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Aortic valve stenosis

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https://www.readbyqxmd.com/read/28636718/trends-and-outcomes-of-off-label-use-of-transcatheter-aortic-valve-replacement-insights-from-the-ncdr-sts-acc-tvt-registry
#1
Ravi S Hira, Sreekanth Vemulapalli, Zhuokai Li, James M McCabe, John S Rumsfeld, Samir R Kapadia, Mahboob Alam, Hani Jneid, Creighton Don, Mark Reisman, Salim S Virani, Neal S Kleiman
Importance: Transcatheter aortic valve replacement (TAVR) was approved by the US Food and Drug Administration for severe aortic stenosis in patients who cannot undergo surgery and for patients at high operative risk. Use of TAVR for off-label indications has not been previously reported. Objective: To evaluate patterns and adverse outcomes of off-label use of TAVR in US clinical practice. Design, Setting and Participants: Patients receiving commercially funded TAVR in the United States are included in the Transcatheter Valve Therapy Registry...
June 21, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28636475/surgical-aortic-valve-replacement-for-stenosis-of-tavi-device
#2
M Sooknunden, M A Radermecker, J O Defraigne, Vincent Tchana-Sato
We here report the case of a stenosis of the CoreValve(®) system due to reduced mobility of prosthesis cusps for which a surgical replacement of the aortic valve was proposed. The exact mechanism leading to this impaired mobility of the leaflets is yet to be determined. We also underline the fact a transcatheter aortic valve implantation (TAVI) device can be replaced by a surgical replacement without excessive operative risks despite the patient being initially considered as high-risk.
March 1, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28633375/final-5-year-clinical-and-echocardiographic-results-for-treatment-of-severe-aortic-stenosis-with-a-self-expanding-bioprosthesis-from-the-advance-study
#3
Ulrich Gerckens, Corrado Tamburino, Sabine Bleiziffer, Johan Bosmans, Peter Wenaweser, Stephen Brecker, Jia Guo, Axel Linke
Aims: The ADVANCE study was designed to evaluate the safety and effectiveness of transcatheter aortic valve implantation (TAVI) with a self-expanding bioprosthesis in real-world patients with symptomatic, severe aortic stenosis at high surgical risk for valve replacement. Methods and results: Study participants were enrolled from 44 experienced centres in 12 countries. Patient eligibility, treatment approach, and choice of anaesthesia were determined by the local Heart Team...
June 13, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28633264/rapidly-progressive-bioprosthetic-aortic-valve-stenosis-due-to-bartonella-species-endocarditis
#4
Kathy Schnitzer, Zafrir Or, Shtiwi Sawaed, Erez Sharoni, Naiel Bisharat
Rapid progression of valvular stenosis in the setting of infective endocarditis is extremely rare. Here we describe a patient with Bartonella endocarditis on a bioprosthetic aortic valve that caused rapidly progressive aortic stenosis without regurgitation. At operation the bioprosthetic valve was severely fibrotic and calcified, with markedly thickened and distorted leaflets and circular partial detachment from the aortic ring. The patient underwent aortic root replacement with aortic bioprosthesis and aortic grafting with reimplantation of the coronary ostia...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28629660/characterization-and-risk-factors-for-aortic-dilatation-in-pediatric-patients-with-bicuspid-aortic-valve
#5
Anna Sabaté-Rotés, Laura Sabidó Sanchez, Ferran Gran Ipiña, Dimpna Albert Brotons, Raúl F Abella, Ferran Rosés Noguer
INTRODUCTION AND OBJECTIVES: Dilatation of the ascending aorta associated with bicuspid aortic valve is a major cause of morbidity and mortality in adults. The main objective was to recognize the aortic involvement in children, its characteristics and risk factors. METHODS: Aortic measures of all pediatric patients with bicuspid aortic valve followed in a tertiary pediatric hospital between 1997 and 2015 were retrospectively taken. Patients with syndromes associated with aortic dilatation were excluded (n=17)...
June 16, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28625366/feasibility-of-transcatheter-aortic-valve-replacement-in-low-risk-patients-with-symptomatic-severe-aortic-stenosis-rationale-and-design-of-the-low-risk-tavr-lrt-study
#6
Toby Rogers, Rebecca Torguson, Roshni Bastian, Paul Corso, Ron Waksman
BACKGROUND: Safety and effectiveness of transcatheter aortic valve replacement (TAVR) in low-risk patients with symptomatic severe aortic stenosis have not yet been established. HYPOTHESIS: Transcatheter aortic valve replacement is feasible in patients with symptomatic severe aortic stenosis and low risk for surgical aortic valve replacement. DESIGN: The LRT study is the first US Food and Drug Administration-approved Investigational Device Exemption prospective multicenter feasibility trial of TAVR in low-risk patients...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28624411/incremental-prognostic-utility-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-patients-with-significant-chronic-aortic-regurgitation-and-preserved-left-ventricular-ejection-fraction
#7
Alaa Alashi, Amgad Mentias, Amjad Abdallah, Ke Feng, A Marc Gillinov, L Leonardo Rodriguez, Douglas R Johnston, Lars G Svensson, Zoran B Popovic, Brian P Griffin, Milind Y Desai
OBJECTIVES: We sought to examine the prognostic utility of left ventricular (LV) global longitudinal strain (GLS) in asymptomatic patients with ≥III+ aortic regurgitation (AR), an indexed LV end-systolic dimension of <2.5 cm/m(2), and preserved left ventricular ejection fraction (LVEF). BACKGROUND: Management of asymptomatic patients with severe chronic AR and preserved LVEF is challenging and is typically based on LV dimensions. METHODS: We studied 1,063 such patients (53 ± 16 years; 77% men) seen between 2003 and 2010 (excluding those with symptoms, obstructive coronary artery disease, acute AR/dissection, aortic/mitral stenosis, more than moderate mitral regurgitation, and previous cardiac surgery)...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28623496/association-between-flow-skewness-and-aortic-dilatation-in-patients-with-aortic-stenosis
#8
Hojin Ha, Hyun Jung Koo, June Goo Lee, Guk Bae Kim, Jihoon Kweon, Sang Joon Lee, Joon Won Kang, Tae Hwan Lim, Dae Hee Kim, Jong Min Song, Duk Hyun Kang, Jae Kwan Song, Young Hak Kim, Namkug Kim, Dong Hyun Yang
We investigated association between hemodynamic characteristics and aortic dilatation in patients with severe aortic stenosis (AS). Eighty patients with severe AS (mean age, 67.2 ± 12.5 years) who underwent multi-detector computed tomography and phase-contrast magnetic resonance imaging at the ascending aorta were retrospectively analyzed. Patients with an ascending aorta diameter >4 cm had a significantly higher forward flow rate at systole (28.5 ± 6.0 vs. 36.2 ± 8.6 L min, P < 0...
June 16, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28623173/outcomes-of-transcatheter-and-surgical-aortic-valve-replacement-in-patients-on-maintenance-dialysis
#9
Fahad Alqahtani, Sami Aljohani, Khaled Boobes, Elad Maor, Assem Sherieh, Charanjit S Rihal, David R Holmes, Mohamad Alkhouli
BACKGROUND: the introduction of transcatheter aortic valve replacement (TAVR) expanded definitive therapy of aortic stenosis to many high-risk patients, but it has not been fully evaluated in the dialysis population. OBJECTIVES: We aimed to evaluate the current trend and in-hospital outcome of Surgical aortic valve replacement (SAVR) and TAVR in the dialysis population. METHODS: Severe aortic stenosis patients on maintenance dialysis who underwent SAVR or TAVR in the Nationwide Inpatient Sample database (NIS) from January 1, 2005, through December 31, 2014, were included in our comparative analysis...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28623117/open-heart-surgery-does-not-increase-the-incidence-of-ipsilateral-ischemic-stroke-in-patients-with-asymptomatic-severe-carotid-stenosis
#10
John E Castaldo, Hussam A Yacoub, Yuebing Li, Hope Kincaid, Donna Jenny
BACKGROUND AND PURPOSE: We evaluated the incidence of perioperative stroke following the institution's 2007 practice change of discontinuing combined carotid endarterectomy and open heart surgery (OHS) for patients with severe carotid stenosis. METHODS: In this retrospective cohort study, we compared 113 patients undergoing coronary artery bypass grafting, aortic valve replacement, or both from 2007 to 2011 with data collected from 2001 to 2006 from a similar group of patients...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28622047/repositionable-and-retrievable-lotus-valve-system-for-the-treatment-of-bicuspid-aortic-stenosis-is-it-time-to-treat-all-valves
#11
Roberto Nerla, Fausto Castriota, Antonio Micari, Estevao de Campos Martins, Alberto Cremonesi
INTRODUCTION: For a long time, a bicuspid valve has been considered a contraindication to transcatheter aortic valve implantation (TAVI) due to worse procedural results. Currently available technologies are changing the scenario, with initial experiences reporting much better results with second-generation devices. AREAS COVERED: This review will analyze the risk and potential pitfalls of TAVI on bicuspid valves and will try ascertain how the use of a new-generation fully repositionable device, the Lotus Valve System (LVS), could improve procedural and clinical results in bicuspid anatomies...
June 16, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28616570/a-study-of-spectrum-of-rheumatic-heart-disease-in-a-tertiary-care-hospital-in-central-nepal
#12
S Laudari, G Subramanyam
BACKGROUND AND AIMS: Rheumatic heart disease is one of the most common cause for heart failure and associated mortalities/morbidities in the young population in developing countries like Nepal imparting huge familial, social and manpower burden. MATERIALS AND METHODS: This is a hospital based descriptive cross-sectional study during June 2014 to April 2016 over a period of 22 months at College of Medical Sciences-Bharatpur including 235 patients with clinical and/or echocardiographic evidence of definite rheumatic heart disease...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616344/vascular-approaches-for-transcatheter-aortic-valve-implantation
#13
REVIEW
Isaac Pascual, Amelia Carro, Pablo Avanzas, Daniel Hernández-Vaquero, Rocío Díaz, Jose Rozado, Rebeca Lorca, María Martín, Jacobo Silva, César Morís
Transcatheter aortic valve implantation (TAVI) is a rapidly evolving therapeutic modality currently available for patients with severe aortic stenosis (AS) that are unsuitable for surgery because of technical/anatomical issues or high-estimated surgical risk. Transfemoral approach is the preferred TAVI delivery route when possible. Alternative non-transfemoral access options include transaortic, trans-subclavian and transapical access. Other approaches are also feasible (transcarotid, transcaval, and antegrade aortic) but are restricted to operators and hospitals with experience...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616342/bicuspid-aortic-valve-syndrome-a-multidisciplinary-approach-for-a-complex-entity
#14
REVIEW
María Martín, Rebeca Lorca, José Rozado, Rubén Alvarez-Cabo, Juan Calvo, Isaac Pascual, Helena Cigarrán, Isabel Rodríguez, César Morís
Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease. It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28611121/advanced-assessment-of-aortic-stenosis-reflecting-the-complex-interplay-of-valve-ventricle-vessel-and-flow
#15
EDITORIAL
Florian von Knobelsdorff-Brenkenhoff
No abstract text is available yet for this article.
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28611119/turbulent-kinetic-energy-assessed-by-multipoint-4-dimensional-flow-magnetic-resonance-imaging-provides-additional-information-relative-to-echocardiography-for-the-determination-of-aortic-stenosis-severity
#16
Christian Binter, Alexander Gotschy, Simon H Sündermann, Michelle Frank, Felix C Tanner, Thomas F Lüscher, Robert Manka, Sebastian Kozerke
BACKGROUND: Turbulent kinetic energy (TKE), assessed by 4-dimensional (4D) flow magnetic resonance imaging, is a measure of energy loss in disturbed flow as it occurs, for instance, in aortic stenosis (AS). This work investigates the additional information provided by quantifying TKE for the assessment of AS severity in comparison to clinical echocardiographic measures. METHODS AND RESULTS: Fifty-one patients with AS (67±15 years, 20 female) and 10 healthy age-matched controls (69±5 years, 5 female) were prospectively enrolled to undergo multipoint 4D flow magnetic resonance imaging...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28610884/outcomes-for-low-risk-surgical-aortic-valve-replacement-a-benchmark-for-aortic-valve-technology
#17
Lily E Johnston, Emily A Downs, Robert B Hawkins, Mohammed A Quader, Alan M Speir, Jeffrey B Rich, Ravi K Ghanta, Leora T Yarboro, Gorav Ailawadi
BACKGROUND: Two large, randomized trials are underway evaluating transcatheter aortic valve replacement (AVR) against conventional surgical AVR. We analyzed contemporary, real-world outcomes of surgical AVR in low-risk patients to provide a practical benchmark of outcomes and cost for evaluating current and future transapical AVR technology. METHODS: From 2010 to 2015, 2,505 isolated AVR operations were performed for severe aortic stenosis at 18 statewide cardiac institutions...
June 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28610440/circumflex-coronary-artery-originating-from-the-right-pulmonary-artery-in-adult
#18
Ahmet Daylan, Serkan Ertugay, Anıl Ziya Apaydın, Emrah Oğuz
Anomalous origin of the circumflex coronary artery from the right pulmonary artery is rare, and symptoms are related to the collateralization and amount of myocardium that it supplies. A 50-year-old woman with severe bicuspid aortic valve stenosis had the diagnosis of anomalous origin of the circumflex coronary artery from the right pulmonary artery before valve replacement. Ligation and division of the circumflex coronary artery was performed. Myocardial ischemia was not observed. The patient was discharged after an uneventful recovery...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28606889/parallel-suture-technique-with-proglide-a-novel-method-for-management-of-vascular-access-during-transcatheter-aortic-valve-implantation-tavi
#19
Ilka Ott, Anupama Shivaraju, Nina R Schäffer, Antonio H Frangieh, Jonathan Michel, Oliver Husser, Christian Hengstenberg, Patrick Mayr, Roisin Colleran, Constanza Pellegrini, Salvatore Cassese, Massimilliano Fusaro, Heribert Schunkert, Adnan Kastrati, Albert M Kasel
AIMS: Aim of this study was to evaluate vascular complications using the "parallel suture technique" in patients receiving Edwards SAPIEN XT (SXT) or SAPIEN S3 (S3) transcatheter heart valve (THV). METHODS AND RESULTS: Two hundred consecutive patients with symptomatic severe aortic stenosis treated with TF-TAVI were included in this study where the "parallel suture technique" was applied for vascular access site closure. This was achieved by placing the sutures medial and lateral to the puncture site...
June 13, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28606674/transcatheter-aortic-valve-implantation-in-patients-with-an-extremely-small-native-aortic-annulus-the-ocean-tavi-registry
#20
Fumiaki Yashima, Masanori Yamamoto, Makoto Tanaka, Ryo Yanagisawa, Takahide Arai, Hideyuki Shimizu, Keiichi Fukuda, Yusuke Watanabe, Toru Naganuma, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Kentaro Hayashida
BACKGROUND: Transcatheter aortic valve implantation (TAVI) has been reported to be advantageous over surgical aortic valve replacement owing to the low incidence of prosthesis-patient mismatch (PPM) and large effective orifice area (EOA). However, data on TAVI for extremely small annuli are limited. The present study aimed to compare post-procedural hemodynamics and morphology between 20-mm and 23-mm Sapien XT (SXT) transcatheter heart valves (THVs) with extremely small annuli (<314mm(2))...
August 1, 2017: International Journal of Cardiology
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