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Paravalvular regurgitation

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
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
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
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
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
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
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
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
Ronald K Binder, Fabian Nietlispach, Tomas Holubec, Francesco Maisano
No abstract text is available yet for this article.
August 28, 2016: European Heart Journal
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
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
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
Karina Huynh
No abstract text is available yet for this article.
October 2016: Nature Reviews. Cardiology
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
Kevin L Greason
No abstract text is available yet for this article.
October 2016: Journal of Thoracic and Cardiovascular Surgery
Saskia Pokorny, Katharina Huenges, Jan Hinerk Hansen, Yannik Schadow, Gunther Fischer, Michael M Morlock, Jochen Cremer, Georg Lutter
OBJECTIVES: A large cohort of patients suffering from severe mitral regurgitation does not meet the indications for conventional surgery and would greatly benefit from a transcatheter approach in the beating heart. Consequently, off-pump transcatheter mitral valve procedures have been the focus of recent research. The aim of this study was the in vivo evaluation and comparison of subannular versus apical fixation of mitral valved stents to show the feasibility of subannular anchorage...
July 29, 2016: European Journal of Cardio-thoracic Surgery
Mohammad Abdelghani, Ben Ren, Ernest Spitzer, Hiroki Tateishi, Hans Jonker, Marcel L Geleijnse, Jan G Tijssen, Robbert J de Winter, Patrick W J C Serruys, Osama I I Soliman
Paravalvular leak (PVL) after transcatheter aortic valve implantation (TAVI) is challenging to quantitate. Transthoracic echocardiography (TTE) is the main tool used for the assessment of PVL but is modestly reproducible. We sought to develop a reproducible echocardiographic approach to assess PVL in the post-TAVI setting. Four observers independently analyzed eleven parameters of PVL severity in 50 pre-discharge TTE studies performed after TAVI. The parameters included color-Doppler parameters [jet circumferential extent (CE) and planimetered vena contracta area in the short-axis view and jet breadth and qualitative features in the long-axis views], continuous-wave Doppler parameters [jet velocity time integral (VTI) and pressure half time (PHT)], quantitative Doppler parameters (regurgitation volume and fraction and effective regurgitant orifice area), aortic diastolic flow reversal and valve stent eccentricity...
October 2016: International Journal of Cardiovascular Imaging
Firas E Zahr, Steven R Lentz
No abstract text is available yet for this article.
July 28, 2016: New England Journal of Medicine
Yigal Abramowitz, Yoshio Maeno, Tarun Chakravarty, Yoshio Kazuno, Nobuyuki Takahashi, Hiroyuki Kawamori, Geeteshwar Mangat, Wen Cheng, Hasan Jilaihawi, Raj R Makkar
OBJECTIVES: The aim of this study was to evaluate the impact of increased aortic angulation (AA) on acute procedural success following transcatheter aortic valve replacement (TAVR). BACKGROUND: The degree of angulation between the aorta and the heart can make accurate positioning of the bioprosthesis during TAVR more demanding, particularly in instances of an extremely angulated or horizontal aortic root. Nonetheless, there are limited data on the impact of AA on the acute success of TAVR...
August 2016: JACC. Cardiovascular Imaging
Yuanjia Zhu, Samir Kapadia, Amar Krishnaswamy, Lars G Svensson, Stephanie Mick
Paravalvular leak-related aortic regurgitation after transcatheter aortic valve replacement (TAVR) is a common complication and is associated with increased short- and long-term mortality. However, the impact of isolated central aortic regurgitation is unknown. We report a case of transapical (TA) TAVR with postprocedural central aortic regurgitation, who returned after two years with progression of regurgitation. A reoperative valve-in-valve TA-TAVR was performed.
September 2016: Journal of Cardiac Surgery
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