, Laurent Bonfils, Pierre Berthoumieu, Nicolas Dumonteil
Transcatheter aortic valve implantation (TAVI) is a recognized therapy for patients with symptomatic severe aortic stenosis (AS). TAVI is superior compared to medical therapy as for mortality in extreme-risk patients, is non-inferior or superior to surgery in high- risk patients and non-inferior to surgery in intermediate-risk patients. However, several limitations affect outcomes after TAVI. Adverse events related to this procedure, like vascular complications, need forpacemaker implantation, paravalvular regurgitation, can be factors limiting TAVI treatment in younger patients at lower risk, as well as uncertainties regarding valve durability...
March 19, 2018: Journal of Cardiovascular Surgery
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