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Valve thrombosis

Vrishank Raghav, Sudeep Sastry, Neelakantan Saikrishnan
Experimental flow field characterization is a critical component of the assessment of the hemolytic and thrombogenic potential of heart valve substitutes, thus it is important to identify best practices for these experimental techniques. This paper presents a brief review of commonly used flow assessment techniques such as Particle image velocimetry (PIV), Laser doppler velocimetry, and Phase contrast magnetic resonance imaging and a comparison of these methodologies. In particular, recommendations for setting up planar PIV experiments such as recommended imaging instrumentation, acquisition and data processing are discussed in the context of heart valve flows...
March 12, 2018: Cardiovascular Engineering and Technology
Tufan Çınar, Mert Ilker Hayıroğlu, Veysel Ozan Tanık, Emre Aruğaslan, Muhammed Keskin, Mahmut Uluganyan, Ahmet Öz, Metin Çağdaş, Ahmet Taha Alper
Prosthetic valve thrombosis (PVT) is a potentially life-threatening complication associated with high morbidity and mortality. The CHA2DS2-VASc is a clinical score used to determine thromboembolism risk in non-valvular atrial fibrillation patients. Therefore; in this study, we aimed to determine predictive value of the CHA2DS2-VASc score for development of PVT in patients with mechanical prosthetic valve. This was a retrospective study included 417 consecutive patients with mechanic prosthetic valve in whom transesophageal echocardiography (TEE) was performed due to different clinical indications from January 2004 to June 2016...
March 9, 2018: Journal of Thrombosis and Thrombolysis
William J Yoon, Pegge Halandras, Bernadette Aulivola, Paul Crisostomo
INTRODUCTION & OBJECTIVES: Cancer patients demonstrate increased risk for venous thromboembolism (VTE), VTE recurrence, and anticoagulation-associated bleeding. Pharmacomechanical thrombolysis and thrombectomy (PMT) improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral deep venous thrombosis (DVT). It remains unknown whether pharmacomechanical thrombolysis can be used safely in patients with active cancer. We hypothesized that perioperative and short-term outcomes of pharmacomechanical iliofemoral DVT thrombolysis would not differ between patients with cancer and those without cancer...
March 5, 2018: Annals of Vascular Surgery
Özge Çetinarslan, Ümit Yaşar Sinan, Emir Barış Ökçün, Cengiz Çeliker, Nuh Nazmi Gültekin
Heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia and thrombosis are potentially fatal adverse reactions to heparin therapy caused by the formation of polyclonal antibodies against the platelet factor 4-heparin complex. Fatal limb and organ damage or death may occur as a result of this immunological drug reaction. Described in this case report is the management of a patient who developed HIT after undergoing a MitraClip transcatheter mitral valve repair. The aim was to encourage clinicians to pay special attention to a frail patient who receives heparin therapy and to advise clinicians that clinical scores and laboratory tests should be used as a complement for certain diagnosis...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Matthew C Koopmann, Robert B McLafferty
Lower extremity deep venous thrombosis is a leading cause of morbidity and mortality. The mainstay of therapy is medical. However, anticoagulation does not remove the thrombus and restore venous patency. In select patients, early thrombus removal and anticoagulation can restore venous patency, preserve venous valve function, and may reduce the incidence of postthrombotic syndrome. Catheter-directed therapies are minimally invasive with low complication rates. However, in patients with a contraindication to thrombolytic agents who can receive anticoagulation, open thrombectomy should be considered if indications for thrombus removal are met and patients are good operative risks...
April 2018: Surgical Clinics of North America
Hoda Hatoum, Jennifer Dollery, Scott M Lilly, Juan A Crestanello, Lakshmi Prasad Dasi
BACKGROUND: This study aims to evaluate the effect of transcatheter aortic valve (TAV) implantation depth and rotation on pressure gradient (PG), leakage fractions (LF), leaflet shear stress and sinus washout in an effort to understand factors that may dictate optimal positioning for valve-in-valve (ViV) procedures. Sinus flow stasis is often associated with prosthetic leaflet thrombosis. While recent ViV in-vitro studies highlighted transcatheter aortic valve (TAV) supra-annular implantation potential benefits to minimize pressure gradients, the relationship between TAV depth and other determinates of valve function remains unknown...
March 1, 2018: Annals of Thoracic Surgery
Mhairi Katrina Doris, Marc Richard Dweck
No abstract text is available yet for this article.
March 1, 2018: Heart: Official Journal of the British Cardiac Society
Ayumi Koga, Ken Okamoto, Hirokazu Tazume, Toshihiro Fukui
Antiphospholipid syndrome is a rare autoimmune disease with a hypercoagulable state causing vascular thrombosis. We present the case of a 42-year old female who underwent mitral valve replacement with a mechanical valve 15 months ago. The postoperative course was uneventful, and echocardiography performed 14 months postoperatively showed good valve function. The patient developed sudden dyspnea 15 months postoperatively and was referred to our hospital. Echocardiography revealed mitral stenosis with stuck leaflets...
January 31, 2018: Heart Surgery Forum
Silje Ekroll Jahren, Paul Philipp Heinisch, David Hasler, Bernhard Michael Winkler, Stefan Stortecky, Thomas Pilgrim, Martina Correa Londono, Thierry Carrel, Hendrik von Tengg-Kobligk, Dominik Obrist
OBJECTIVES: Bioprosthetic valve thrombosis has been considered uncommon, but recent studies have shown that it is more frequent than previously thought. Insufficient washout of the aortic sinus is believed to be a risk factor for bioprosthetic valve thrombosis. The objective of this in vitro experiment was to investigate the impact of aortic root morphology on blood flow in the aortic sinus and to relate these results to in vivo data obtained in patients with a transcatheter aortic valve implant...
February 21, 2018: Interactive Cardiovascular and Thoracic Surgery
Tian-Yuan Xiong, Yan-Biao Liao, Yuan Feng, Ming-Yue Zhao, Zhen-Gang Zhao, Yi-Jian Li, Xiao-Jing Liu, Mao Chen
The imaging finding of hypo-attenuated leaflet thickening (HALT) on bioprosthesis after transcatheter aortic valve replacement (TAVR) has been reported. The underlying mechanism is not clear, but leaflet thrombosis is speculated to be the cause. Heterogeneous antiplatelet responses may play a role in the process. This is a prospective, single-center pilot study in patients who received successful TAVR from June 2012 to November 2016. HALT on post-procedural multi-detector computed tomography. We thoroughly genotyped 34 SNPs and 8 SNPs that have been reported for clopidogrel and aspirin resistance...
February 24, 2018: Journal of Thrombosis and Thrombolysis
Jeremy W Vandiver, K Diane Beavers
Anticoagulant therapy and antiplatelet therapy are used regularly for prevention of arterial and venous thrombosis, and combinations of the two drug classes are seen with relative frequency in clinical practice. While co-prescribing is as high as 39-55% in some real-world cohort studies, the number of patients that meet criteria for combination therapy based on the overall body of evidence is likely much lower. This may not always be realized by prescribers, and many patients may be continued on long term combination therapies that provide little additional benefit, and carry significant risk for harm...
February 24, 2018: Journal of Thrombosis and Thrombolysis
Marcus Lehmann, Rogier M Schoeman, Patrick J Krohl, Alison M Wallbank, Joseph R Samaniuk, Martine Jandrot-Perrus, Keith B Neeves
OBJECTIVE: The objective of this study was to measure the role of platelets and red blood cells on thrombus propagation in an in vitro model of venous valvular stasis. APPROACH AND RESULTS: A microfluidic model with dimensional similarity to human venous valves consists of a sinus distal to a sudden expansion, where for sufficiently high Reynolds numbers, 2 countercurrent vortices arise because of flow separation. The primary vortex is defined by the points of flow separation and reattachment...
February 22, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Doreen Richardt, Sherazade Luise Haban-Rackebrandt, Sina Stock, Michael Scharfschwerdt, Hans-Hinrich Sievers
OBJECTIVES: Transcatheter aortic valve implantation is a treatment strategy for degenerated aortic valve prostheses, but there is some concern regarding valve thrombosis. The optimal anticoagulation strategy for implantation of a transcatheter aortic valve prosthesis remains unclear. METHODS: Aortic root models with the Sapien-XT and S3 prostheses (sizes 23 and 26) fixed in a Perimount Magna Ease bioprosthesis (sizes 23 and 25) were constructed. The haemodynamics of the left ventricle were imitated in a proved in vitro model...
February 15, 2018: European Journal of Cardio-thoracic Surgery
Jelle Vandersteene, Edward Baert, Stijn Schauvliege, Kimberley Vandevelde, Frank Dewaele, Filip De Somer, Dirk Van Roost
The ventriculosinus shunt is a promising treatment for hydrocephalus. Currently, different shunt techniques exist, and it is not clear whether one is preferable. This pilot study reports on a non-hydrocephalic goat model (Saanen breed) that provides opportunities to evaluate and optimize several aspects of the ventriculosinus shunt technique. Analysis of the coagulation properties of 14 goats by a viscoelastic coagulation monitor showed that goats have a hypercoagulable state compared to humans. This property can be partially counteracted by antiplatelet drugs...
January 1, 2018: Laboratory Animals
Nagaraja Moorthy, Rajiv Ananthakrishna, Dattatreya P V Rao, Satvic C Manjunath, Manjunath C Nanjappa
Intermittent dysfunction of mechanical mitral valve prosthesis is an uncommon condition. It carries serious clinical implications if unrecognized. Here, we present a case of a 28-year-old female with a history of rheumatic multivalvular disease, for which she had undergone double valve replacement and tricuspid annuloplasty. Six months later, she presented with heart failure. Clinical examination revealed intermittent loss of closing clicks followed by a pansystolic murmur at the apex, suggestive of mitral prosthetic valve dysfunction...
March 2018: Echocardiography
Bonou Maria, Tzanis Georgios, Viniou Nora-Athina, Biliou Smaragda, Barbetseas John
No abstract text is available yet for this article.
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Michelle Remião Ugolini Lopes, Adriana Danowski, Andreas Funke, Jozelia Rêgo, Roger Levy, Danieli Castro Oliveira de Andrade
Antiphospholipid syndrome (APS) is an autoimmune disease characterized by antiphospholipid antibodies (aPL) associated with thrombosis and/or pregnancy morbidity. Most APS events are directly related to thrombotic events, which may affect small, medium or large vessels. Other clinical features like thrombocytopenia, nephropathy, cardiac valve disease, cognitive dysfunction and skin ulcers (called non-criteria manifestations) add significant morbidity to this syndrome and represent clinical situations that are challenging...
November 2017: Revista da Associação Médica Brasileira
S S Kothari, Siddharthan Deepti, Nitish Rai
A 31-year-old man with a mitral bioprosthetic valve presented with recent worsening of exertional dyspnoea 7 years after the mitral valve replacement. Evaluation revealed an increased gradient across the thickened mitral bioprosthetic valve leaflets. Marked eosinophilia was present and was considered as a putative cause for bioprosthetic valve thrombosis. The treatment with systemic corticosteroids and oral anticoagulation led to complete resolution of symptoms with significant decrease in mitral bioprosthetic valve gradient and leaflet thinning...
February 8, 2018: BMJ Case Reports
Aaron B Hesselson, Sandeep Duggal, Michael Rukavina, Peter L Gallagher, Gery F Tomassoni
BACKGROUND: Barriers to successful left ventricular lead placement within the coronary venous anatomy may include focal stenoses, thromboses, phrenic nerve stimulation, vessel tortuosity, small vessel caliber, non-excitable tissue and valve presence. A large series describing the utilization of coronary venous angioplasty (CVAP) for relief of these issues is absent in the literature. OBJECTIVE: We report our experience for all patients treated with CVAP in a single-center 13-year experience...
February 12, 2018: Pacing and Clinical Electrophysiology: PACE
Do Jung Kim, Hyo-Hyun Kim, Shin-Young Lee, Sak Lee, Byung-Chul Chang
Background: Sutureless aortic valve replacement (SU-AVR) has been developed as an alternative surgical treatment for patients with symptomatic severe aortic stenosis (AS). The aim of this study was to evaluate the clinical outcomes of SU-AVR through an assessment of hemodynamic performance and safety. Methods: From December 2014 to June 2016, a total of 12 consecutive patients with severe AS underwent SU-AVR. The endpoints were overall survival and valve-related complications (paravalvular leakage, valve thrombosis, migration, endocarditis, and permanent pacemaker implantation)...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
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