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Valve thrombosis

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https://www.readbyqxmd.com/read/29352701/bailout-surgical-explantation-of-a-transcatheter-valve-in-valve-for-subacute-thrombosis-when-there-is-no-time-for-anticoagulation-case-report-and-literature-review
#1
Francesco Notaristefano, Matteo Rocco Reccia, Salvatore Notaristefano, Roberto Annunziata, Rocco Sclafani, Giuseppe Ambrosio, Claudio Cavallini
Trancatheter heart valve (THV) thrombosis is effectively treated with anticoagulation but alternative therapies are required when a faster gradient reduction is needed. Open heart surgery has been rarely performed due to the high perioperative mortality and only five cases have been described so far. Here we describe a case of emergent surgical explantation for THV thrombosis after a valve-in-valve. A 67years old man underwent transcatheter aortic valve implantation for a failed surgical bioprosthesis Epic 21mm (St...
December 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29351635/reversibility-of-severe-mitral-valve-regurgitation-after-left-ventricular-assist-device-implantation-single-centre-observations-from-a-real-life-population-of-patients
#2
Monica Dobrovie, Ricardo A Spampinato, Elena Efimova, Jaqueline G da Rocha E Silva, Julia Fischer, Michael Kuehl, Jens-Uwe Voigt, Ann Belmans, Agnieszka Ciarka, Fernanda Bonamigo Thome, Valerie Schloma, Yaroslava Dmitrieva, Sven Lehmann, Jochen Hahn, Elfriede Strotdrees, Friedrich-Wilhelm Mohr, Jens Garbade, Anna L Meyer
OBJECTIVES: This study evaluates the impact of untreated preoperative severe mitral valve regurgitation (MR) on outcomes after left ventricular assist device (LVAD) implantation. METHODS: Of the 234 patients who received LVAD therapy in our centre during a 6-year period, we selected those who had echocardiographic images of good quality and excluded those who underwent mitral valve replacement prior to or mitral valve repair during LVAD placement. The 128 patients selected were divided into 2 groups: Group A with severe MR (n = 65) and Group B with none to moderate MR (n = 63, 28 with moderate MR)...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29334746/-the-current-role-of-warfarin
#3
Jana Michalcová, Alena Buliková, Jiřina Zavřelová, Marie Prudková, Miroslav Penka
Well-managed warfarin therapy remains an important method of anticoagulation in the 21st century, despite the introduction of new antithrombotics into the clinical practice. The main advantages of warfarin are decades of treatment experience, the possibility to monitor its anticoagulant effect using the INR and the last, but not least, the low cost. Currently, approximately 75 % of anticoagulated patients in the Czech Republic are treated with warfarin and warfarin remains the only option for oral anticoagulant therapy in certain clinical conditions (particularly in patients with valvular atrial fibrillation or mechanical heart valves)...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29305851/quantitative-assessment-of-inflow-malposition-in-two-continuous-flow-left-ventricular-assist-devices
#4
Erik N Sorensen, Zachary N Kon, Erika D Feller, Si M Pham, Bartley P Griffith
BACKGROUND: We previously investigated preoperative variables associated with qualitative inflow cannula (IFC) malposition in the Heartmate II continuous-flow left ventricular assist device. In this report, we assess IFC malposition quantitatively in recipients of both the Heartmate II and the Heartware and examine its association with device thrombosis. METHODS: Malposition was quantified based on angular deviation from a hypothetical ideal IFC position in two orthogonal computed tomography (CT) imaging planes...
January 3, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29304514/antithrombotic-treatment-after-transcatheter-heart-valves-implant
#5
Sabato Sorrentino, Gennaro Giustino, Kamilia Moalem, Ciro Indolfi, Roxana Mehran, George D Dangas
Transcatheter heart valve replacement technology was introduced as alternative to surgery for the growing high-risk profile population. Developed first, aortic valve replacement (TAVR) became a standard of care for patients with severe aortic stenosis at high operative risk, with a potential future use also for low-risk subjects. In the last decade, a multitude of transcatheter mitral valve replacement (TMVR) devices have been developed for the treatment of severe mitral regurgitation, with encouraging results coming from first-in-man and feasibility studies...
January 5, 2018: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/29302946/the-role-of-protein-z-and-protein-z-dependent-protease-inhibitor-polymorphisms-in-the-development-of-prosthetic-heart-valve-thrombosis
#6
Süleyman Karakoyun, Mustafa Ozan Gürsoy, Macit Kalçık, Mahmut Yesin, Sabahattin Gündüz, Mehmet Ali Astarcıoğlu, Zübeyde Bayram, Beytullah Çakal, Emrah Bayam, Mehmet Özkan
BACKGROUND: Protein Z (PZ) is a vitamin K-dependent factor that is synthesized mainly by the liver. It acts as an activator of serpin, the protein Z-dependent inhibitor (ZPI), which inhibits factor Xa. The potential role of alterations in protein Z and/or ZPI levels in the pathogenesis of thrombotic and/or hemorrhagic diseases has been previously investigated, but results have been conflicting. The study aim was to evaluate the role of PZ/ZPI polymorphisms in the development of prosthetic valve thrombosis (PVT)...
July 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/29302462/valve-sparing-aortic-root-replacement-midterm-outcomes-and-quality-of-life
#7
Abdel-Kémal Bori Bata, Nicolas D'Ostrevy, Bruno Pereira, Etienne Geoffroy, Nicolas Dauphin, Vedat Eljezi, Kasra Azarnoush, Lucie Ulman, Lionel Camilleri
Background: This study evaluated the midterm outcomes, the valve related events and quality of life of patients treated by valve-sparing aortic root replacement (VSRR). Methods: From January 2003 to December 2014, 88 consecutive patients diagnosed with an aortic root aneurysm or ascending aortic aneurysms underwent VSRR surgery. The mean age was 55±14 (range 19-77) years. A total of 84% of the patients were male; 89% were in New York Heart Association functional class I or II, 55% had aortic regurgitation (AR) grade III or IV...
December 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29297076/effect-of-mechanically-expanded-vs-self-expanding-transcatheter-aortic-valve-replacement-on-mortality-and-major-adverse-clinical-events-in-high-risk-patients-with-aortic-stenosis-the-reprise-iii-randomized-clinical-trial
#8
Ted E Feldman, Michael J Reardon, Vivek Rajagopal, Raj R Makkar, Tanvir K Bajwa, Neal S Kleiman, Axel Linke, Dean J Kereiakes, Ron Waksman, Vinod H Thourani, Robert C Stoler, Gregory J Mishkel, David G Rizik, Vijay S Iyer, Thomas G Gleason, Didier Tchétché, Joshua D Rovin, Maurice Buchbinder, Ian T Meredith, Matthias Götberg, Henrik Bjursten, Christopher Meduri, Michael H Salinger, Dominic J Allocco, Keith D Dawkins
Importance: Transcatheter aortic valve replacement (TAVR) is established for selected patients with severe aortic stenosis. However, limitations such as suboptimal deployment, conduction disturbances, and paravalvular leak occur. Objective: To evaluate if a mechanically expanded valve (MEV) is noninferior to an approved self-expanding valve (SEV) in high-risk patients with aortic stenosis undergoing TAVR. Design, Setting, and Participants: The REPRISE III trial was conducted in 912 patients with high or extreme risk and severe, symptomatic aortic stenosis at 55 centers in North America, Europe, and Australia between September 22, 2014, and December 24, 2015, with final follow-up on March 8, 2017...
January 2, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29286428/stenosis-of-the-inferior-vena-cava-a-murine-model-of-deep-vein-thrombosis
#9
Holly Payne, Alexander Brill
Deep vein thrombosis (DVT) and its devastating complication, pulmonary embolism, are a severe health problem with high mortality. Mechanisms of thrombus formation in veins remain obscure. Lack of mobility (e.g., after surgery or long-haul flights) is one of the main factors leading to DVT. The pathophysiological consequence of the lack of mobility is blood flow stagnation in venous valves. Here, a model is described that mimics such flow disturbance as a thrombosis-driving factor. In this model, partial flow restriction (stenosis) in the inferior vena cava (IVC) is created...
December 22, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29284171/post-tavi-follow-up-with-mdct-of-the-valve-prosthesis-technical-application-regular-findings-and-typical-local-post-interventional-complications
#10
Martin Soschynski, Fabio Capilli, Philipp Ruile, Franz-Josef Neumann, Mathias Langer, Tobias Krauss
BACKGROUND:  Transcatheter aortic valve implantation (TAVI) has evolved into an alternative procedure to surgical valve replacement for high-risk patients with aortic valve stenosis. Despite technical innovations, there is still a risk of complications during and after the intervention. After a TAVI procedure, ECG-gated multidetector computed tomography (MDCT) plays an important role in the early diagnosis of local complications. In this article, we explain for the first time how the technical acquisition of MDCT in the region of the aortic root is performed as post-interventional control of the TAVI prosthesis...
December 28, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/29281606/expanding-indications-for-tavr-the-preferred-procedure-in-intermediate-risk-patients
#11
REVIEW
David L Brown
Transcatheter aortic valve replacement (TAVR) has steadily replaced surgical aortic valve replacement (SAVR) in symptomatic patients with severe aortic stenosis, primarily those at high risk for surgical complications. As TAVR use increases, spurred by technological advances in valve design and patient preferences for the less-invasive procedure, studies have provided data supporting the efficacy and safety of TAVR. Recently, TAVR has expanded to intermediate-risk patients, increasing the potential patient population...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29277547/recurrent-bioprosthetic-valve-thrombosis-should-long-term-anticoagulation-be-considered
#12
Matthew S Yong, Robert Grant, Pankaj Saxena, Sumit Yadav
Bioprosthetic valve thrombosis (BPVT) is an important and potentially reversible cause of valvular dysfunction. This complication can occur many years after surgery and understanding of the precise mechanisms and risk factors are limited. Anticoagulation therapy has been demonstrated to be effective in improving BPVT. However, the optimal duration of therapy and the risk of recurrence are unknown. Herein, we describe two cases-one of late BPVT and one of recurrence of BPVT after cessation of anticoagulation therapy...
December 11, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29276174/routine-use-of-anticoagulation-after-transcatheter-aortic-valve-replacement-initial-safety-outcomes-from-a-single-center-experience
#13
Sergey Gurevich, Brett Oestreich, Rosemary F Kelly, Mackenzie Mbai, Stefan Bertog, Demetris Yannopoulos, Santiago Garcia
BACKGROUND: Subclinical leaflet thrombosis (SCLT) can be seen in up to 12% of patients after transcatheter aortic valve replacement (TAVR). Anticoagulation appears to prevent and reverse SCLT but concerns exist about bleeding risk. METHODS: Our program adopted a strategy of routine anticoagulation after TAVR, starting warfarin on post-procedure day 0 and continuing for 3months in 10/2015. We report the initial safety and efficacy outcomes of this approach. Bleeding events were assessed using Valve Academic Research Consortium (VARC) and Bleeding Academic Research Consortium (BARC) definitions...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29258394/quality-of-anticoagulation-with-warfarin-at-a-tertiary-hospital-in-botswana
#14
Julius C Mwita, Joel M Francis, Anthony A Oyekunle, Marea Gaenamong, Monkgogi Goepamang, Mgaywa G M D Magafu
Warfarin treatment requires regular and proper monitoring to avoid overanticoagulation and at the same time to prevent thromboembolic complications. This study assessed the quality of warfarin anticoagulation at Princess Marina Hospital in Botswana. This cross-sectional study consecutively enrolled patients who were on warfarin for at least 3 months in the outpatient medical clinic. The level of anticoagulation was determined by the time in therapeutic range (TTR) using the Rosendaal method that calculates the percentage of days when the international normalized ratio is in the therapeutic range (2...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29235436/bioprosthetic-aortic-valve-leaflet-thrombosis-detected-by-multidetector-computed-tomography-is-associated-with-adverse-cerebrovascular-events-a-meta-analysis-of-observational-studies
#15
Hashrul N Rashid, Robert P Gooley, Nitesh Nerlekar, Abdul R Ihdayhid, Liam M McCormick, Arthur Nasis, James D Cameron, Adam J Brown
AIMS: Leaflet thrombosis (LT) has become increasingly recognised following transcatheter and surgical aortic ABV replacement and can be reliably identified by MDCT. However, it is ongoing debate whether MDCT-defined LT is associated with adverse cerebrovascular outcomes. We performed a systematic review and meta-analysis to assess the incidence and clinical outcomes associated with multidetector computed tomography (MDCT)-defined leaflet thrombosis following aortic bioprosthetic valve (ABV) replacement...
December 12, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29217087/evolution-of-simplified-frozen-elephant-trunk-repair-for-acute-debakey-type-i-dissection-midterm-outcomes
#16
Eric E Roselli, Jay J Idrees, Faisal G Bakaeen, Michael Z Tong, Edward G Soltesz, Stephanie Mick, Douglas R Johnston, Mathew J Eagleton, Venu Menon, Lars G Svensson
BACKGROUND: A modified technique for frozen elephant trunk (FET) repair of acute DeBakey type I dissection has evolved. Procedural modifications are described and midterm outcomes evaluated. METHODS: From 2009 to 2016, 72 patients with DeBakey type I dissection underwent emergency simplified FET. Mean age was 59 ± 15 years. Presentation included malperfusion (n = 22, 31%), rupture (n = 12, 16%), and aortic insufficiency (n = 42, 58%). Concomitant procedures included valve replacement (n = 9), root replacement (n = 11; valve sparing n = 6), cusp repair (n = 11), and valve resuspension (n = 21)...
December 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29215545/metal-artifact-free-and-dose-efficient-computed-tomography-imaging-of-a-cardiac-prosthetic-valve-using-spectral-shaping-of-the-x-ray-beam-a-case-report
#17
Christoph Schabel, Nishant K Sekaran, Andrew Wang, Lynne Hurwitz
Bioprosthetic valve (BPV) thrombosis can be challenging to diagnose with cardiac computed tomography owing to metal artifacts of the BPV. In this case report, an optimized metal artifact reduction protocol using a third-generation dual-source multidetector computed tomographic scanner with high kVp (Sn150kVp) and tin (Sn) filtration and high temporal resolution yielded high-quality, artifact-free, dynamic images of a thrombosed mitral BPV.
December 5, 2017: Journal of Computer Assisted Tomography
https://www.readbyqxmd.com/read/29211226/implantation-of-short-term-and-long-term-right-ventricular-assist-devices
#18
Christiano Castello Branco Caldeira, Regimar Carla Machado, Debora Castello Branco Caldeira
The last decade has seen considerable growth in the use of left ventricular assist devices (LVAD), in end-phase heart failure treatment. The indications, contraindications and implantation techniques are well-defined. However, information about mechanical support for right ventricular failure is lacking. The aim of this communication is to present alternative techniques for implantation of short- and longterm right ventricular assist devices. Implanting the device in the right atrium has certain advantages when compared with the right ventricle...
September 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29204246/constricted-microfluidic-devices-to-study-the-effects-of-transient-high-shear-exposure-on-platelets
#19
Nesreen Z Alsmadi, Sarah J Shapiro, Christopher S Lewis, Vinit M Sheth, Trevor A Snyder, David W Schmidtke
Due to the critical roles that platelets play in thrombosis during many biological and pathological events, altered platelet function may be a key contributor to altered hemostasis, leading to both thrombotic and hemorrhagic complications. Platelet adhesion at arterial shear rates occurs through binding to von Willebrand Factor via the glycoprotein (GP) GPIb receptor. GPIb binding can induce platelet activation distinguishable by P-selectin (CD62P) surface expression and αIIbβ3 activation, resulting in platelet aggregation and formation of the primary hemostatic plug to stop bleeding...
November 2017: Biomicrofluidics
https://www.readbyqxmd.com/read/29201439/management-of-an-acute-ischemic-stroke-during-thrombolytic-treatment-in-a-pregnant-patient-with-prosthetic-valve-thrombosis
#20
Macit Kalçık, Mahmut Yesin, Emrah Bayam, Mustafa Ozan Gürsoy, Ahmet Güner, Sabahattin Gündüz, Mehmet Özkan
Prosthetic valve thrombosis (PVT) is a life-threatening complication in pregnant women with mechanical prosthetic heart valves. Thrombolytic therapy (TT) has evolved as an effective treatment alternative to surgery, which is associated with very high maternal and fetal mortality and morbidity in these patients. Acute ischemic stroke may rarely occur during TT for PVT. Here, we present a pregnant patient who was complicated with cerebral thromboembolism during TT for PVT and successfully managed with continuation of TT...
September 2017: Interventional Medicine & Applied Science
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