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Paravalvular regurgitation

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https://www.readbyqxmd.com/read/29158054/early-outcomes-for-valve-in-valve-tavr-in-degenerative-freestyle-bioprostheses
#1
Stephane Leung Wai Sang, Tyler Beute, John Heiser, Duane Berkompas, Justin Fanning, William Merhi
OBJECTIVES: Transcatheter aortic valve replacement (TAVR) is used increasingly to treat bioprosthetic valve failure. A paucity of data exists regarding valve-in-valve (ViV) TAVR in degenerated Freestyle stentless bioprostheses (FSB). This study sought to evaluate the feasibility and short-term outcomes of ViV TAVR in previously placed FSB. METHODS: From October 2014 to September 2016, 22 patients underwent ViV TAVR with a self-expanding transcatheter valve for a failing FSB at a single institution...
November 17, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29130587/pushing-boundaries-implantation-of-the-34-mm-medtronic-corevalve-in-patients-with-a-large-aortic-annulus
#2
Adham Elmously, Berhane Worku, S Chiu Wong, Arash Salemi
The relationship between adherence to the recommended CoreValve sizing parameters and clinical outcomes is not well known for the recently released 34 mm valve, which is currently the largest available transcatheter valve. There is a presumed temporal reduction in paravalvular regurgitation in patients who receive an in-range valve, however, certain patients possess annular dimensions that are too large. We therefore describe two patients with annular dimensions larger than the manufacturer recommended range for the 34 mm CoreValve, who despite this underwent transcatheter aortic valve replacement with excellent clinical outcomes...
November 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29128473/transfemoral-aortic-valve-implantation-is-more-successful-with-the-edwards-sapien-3-compared-with-the-edwards-xt-for-the-treatment-of-symptomatic-severe-aortic-stenosis
#3
Birgid Gonska, Julia Seeger, Alexander Junker, Christoph Rodewald, Ulrike Trepte, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual aortic regurgitation (AR) after transfemoral aortic valve implantation (TAVI) is associated with increased mortality. The new Edwards Sapien 3 valve (ES3) is designed to reduce paravalvular AR. AIM: To compare a new-generation and a late-generation balloon-expandable transcatheter heart valve. METHODS: In this study, 100 consecutive patients treated with the ES3 for symptomatic native severe aortic stenosis were compared with 100 consecutive patients treated with the Edwards Sapien XT valve (EXT); all valves were implanted via transfemoral access...
November 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29118948/transcatheter-heart-valve-in-valve-implantation-with-edwards-sapien-bioprosthetic-valve-for-different-degenerated-bioprosthetic-valve-positions-first-iranian-viv-report-with-mid-term-follow-up
#4
Ali Mohammad Haji Zeinali, Kyomars Abbasi, Mohammad Saheb Jam, Shahrooz Yazdani, Seyedeh Hamideh Mortazavi
Introduction: After early successful experience with transcatheter aortic valve replacement (TAVR), concept of transcatheter implantation of a new valve within a failing bioprosthetic valve emerged. Valve-in-valve (ViV) implantation seems to be a simpler option for high risk surgical patients. Methods: We performed five ViV procedures in different valve positions. We included patients with failing bioprosthetic valves with high surgical risk due to concomitant comorbidities. We performed 2 transapical ViV procedures for failing mitral bioprosthetic valves, 1 transfemoral procedure for failing pulmonary valve and 2 transfemoral ViV implantation for failing tricuspid bioprosthetic valves...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29105984/hemodynamic-classification-of-paravalvular-leakage-after-transcatheter-aortic-valve-implantation-compared-with-angiographic-or-echocardiographic-classification-for-prediction-of-1-year-mortality
#5
Simon Schoechlin, Tim Brennemann, Abdelhakim Allali, Philip Ruile, Nikolaus Jander, Martin Allgeier, Michael Gick, Gert Richardt, Franz-Josef Neumann, Mohamed Abdel-Wahab
OBJECTIVES: We sought to assess angiographic, echocardiographic and hemodynamic grading of paravalvular leakage (PVL) after transcatheter aortic valve implantation (TAVI) with respect to prediction of 1-year mortality. BACKGROUND: Meaningful criteria for the severity of PVL are needed to allow intraprocedural guidance and patient management after TAVI. METHODS: We pooled the prospective TAVI databases of 2 German centers. During TAVI, PVL was assessed angiographically and by the aortic regurgitation index (ARI)...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105953/comparison-of-self-expanding-and-balloon-expandable-transcatheter-aortic-valves-morphology-and-association-with-paravalvular-regurgitation-evaluation-using-multidetector-computed-tomography
#6
João G Almeida, Sara M Ferreira, Paulo Fonseca, Tiago Dias, Cláudio Guerreiro, Ana Barbosa, Pedro Teixeira, Mónica Carvalho, Wilson Ferreira, Nuno D Ferreira, Pedro Braga, José Ribeiro, Vasco G Ribeiro
OBJECTIVES: Compare final morphology of self-expanding and balloon-expandable prosthesis and association with paravalvular regurgitation (PVR). BACKGROUND: PVR after transcatheter aortic valve replacement (TAVR) remains a frequent complication. A better understanding of the prosthesis geometry may be important to improve selection of the best device for each case and possibly reduce the rates of PVR. METHODS: Retrospective study including patients consecutively submitted to transcatheter aortic valve replacement: August/2007-October/2016...
November 6, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29105327/hemodynamic-guidance-of-mitral-paravalvular-leak-closure-the-v-is-the-key
#7
EDITORIAL
James A Goldstein
Severe mitral paravalvular leak (PVL) induces elevated mean left atrial (LA) pressure (LAP) and prominent V waves, leading to pulmonary hypertension and right heart failure PVL closure promptly reduces V wave and mean LAP, correlates with improved echo regurgitation grade, and exerts immediate benefit to the lungs and right heart Hemodynamic response patterns facilitate PVL closure.
November 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29101983/acr-appropriateness-criteria-%C3%A2-imaging-for-transcatheter-aortic-valve-replacement
#8
Jonathon A Leipsic, Philipp Blanke, Michael Hanley, Juan C Batlle, Michael A Bolen, Richard K J Brown, Benoit Desjardins, Robert T Eberhardt, Heather L Gornik, Lynne M Hurwitz, Hersh Maniar, Himanshu J Patel, Elizabeth F Sheybani, Michael L Steigner, Nupur Verma, Suhny Abbara, Frank J Rybicki, Jacobo Kirsch, Karin E Dill
Aortic stenosis is a common valvular condition with increasing prevalence in aging populations. When severe and symptomatic, the downstream prognosis is poor without surgical or transcatheter aortic valve replacement. Transcatheter aortic valve replacement is now considered a viable alternative to surgical aortic valve replacement in patients considered high and intermediate risk for surgery. Pre-intervention imaging with echocardiography and CT are essential for procedure planning and device selection to help optimize clinical outcomes with MR angiography playing largely a complementary role...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29101108/transthoracic-echocardiography-is-adequate-for-intraprocedural-guidance-of-transcatheter-aortic-valve-implantation
#9
Renuka Jain, Daniel P O'Hair, Tanvir K Bajwa, Denise Ignatowski, Daniel Harland, Amanda M Kirby, Tracy Hammonds, Suhail Q Allaqaband, Jonathan Kay, Bijoy K Khandheria
BACKGROUND: While transcatheter aortic valve implantation (TAVI) has traditionally been supported intraprocedurally by transoesophageal echocardiography (TOE), transthoracic echocardiography (TTE) is increasingly being used. We evaluated echocardiographic imaging characteristics and clinical outcomes in patients who underwent TTE during TAVI (TTE-TAVI). METHODS AND RESULTS: A select team of dedicated sonographers and interventional echocardiographers performed TTE-TAVI in 278 patients, all of whom underwent TAVI through transfemoral access...
December 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29066342/bioprosthesis-leaflet-thrombosis-following-self-expanding-valve-in-valve-transcatheter-aortic-valve-replacement-in-patient-taking-factor-xa-inhibitor-and-warfarin-a-case-report
#10
Kyle D Buchanan, M Chadi Alraies, Gaby Weissman, Itsik Ben-Dor, Lowell F Satler, Ron Waksman
An 87-year-old female with symptomatic severe aortic stenosis underwent transcatheter valve replacement (TAVR) via the transfemoral approach with a 29mm self-expanding device. Moderate to severe paravalvular regurgitation led to the development of congestive heart failure and hospital readmission 1 month following TAVR. A second 29mm valve was placed to abolish the paravalvular regurgitation. Routine follow-up computed tomography (CT) imaging demonstrated leaflet thickening and decreased leaflet mobility suggesting valve thrombosis, despite adherence to Factor Xa inhibitor...
May 11, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29062745/review-of-minimal-access-versus-transcatheter-aortic-valve-replacement-for-patients-with-severe-aortic-stenosis
#11
Carson T Hoffmann, Jacob A Heiner, Tom C Nguyen
Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (miniAVR) have become alternatives to surgical aortic valve replacement via median sternotomy (SAVR) to treat severe aortic stenosis (AS). Despite increased interest and utilization, few studies have directly compared TAVR and miniAVR. A review of the current literature shows TAVR to be an indispensable tool for inoperable, high-risk, and perhaps intermediate-risk patients with severe AS. However, it is associated with a number of deleterious perioperative outcomes, such as valvular regurgitation and vascular complications...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29062742/long-term-outcomes-and-prosthesis-performance-after-transcatheter-aortic-valve-replacement-results-of-self-expandable-and-balloon-expandable-transcatheter-heart-valves
#12
Giuseppe Tarantini, Paola A M Purita, Augusto D'Onofrio, Chiara Fraccaro, Anna Chiara Frigo, Gianpiero D'Amico, Luca Nai Fovino, Marta Martin, Francesco Cardaioli, Mostafa R A Badawy, Massimo Napodano, Gino Gerosa, Sabino Iliceto
BACKGROUND: Data on transcatheter aortic valve replacement (TAVR) long-term clinical outcomes and hemodynamic performance of the self-expandable CoreValve (CV) and the balloon-expandable Edwards SAPIEN XT (ES) (Edwards Lifesciences, Irvine, California, USA) transcatheter heart valves (THV) are limited. Therefore, this study aimed to compare long-term clinical outcome data and hemodynamic performance of TAVR with either CV or ES. METHODS: We reviewed prospectively collected data of 171 patients treated with TAVR for severe aortic stenosis (AS) at our center between June 2007 and December 2010, with last follow-up contact in 2016...
September 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29061548/acute-performance-of-a-novel-restorative-transcatheter-aortic-valve-preclinical-results
#13
Yosuke Miyazaki, Osama I Soliman, Mohammad Abdelghani, Athanasios Katsikis, Christophe Naz, Susana Lopes, Boris Warnack, Martijn Cox, Yoshinobu Onuma, Patrick W Serruys
AIMS: The XELTIS aortic valve leaflets are made from a bioabsorbable supramolecular polymer that guides the tissue to restoring itself. It is mounted on a self-expandable nitinol frame that includes three feelers and a native leaflet clipping mechanism. We sought to investigate the acute valve performance in a preclinical setting. METHODS AND RESULTS: In 33 sheep, 26 mm XELTIS aortic valve were transapically implanted in a 23 mm native annulus. Aortography (analysable, n=28) and echocardiography (analysable, n=20) were acquired immediately after implantation of the XELTIS aortic valve to assess the acute device performance...
October 24, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29050627/outcomes-for-the-commercial-use-of%C3%A2-self-expanding-prostheses-in-transcatheter-aortic-valve-replacement-a-report-from-the-sts-acc-tvt-registry
#14
Paul Sorajja, Susheel Kodali, Michael J Reardon, Wilson Y Szeto, Stanley J Chetcuti, James Hermiller, Sharla Chenoweth, David H Adams, Jeffrey J Popma
OBJECTIVES: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry. BACKGROUND: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29049787/sutureless-aortic-valve-replacement-versus-transcatheter-aortic-valve-implantation-a-meta-analysis-of-comparative-matched-studies-using-propensity-score-matching
#15
Massimo Meco, Antonio Miceli, Andrea Montisci, Francesco Donatelli, Silvia Cirri, Matteo Ferrarini, Antonio Lio, Mattia Glauber
OBJECTIVES: The aim of this meta-analysis was to compare outcomes of patients undergoing transcatheter aortic valve implantation (TAVI) with those undergoing surgical aortic valve replacement using sutureless valves. METHODS: A systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was performed. RESULTS: No randomized controlled trials were identified...
September 11, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049565/a-low-cost-bioprosthetic-semilunar-valve-for-research-disease-modelling-and-surgical-training-applications
#16
Benoit Rosa, Zurab Machaidze, Borami Shin, Sunil Manjila, David W Brown, Christopher W Baird, John E Mayer, Pierre E Dupont
OBJECTIVES: This paper provides detailed instructions for constructing low-cost bioprosthetic semilunar valves for animal research and clinical training. This work fills an important gap between existing simulator training valves and clinical valves by providing fully functioning designs that can be employed in ex vivo and in vivo experiments and can also be modified to model valvular disease. METHODS: Valves are constructed in 4 steps consisting of creating a metal frame, covering it with fabric and attaching a suture ring and leaflets...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049564/a-new-technique-to-implant-a-transcatheter-inflatable-fully-repositionable-prosthesis-in-aortic-stenosis-with-severe-asymmetric-calcification
#17
Hasan Bushnaq, Christoph Raspé, Alper Öner, Seyrani Yücel, Hüseyin Ince, Sebastian-Patrick Sommer
OBJECTIVES: In contrast to stented transcatheter aortic valves, the Direct Flow Medical (DFM) valve is a stentless bovine aortic bioprosthesis mounted in a non-metallic inflatable frame. Hence, severe asymmetric annular calcification may result in residually elevated transaortic pressure gradients after DFM implantation. We present a novel intraprocedural dilatation (IDIL) technique for successful implantation of the DFM valve in the presence of complex annular calcification. METHODS: Between January 2014 and May 2015, 55 patients underwent DFM valve-based transcatheter aortic valve implantation at our institution...
November 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29017748/transcatheter-aortic-valve-implantation-in-patients-with-a-large-aortic-annulus
#18
Peter Barr, John Ormiston, Jim Stewart, Parma Nand, Tharumenthiran Ramanathan, Mark Webster
BACKGROUND: As the indications for transcatheter aortic valve implantation (TAVI) have expanded, so to have the demands on interventionists to allow as many patients to access this technology as possible. METHODS: We retrospectively reviewed our TAVI database for patients who had received a 29mm SAPIEN 3 valve despite having an annular area greater than the manufacturer-recommended upper limit of 683mm(2), as determined by multi-detector computed tomography (MDCT)...
September 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28994656/videodensitometric-quantification-of-paravalvular-regurgitation-of-a-transcatheter-aortic-valve-in-vitro-validation
#19
Mohammad Abdelghani, Yosuke Miyazaki, Ellen S de Boer, Jean-Paul Aben, Math van Sloun, Todd Suchecki, Marcel van 't Veer, Osama Soliman, Yoshinobu Onuma, Robbert de Winter, Pim A L Tonino, Marcel C M Rutten, Frans N van de Vosse, Patrick W Serruys
AIMS: Videodensitometric assessment of aortography provides a periprocedural quantitation of prosthetic valve regurgitation (PVR) after transcatheter aortic valve implantation. We sought to compare the videodensitometric parameters of PVR severity to the regurgitation fraction (RF) in a controlled in-vitro setting. METHODS AND RESULTS: In a mock circulation system, a transcatheter balloon-expandable valve inserted at the aortic valve position was gradually deformed to induce different grades of paravalvular leakage and the RF was measured with a transonic flow probe...
October 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28992963/transapical-transcatheter-aortic-valve-replacement-with-a-novel-transcatheter-aortic-valve-replacement-system-in-high-risk-patients-with-severe-aortic-valve-diseases
#20
Liming Zhu, Yingqiang Guo, Wei Wang, Huan Liu, Ye Yang, Lai Wei, Chunsheng Wang
OBJECTIVES: The clinical experience of a novel transapical transcatheter aortic valve replacement system, the J-Valve (JC Medical Inc, Burlingame, Calif), in high-risk patients with severe aortic valve diseases is limited. METHODS: A total of 107 high-risk patients (mean age, 74.4 ± 5.2 years) underwent transcatheter aortic valve replacement with the J-Valve from March 2014 to July 2015, which included 63 patients with aortic stenoses and 44 patients with aortic regurgitation...
September 15, 2017: Journal of Thoracic and Cardiovascular Surgery
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