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Paravalvular regurgitation

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https://www.readbyqxmd.com/read/28918980/outcomes-of-aortic-valve-replacement-according-to-surgical-approach-in-intermediate-and-low-risk-patients-a-propensity-score-analysis
#1
Corazon M Calle-Valda, Rio Aguilar, Amparo Benedicto, Anas Sarraj, Emilio Monguio, Daniel Munoz, Nieves De Antonio, Guillermo Reyes
BACKGROUND: Previous trials have shown that, among high-risk patients with aortic stenosis, survival rates are similar for transcatheter aortic-valve implantation (TAVI) and surgical aortic valve replacement. The study aimed to compare the outcomes of aortic valve replacement according to the adopted surgical approach in intermediate and low risk patients. METHODS: This is a retrospective, observational, cohort study of prospectively collected data from 421 patients undergoing isolated aortic valve replacement between 2011 and 2015...
September 6, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28893830/assessment-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-add-clinical-signs-to-echocardiographic-data
#2
Corstiaan A den Uil, Mihai Strachinaru, Ben van der Hoven, J Han J Meeder
A 62-year old male with pulmonary fibrosis and aortic valve stenosis underwent TAVI (Corevalve Evolut XL 34 mm) in the build-up for lung transplantation (LuTx). Following post-dilation for a large annular perimeter, moderate paravalvular aortic regurgitation (AR) was observed. After 6 weeks, he was admitted to the ICU with respiratory failure(A). TTE demonstrated residual mild AR (based on a small excentric paravalvular AR jet, <10% circumferential extent, pressure half-time was not reliably measured) and together with borderline elevated NT-pro-BNP, the consultant cardiologist authorized LuTx listing...
September 11, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28870877/very-low-pacemaker-rate-following-acurate-neo-transcatheter-heart-valve-implantation
#3
Stefan Toggweiler, Henrik Nissen, Brynjolfur Mogensen, Florim Cuculi, Christian Fallesen, Karsten Tange Veien, Miriam Brinkert, Richard Kobza, Andreas Rück
AIMS: Investigate if minimizing trauma to the aortic annulus and left ventricular outflow tract reduces the occurrence of new conduction disorders and need for permanent pacemakers. METHODS AND RESULTS: A total of 175 patients (58% women, mean age 83 ± 6 years) underwent transfemoral TAVI with the Boston Scientific ACURATE neo at three centers in Europe. Prosthesis size selection was based on perimeter derived annular diameter. Predilatation was performed in all with a balloon 1...
September 5, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28864319/evaluation-of-imaging-strategy-to-optimize-and-improve-outcome-of-transcatheter-aortic-valvular-implantation
#4
Charlotte Casset, Adrien Jankowski, Bernard Bertrand, Carole Saunier, Nicolas Piliero, Mathieu Rodiere, Gilbert Ferretti, Jean-Louis Quesada, Alexis Broisat, Laurent Riou, Daniel Fagret, Catherine Ghezzi, Gérald Vanzetto, Gilles Barone-Rochette
Cardiac computed tomography (CT) provides additional information with ultrasound in the transcatheter heart valve (THV) size selection. However, the influence of these incremental data on outcomes has not been evaluated in a randomized study. A single-center prospective, randomized, and open study was performed. Patients referred for transfemoral transcatheter aortic valve implantation with a balloon-expandable endoprothesis were included. THV size selection was performed using either transthoracic and transesophageal echocardiography data (control group) or ultrasound and CT results (CT group)...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862381/a-systematic-review-of-reported-cases-of-combined-transcatheter-aortic-and-mitral-valve-interventions
#5
Tomo Ando, Hisato Takagi, Alexandros Briasoulis, Tesfaye Telila, David P Slovut, Luis Afonso, Cindy L Grines, Theodore Schreiber
OBJECTIVES: To summarize the published data of combined transcatheter aortic and mitral valve intervention (CTAMVI). BACKGROUND: CTAMVI, a combination of either transcatheter aortic valve replacement (TAVR) or transcatheter aortic valve-in-valve (TAViV) and transcatheter mitral valve replacement (TMVR), transcatheter mitral valve-in-valve/valve-in-ring (TMViV/ViR), or percutaneous mitral valve repair (PMVR) is an attractive alternative in high-surgical risk patients with combined aortic and mitral valve disease...
September 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28838487/cardioscopically-guided-beating-heart-surgery-paravalvular-leak-repair
#6
Benoit Rosa, Zurab Machaidze, Margherita Mencattelli, Sunil Manjila, Borami Shin, Karl Price, Michael A Borger, Vinod Thourani, Pedro Del Nido, David W Brown, Christopher W Baird, John E Mayer, Pierre E Dupont
PURPOSE: There remains a paucity of direct visualization techniques for beating-heart intracardiac procedures. To address this need, we evaluated a novel cardioscope in the context of aortic paravalvular leaks (PVLs) localization and closure. DESCRIPTION: A porcine aortic PVL model was created using a custom-made bioprosthetic valve, and PVL presence was verified by epicardial echocardiography. Transapical delivery of occlusion devices guided solely by cardioscopy was attempted 13 times in a total of three pigs...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28838477/transcatheter-mitral-valve-implantation-using-the-highlife-system
#7
Marco Barbanti, Nicolò Piazza, Sarah Mangiafico, Jean Buithieu, Sabine Bleiziffer, Giuseppe Ronsivalle, Salvatore Scandura, Angelo Giuffrida, Antonio Popolo Rubbio, Massimo Mazzamuto, Carmelo Sgroi, Rüdiger Lange, Corrado Tamburino
OBJECTIVES: This study is the first report of 2 cases of HighLife (HighLife, Paris, France) implantation in humans. BACKGROUND: Transcatheter mitral valve implantation represents a promising approach to treating mitral regurgitation in patients at increased risk of perioperative mortality. The HighLife transcatheter mitral valve is a 2-component system. The valve is implanted in the mitral position and is anchored by interacting and then reaching an equilibrium position with a previously positioned subannular implant...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28836953/efficacy-and-safety-of-transcatheter-aortic-valve-replacement-in-aortic-stenosis-patients-at-low-to-moderate-surgical-risk-a-comprehensive-meta-analysis
#8
Ahmed Elmaraezy, Ammar Ismail, Abdelrahman Ibrahim Abushouk, Moutaz Eltoomy, Soha Saad, Ahmed Negida, Osama Mahmoud Abdelaty, Ahmed Ramadan Abdallah, Ahmed Magdy Aboelfotoh, Hossam Mahmoud Hassan, Aya Gamal Elmaraezy, Mahmoud Morsi, Farah Althaher, Moath Althaher, Ammar M AlSafadi
BACKGROUND: Recently, transcatheter aortic valve replacement (TAVR) has become the procedure of choice in high surgical risk patients with aortic stenosis (AS). However, its value is still debated in operable AS cases. We performed this meta-analysis to compare the safety and efficacy of TAVR to surgical aortic valve replacement (SAVR) in low-to-moderate surgical risk patients with AS. METHODS: A systematic search of five authentic databases retrieved 11 eligible studies (20,056 patients)...
August 24, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28836337/overexpansion-of-the-29-mm-sapien-3-transcatheter-heart-valve-in-patients-with-large-aortic-annuli-area-%C3%A2-683-mm-2-a-case-series
#9
Moses Mathur, James M McCabe, Gabriel Aldea, Jay Pal, Creighton W Don
OBJECTIVES: To evaluate overexpanded 29 mm SAPIEN (S3) transcatheter heart valves in patients with aortic annuli area >683 mm(2) . BACKGROUND: The largest valve area the 29 mm S3 is specified for is 683 mm(2) . Valve overexpansion has been performed in patients with larger aortic annuli, but data are limited. Moreover, feasibility in areas >740 mm(2) is unknown. METHODS: All 29 mm S3 transcatheter aortic valve replacements (TAVR) at a single center over 23-months were retrospectively reviewed...
August 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28830749/comparison-of-outcomes-in-new-generation-versus-early-generation-heart-valve-in-transcatheter-aortic-valve-implantation-a-systematic-review-and-meta-analysis
#10
Tomo Ando, Hisato Takagi, Tesfaye Telila, Luis Afonso
BACKGROUND: New-generation (NG) valves for transcatheter aortic valve implantation (TAVI) has recently been widely used in real-world practice, yet its comparative outcomes with early-generation (EG) valves remain under-explored. METHODS: An electronic literature search using PUBMED and EMBASE was conducted from inception to April 2017 for matched-cohort studies. Articles that compared the outcomes of NG vs. EG valves post TAVI with at least one of the following clinical outcome reported were included: all-cause mortality, major or life-threatening bleeding, major vascular complications (MVC), significant (more than moderate) paravalvular regurgitation (PVR), cerebrovascular events, significant (stage 2 or 3) acute kidney injury (AKI) and new permanent pacemaker implantation (PPI) that occurred either in-hospital or within 30-days...
July 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28819953/impact-of-post-dilatation-on-the-reduction-of-paravalvular-leak-and-mortality-after-transcatheter-aortic-valve-implantation
#11
Paweł Kleczyński, Artur Dziewierz, Marzena Daniec, Maciej Bagieński, Łukasz Rzeszutko, Danuta Sorysz, Jarosław Trębacz, Robert Sobczyński, Marek Tomala, Dariusz Dudek
BACKGROUND: Post-implantation paravalvular leak (PVL) remains a significant complication of transcatheter aortic valve implantation (TAVI). More importantly, its occurrence may impact long-term mortality. AIM: We sought to evaluate the effects of balloon post-dilatation (PD) on the reduction of PVL and mortality in patients undergoing TAVI. METHODS: A total of 101 consecutive patients undergoing TAVI were enrolled. Angiography, echocardiography, and the aortic regurgitation index (ARI) were used to assess the severity of PVL before and after balloon PD...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28812435/transcatheter-aortic-valve-implantation-compared-with-surgical-aortic-valve-replacement-in-patients-with-anaemia
#12
Paola D'Errigo, Fausto Biancari, Stefano Rosato, Corrado Tamburino, Marco Ranucci, Gennaro Santoro, Marco Barbanti, Martina Ventura, Danilo Fusco, Fulvia Seccareccia
OBJECTIVES: We compared the outcome of anaemic patients undergoing transcatheter (TAVI) and surgical aortic valve replacement (SAVR) for severe aortic valve stenosis. METHODS: Anaemic patients (haemoglobin <13.0 g/dL in men and <12.0 g/dL in women) undergoing TAVI and SAVR from the OBSERVANT study were the subjects of this analysis. RESULTS: Preoperative anaemia was an independent predictor of 3-year mortality after either TAVI (HR 1...
August 16, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28804056/transfemoral-tavi-using-the-self-expandable-acurate-neo-tm-prosthesis-one-year-outcomes-of-the-multicenter-ce-approval-cohort
#13
Helge Möllmann, Thomas Walther, Dimytri Siqueira, Patrick Diemert, Hendrik Treede, Eberhard Grube, Georg Nickenig, Stephan Baldus, Tanja Rudolph, Toru Kuratani, Yoshiki Sawa, Joerg Kempfert, Won-Keun Kim, Alexandre Abizaid
AIMS: The aim of this study was to assess the safety and performance of the ACURATE neoTM transcatheter heart valve and its transfemoral delivery system. METHODS AND RESULTS: The prospective, multi-center "CE-approval cohort" consists of a prospective series of the first 89 patients implanted with the ACURATE neoTM prosthesis. The primary endpoint was all-cause mortality at 30 days. Mean patient age was 83.7±4.4 years and logistic EuroSCORE-I was 26.5±7.7%. Procedural success was obtained in 84 patients (94...
August 15, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28799521/transcatheter-mitral-valve-replacement-long-term-outcomes-of-first-in-man-experience-with-an-apically-tethered-device-a-case-series-from-a-single-centre
#14
Alison Duncan, Anan Daqa, James Yeh, Simon Davies, Anselm Uebing, Cesare Quarto, Neil Moat
AIMS: Transcatheter mitral valve replacement (TMVR) is a novel technique for treating mitral regurgitation. We report 18-month/2-year outcomes of the 5 first-in-man patients undergoing chronic TMVR with the Tendyne device. METHODS AND RESULTS: Five patients (STS score 14%-23%) underwent TMVR using a Tendyne system under compassionate use at a single centre. 1 patient (who was noncompliant with anti-coagulation) died 9 months after TMVR following a cerebrovascular accident...
August 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28739246/three-dimensional-measurement-of-aortic-annulus-dimensions-using-area-or-circumference-for-transcatheter-aortic-valve-replacement-valve-sizing-does-it-make-a-difference
#15
Alexandros Papachristidis, Michael Papitsas, Damian Roper, Yanzhong Wang, Rafal Dworakowski, Jonathan Byrne, Olaf Wendler, Philip MacCarthy, Mark J Monaghan
BACKGROUND: The use of transcatheter aortic valve replacement (TAVR) is increasing worldwide. We present our 6-year experience using three-dimensional (3D) transesophageal echocardiography (TEE) and investigate whether different sizing methods of the aortic annulus lead to different prosthesis size that may impact outcome. METHODS: We investigated 262 patients who underwent TAVR and had 3D TEE data sets of the aortic annulus. We have used the area-derived diameter (Darea = 2(area/π)) and the circumference-derived diameter (Dcirc = Circumference/π) to size the prosthesis in separate populations in different time periods...
September 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28734891/ct-defined-prosthesis-patient-mismatch-downgrades-frequency-and-severity-and%C3%A2-demonstrates-no-association-with-adverse-outcomes-after-tavr
#16
John Mooney, Stephanie L Sellers, Phillip Blanke, Philippe Pibarot, Rebecca T Hahn, Danny Dvir, Pamela S Douglas, Neil J Weissman, Susheel K Kodali, Vinod H Thourani, Hasan Jilaihawi, Omar Khalique, Craig R Smith, Shaw Hua Kueh, Mickael Ohana, Romi Grover, Christopher Naoum, Aaron Crowley, Wael A Jaber, Maria C Alu, Rupa Parvataneni, Michael Mack, John G Webb, Martin B Leon, Jonathon A Leipsic
OBJECTIVES: This study sought to determine if indexed effective orifice area (EOAi), using left ventricular outflow tract measured from computed tomography (EOAiCT), reclassified prosthesis-patient mismatch (PPM) compared with conventional echocardiogram-defined measurements (EOAiTTE). BACKGROUND: PPM does not predict mortality following transcatheter aortic valve replacement (TAVR). However, it is unknown if the EOAiCT of the left ventricular outflow tract improves risk stratification...
July 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28707362/left-atrial-pressure-and-predictors-of-survival-after-percutaneous-mitral-paravalvular-leak-closure
#17
Elad Maor, Claire E Raphael, Sidakpal S Panaich, Mohamad Alkhouli, Allison Cabalka, Donald J Hagler, Peter M Pollak, Guy S Reeder, Mackram F Eleid, Charanjit S Rihal
BACKGROUND: Data on the clinical utility of left atrial (LA) hemodynamic monitoring during percutaneous mitral interventions are limited. OBJECTIVES: To evaluate the association between intraprocedural LA pressures during percutaneous mitral paravalvular leak (PVL) closure and long term survival. METHODS: Patients who underwent mitral PVL repair with invasive LA pressure monitoring were divided at baseline to three tertiles based on their mean final LA pressure (<25%; 25-30%; >30% of mean systolic blood pressure)...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28683542/feasibility-and-applicability-of-static-vascular-outline-roadmapping-during-tavi
#18
Navid Madershahian, Carolyn Weber, Payman Majd, Tanja Rudolph, Elmar Kuhn, Maximilian Scherner, Yeong-Hoon Choi, Kaveh Eghbalzadeh, Volker Rudolph, Cherif Sahyoun, Thorsten Wahlers
BACKGROUND: We investigated the application and feasibility of a novel software tool designed for the visualization of the aortic root during transcatheter aortic valve implantation (TAVI). The final positioning of the device prior deployment remains the most critical phase during TAVI. METHODS: Philips "Vascular Outlining" prototype application was used during balloon expandable Edwards Lifesciences SapienXT valve deployment. It processes any angiographic sequences, extracting the static outline of vessels and projecting the two- dimensional vessel margins as a roadmap on live fluoroscopy...
July 5, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28667514/comparison-of-different-invasive-hemodynamic-measurements-as-a-prediction-tool-for-mortality-after-transcatheter-aortic-valve-replacement-in-men-a-retrospective-observational-study
#19
Anthony A Bavry, Seyed H Aalaei-Andabili, Ashkan Karimi, Ki Park, Calvin Y Choi, Eddie W Manning, Thomas M Beaver, Wade W Stinson
INTRODUCTION: Hemodynamic measurements can assess for paravalvular aortic regurgitation after transcatheter aortic valve replacement (TAVR). This study compared the utility of different invasive hemodynamic measures in providing prognostic information. METHODS: This retrospective observational study of TAVR patients at a Veterans Hospital assessed aortic regurgitation index, diastolic delta, pulse pressure, and heart rate adjusted diastolic delta obtained at valve implantation...
June 30, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28648426/percutaneous-closure-of-symptomatic-large-tricuspid-paravalvular-regurgitation-using-two-muscular-vsd-occluders
#20
Aritra Mukherji, Rajaram Anantharaman, Raghavan Subramanyan
Paravalvular leaks are common following valve replacement surgery. Majority are benign and do not require any active intervention. However, occasionally severe paravalvular regurgitation can produce heart failure and/or hemolysis, needing closure of the defect. It is more commonly associated with aortic and mitral prosthesis, symptomatic tricuspid paravalvular regurgitation being a rare entity. In this report we present the successful percutaneous transcatheter closure of a large paravalvular tricuspid regurgitation in a 59-year old lady with history of multiple previous operations...
May 2017: Indian Heart Journal
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