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Paravalvular regurgitation

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https://www.readbyqxmd.com/read/27899293/valvular-regurgitation-after-implantation-of-prostheses-secured-with-cor-knot-automated-fasteners
#1
Alexander A Brescia, Steven F Bolling, Himanshu J Patel
Valvular regurgitation is a recognized complication of aortic and mitral valve procedures, with paravalvular leak the primary mechanism and transvalvular less common. The Cor-knot automated fastener (LSI SOLUTIONS, Victor, NY, USA) has been shown to be a safe, viable alternative to knot pushers or manual tying for use in these procedures. Here we present two cases in which Cor-Knot fastener orientation appeared to result in transvalvular regurgitation necessitating redo operation. With adjunctive use of Cor-Knot devices, fastener orientation relative to valve geometry must be assessed for optimal results...
November 26, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27890512/safety-and-efficacy-of-valve-repositioning-during-transcatheter-aortic-valve-replacement-with-the-lotus-valve-system
#2
Hashrul N Z Rashid, Robert Gooley, Liam McCormick, Sarah Zaman, Satish Ramkumar, Damon Jackson, Ameera Amiruddin, Arthur Nasis, James Cameron, Ian T Meredith
OBJECTIVE: To determine the safety and efficacy of valve repositioning following transcatheter aortic valve replacement (TAVR) with the Lotus Valve System (Boston Scientific, Marlborough, MA, USA). INTRODUCTION: TAVR is a well-established treatment for severe aortic stenosis. The Lotus Valve System is fully repositionable and retrievable. Valve repositioning has the potential to minimize TAVR-related complications caused by valve malposition; however, the effect on adverse event rates such as stroke is unknown...
November 24, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27882613/improvements-of-procedural-results-with-a-new-generation-self-expanding-transfemoral-aortic-valve-prosthesis-in-comparison-to-the-old-generation-device
#3
Bruna Gomes, Nicolas A Geis, Emmanuel Chorianopoulos, Benjamin Meder, Florian Leuschner, Hugo A Katus, Raffi Bekeredjian
OBJECTIVES: In this study, we compare procedural results of our first Evolut R (Medtronic, Minneapolis, MN, USA) implantations with the last CoreValve implantations. Main endpoints include paravalvular regurgitation, major vascular complications, stroke, and pacemaker implantation. BACKGROUND: The evolution of transcatheter aortic valve replacement (TAVR) was possible due to various technical improvements, leading to better periprocedural and long-term outcome. The newly designed Evolut R valve has the potential to further improve TAVR's performance...
November 24, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27862027/surgical-transapical-approach-for-prosthetic-mitral-paravalvular-leak-closure-early-results
#4
Unal Aydin, Onur Sen, Ersin Kadirogullari, Burak Onan, Aydin Yildirim, Ihsan Bakir
The objective is to demonstrate safety and early clinical results of surgical transapical closure of paravalvular leaks (PVLs) following mitral valve replacement in significant regurgitation. Between March 2014 and February 2015, 12 patients (mean age 52.1 ± 6.0 years, 66.6% male) with severe symptomatic mitral PVLs (n = 13) underwent surgical transapical closure procedure through left mini-thoracotomy. All patients were in NYHA functional class III-IV and median logistic EuroSCORE was 24.2 ± 6...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27852481/mitral-paravalvular-leak-closure
#5
REVIEW
Paul Sorajja
For patients with paravalvular mitral prosthetic regurgitation, percutaneous repair is an established therapy for the treatment of symptoms of heart failure or hemolytic anemia. Percutaneous repair of paravalvular mitral regurgitation is a complex procedure with unique technical challenges, even when performed in experienced centers. Herein, the author discusses patient selection, catheter-based techniques for repair, and clinical outcomes of percutaneous repair for paravalvular mitral regurgitation.
January 2016: Interv Cardiol Clin
https://www.readbyqxmd.com/read/27761871/the-crucial-role-of-cardiac-imaging-in-transcatheter-aortic-valve-replacement-tavr-pre-and-post-procedural-assessment
#6
Saif Al-Najafi, Frank Sanchez, Stamatios Lerakis
Transcatheter valve interventions have emerged as one of the most important developments in structural heart disease over the past 20 years. Initially, these interventions were directed at patients with severe aortic stenosis and high surgical risk; however, their applications have extended to involve other native valves' pathologies, degenerated prosthetic valves, as well as patients of lower surgical risk. In this article, we discuss the importance of cardiac imaging in transcatheter aortic valve replacement (TAVR) by exploring the current practices, guidelines, and recommendations with the supporting data...
December 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27692768/concept-of-an-expandable-cardiac-valve-for-surgical-implantation-in-infants-and-children
#7
Sitaram M Emani, Breanna L Piekarski, David Zurakowski, Christopher A Baird, Audrey C Marshall, James E Lock, Pedro J Del Nido
BACKGROUND: Options for cardiac valve replacement in children are limited to fixed-diameter prostheses that do not accommodate for somatic growth. An externally stented bovine jugular vein graft has been modified for surgical valve replacement in pediatric patients, with the intention of subsequent valve expansion in the catheterization laboratory as the child grows. METHODS: Pediatric patients at a single institution who underwent surgical implantation of an expandable bovine jugular vein valve between 2010 and 2014 were reviewed retrospectively...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27645964/iterative-learning-of-transcatheter-mitral-valve-replacement-in-mitral-valve-annulus-calcification-management-and-prevention-of-transcatheter-mitral-valve-replacement-dislocation
#8
Michal Hulman, Martin Bena, Panagiotis Artemiou, Ivo Gasparovic, Vladan Hudec, Ronak Rajani, Vinayak Bapat
Transcatheter mitral valve replacement using balloon-expandable valves is an emerging technique for the treatment of patients with significant mitral regurgitation who have been judged to be inoperable owing to significant mitral valve annulus calcification. Although initial reports have been promising, there remains a lack of consensus as to how to plan for transcatheter mitral valve replacement deployment in terms of appropriateness, sizing, and positioning to mitigate the risks of valve displacement and paravalvular regurgitation...
October 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27640030/transcatheter-aortic-valve-implantation-in-bicuspid-aortic-valve-stenosis
#9
Gidon Y Perlman, Philipp Blanke, John G Webb
Bicuspid aortic stenosis (AS) is not rare in patients treated with transcatheter aortic valve implantation (TAVI). Bicuspid valves have unique anatomy which could affect the results of TAVI; however, multiple recent reports have shown that TAVI is safe and effective in this population. Paravalvular aortic regurgitation was initially found to be more frequent in bicuspid patients, but newer-generation devices have shown superior results in this respect. Higher rates of pacemaker implantation after TAVI in bicuspid AS do require further investigation...
September 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27639741/redo-tavi-initial-experience-at-two-german-centres
#10
Tobias Schmidt, Christian Frerker, Hannes Alessandrini, Michael Schlüter, Felix Kreidel, Ulrich Schäfer, Thomas Thielsen, Karl-Heinz Kuck, John Jose, Erik W Holy, Mohamed El-Mawardy, Abdelhakim Allali, Gert Richardt, Mohamed Abdel-Wahab
AIMS: The aim of this study was to assess the feasibility and early outcomes of transcatheter aortic valve implantation (TAVI) in dysfunctional TAVI prostheses (redo TAVI). METHODS AND RESULTS: Nineteen redo TAVI procedures were performed between October 2011 and November 2015 at two German centres. Mean age was 78 years, 13 (68%) were male, and the mean logistic EuroSCORE was 32%. Median time elapsed since index TAVI was 644 days (interquartile range 191-1,831)...
September 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27620637/timing-of-surgical-intervention-for-aortic-regurgitation
#11
REVIEW
Brett Hiendlmayr, Joseph Nakda, Ossama Elsaid, Xuan Wang, Aidan Flynn
Aortic regurgitation is a frequently encountered condition, in which traditional measurements of severity have proven to be of limited value in identifying those who would be best served by aortic valve replacement. Novel methods of assessing severity are vital, particularly as an entirely new paradigm of aortic regurgitation has surfaced, with the advent of transcatheter aortic valve replacement (TAVR), and the adverse events that are being observed with varying degrees of aortic regurgitation. With that in mind, a comprehensive assessment of aortic regurgitation should now include indexed left ventricular systolic volumes and a comprehensive assessment of right ventricular function, in addition to the quantitative measures that are currently recommended...
November 2016: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27614379/the-balloon-expandable-edwards-sapien-3-valve-is-superior-to-the-self-expanding-medtronic-corevalve-in-patients-with-severe-aortic-stenosis-undergoing-transfemoral-aortic-valve-implantation
#12
Birgid Gonska, Julia Seeger, Justus Baarts, Christoph Rodewald, Dominik Scharnbeck, Wolfgang Rottbauer, Jochen Wöhrle
BACKGROUND: Residual paravalvular moderate or severe aortic regurgitation (AR) has been an independent risk factor for mortality after transcatheter aortic valve implantation (TAVI). The design of the third generation Edwards Sapien 3 (ES3; Edwards Lifesciences, Irvine, CA, USA) valve was optimized with an outer skirt to address the issue of paravalvular AR. METHODS AND RESULTS: We compared 100 consecutive patients treated with the ES3 for severe aortic stenosis with 100 patients treated with the Medtronic CoreValve (CV; Medtronic, Minneapolis, MN, USA) (Clinical Trial Registration: NCT02162069)...
September 7, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27609256/transcatheter-aortic-valve-replacement-using-transaortic-access-experience-from%C3%A2-the-multicenter-multinational-prospective-route-registry
#13
Vinayak Bapat, Derk Frank, Ricardo Cocchieri, Dariusz Jagielak, Nikolaos Bonaros, Marco Aiello, Joel Lapeze, Mika Laine, Sidney Chocron, Douglas Muir, Walter Eichinger, Matthias Thielmann, Louis Labrousse, Kjell Arne Rein, Jean-Philippe Verhoye, Gino Gerosa, Hardy Baumbach, Peter Bramlage, Cornelia Deutsch, Martin Thoenes, Mauro Romano
OBJECTIVES: The Registry of the Utilization of the TAo-TAVR approach using the Edwards SAPIEN Valve (ROUTE) was established to assess the effectiveness and safety of the use of transaortic (TAo) access for transcatheter aortic valve replacement (TAVR) procedures (NCT01991431). BACKGROUND: TAVR represents an alternative to surgical valve replacement in high-risk patients. Whereas the transfemoral access route is used commonly as the first-line approach, transapical access is an option for patients not suitable for transfemoral treatment mainly due to anatomic conditions...
September 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27578840/outcomes-of-redo-transcatheter-aortic-valve-replacement-for-the-treatment-of-postprocedural-and-late-occurrence-of-paravalvular-regurgitation-and-transcatheter-valve-failure
#14
Marco Barbanti, John G Webb, Claudia Tamburino, Nicolas M Van Mieghem, Raj R Makkar, Nicolò Piazza, Azeem Latib, Jan-Malte Sinning, Kim Won-Keun, Sabine Bleiziffer, Francesco Bedogni, Samir Kapadia, Didier Tchetche, Josep Rodés-Cabau, Claudia Fiorina, Luis Nombela-Franco, Federico De Marco, Peter P de Jaegere, Tarun Chakravarty, Beatriz Vaquerizo, Antonio Colombo, Lars Svensson, Rüdiger Lange, Georg Nickenig, Helge Möllmann, Thomas Walther, Francesco Della Rosa, Yacine Elhmidi, Danny Dvir, Nedy Brambilla, Sebastiano Immè, Carmelo Sgroi, Simona Gulino, Denise Todaro, Gerlando Pilato, Anna Sonia Petronio, Corrado Tamburino
BACKGROUND: Transcatheter aortic valves can degenerate in a manner similar to surgical bioprostheses. METHODS AND RESULTS: Clinical and echocardiographic outcomes of patients who underwent redo transcatheter aortic valve replacement (TAVR) procedures >2 weeks post procedure were collected from 14 centers. Among 13 876 patients, 50 (0.4%) underwent redo TAVR procedure at participating centers. Indications for redo TAVR were moderate-severe prosthetic aortic valve stenosis (n=10, 21...
September 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27572071/percutaneous-treatment-of-severe-transvalvular-and-paravalvular-regurgitation-in-a-failing-surgical-aortic-valve-prosthesis-due-to-recurrent-endocarditis
#15
Ronald K Binder, Fabian Nietlispach, Tomas Holubec, Francesco Maisano
No abstract text is available yet for this article.
August 28, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27540996/international-expert-consensus-on-sutureless-and-rapid-deployment-valves-in-aortic-valve-replacement-using-minimally-invasive-approaches
#16
Mattia Glauber, Simon C Moten, Eugenio Quaini, Marco Solinas, Thierry A Folliguet, Bart Meuris, Antonio Miceli, Peter J Oberwalder, Manfredo Rambaldini, Kevin H T Teoh, Gopal Bhatnagar, Michael A Borger, Denis Bouchard, Olivier Bouchot, Stephen C Clark, Otto E Dapunt, Matteo Ferrarini, Theodor J M Fischlein, Guenther Laufer, Carmelo Mignosa, Russell Millner, Philippe Noirhomme, Steffen Pfeiffer, Xavier Ruyra-Baliarda, Malakh Lal Shrestha, Rakesh M Suri, Giovanni Troise, Borut Gersak
OBJECTIVE: To define the benefit of sutureless and rapid deployment valves in current minimally invasive approaches in isolated aortic valve replacement. METHODS: A panel of 28 international experts with expertise in both minimally invasive aortic valve replacement and rapid deployment valves was constituted. After thorough literature review, the experts rated evidence-based recommendations in a modified Delphi approach. RESULTS: No guideline could be retrieved...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27537190/transcatheter-mitral-valve-implantation-30-day-outcome-of-first-in-man-experience-with-an-apically-tethered-device
#17
Cesare Quarto, Simon Davies, Alison Duncan, Alistair Lindsay, Georg Lutter, Lucian Lozonschi, Neil Moat
OBJECTIVE: A small number of transcatheter mitral valve implants (TMVIs) have been reported using devices designed to treat secondary mitral regurgitation (MR). However, MR has many etiologies, and patients have a broad spectrum of annular size, geometry, and lesions. There are a number of technical challenges for TMVI including left ventricular outflow tract obstruction and paravalvular MR. Thirty days' outcome of first-in-man implants with a novel TMVI device is reported. METHODS: The Tendyne TMVI system consists of a porcine pericardial valve in a tethered nitinol frame...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27514789/transapical-tricuspid-valve-in-ring-implantation-an-alternative-approach-to-a-challenging-clinical-scenario
#18
Evaldas Girdauskas, Bernward Lauer, Thomas Kuntze
We report on a transapical tricuspid valve-in-ring implantation performed via right ventricular apex using the Sapien-XT-prosthesis. A 57-year-old woman with recurrent episodes of right heart failure and three previous sternotomies, including tricuspid valve repair with a 32 mm Carpentier-Edwards-Classic annuloplasty ring was admitted due to recurrent severe tricuspid regurgitation. Given the excessive surgical risk, a 29 mm Sapien-XT-prosthesis was selected for valve-in-ring implantation. Transapical valve-in-ring implantation procedure was uneventful...
August 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27510550/valvular-disease-vwf-testing-for-paravalvular-regurgitation-during-tavi
#19
Karina Huynh
No abstract text is available yet for this article.
October 2016: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/27495961/outcome-after-general-anesthesia-versus-monitored-anesthesia-care-in-transfemoral-transcatheter-aortic-valve-replacement
#20
Paola D'Errigo, Marco Ranucci, Remo Daniel Covello, Fausto Biancari, Stefano Rosato, Marco Barbanti, Francesco Onorati, Corrado Tamburino, Gennaro Santoro, Claudio Grossi, Francesco Santini, Katia Bontempi, Danilo Fusco, Fulvia Seccareccia
OBJECTIVE: To evaluate outcomes of monitored anesthesia care (MAC) compared with general anesthesia (GA) in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). DESIGN: Secondary analysis from the observational and prospective OBSERVANT (OBservational Study of Effectiveness of avR-taVi procedures for severe Aortic steNosis Treatment) study. SETTING: Multicenter study, including Italian hospitals performing TAVR interventions...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
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