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Bioprosthetic heart valves

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https://www.readbyqxmd.com/read/28917497/comparison-of-outcome-of-possible-versus-definite-infective-endocarditis-involving-prosthetic-or-bioprosthetic-heart-valves
#1
Laurent Fauchier, Lauriane Pericart, Thierry Bourguignon, Thibaud Genet, Arnaud Bisson, Anne Bernard, Louis Bernard, Dominique Babuty
The objectives of this study were to describe and compare the clinical characteristics and outcomes of patients with definite and possible infective endocarditis (IE) involving prosthetic heart valve, and to identify prognostic factors for long-term mortality, using data from an unselected cohort of consecutive patients. We studied data from 133 consecutive patients with IE involving prosthetic heart valve seen in an academic institution between 1990 and 2012. Patients were classified according to the modified Duke criteria for IE: patients with possible IE (n = 47, 35%) and patients with definite IE (n = 86, 65%)...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28915471/characterization-of-mechanical-properties-of-pericardium-tissue-using-planar-biaxial-tension-and-flexural-deformation
#2
Kyle Murdock, Caitlin Martin, Wei Sun
Flexure is an important mode of deformation for native and bioprosthetic heart valves. However, mechanical characterization of bioprosthetic leaflet materials has been done primarily through planar tensile testing. In this study, an integrated experimental and computational cantilever beam bending test was performed to characterize the flexural properties of glutaraldehyde-treated bovine and porcine pericardium of different thicknesses. A strain-invariant based structural constitutive model was used to model the pericardial mechanical behavior quantified through the bending tests of this study and the planar biaxial tests previously performed...
September 12, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28913586/evolving-indications-for-transcatheter-aortic-valve-interventions
#3
REVIEW
Anna Franzone, Thomas Pilgrim, Stefan Stortecky, Stephan Windecker
PURPOSE OF REVIEW: The purpose of this review was to summarize recent progress in the field of transcatheter aortic valve replacement (TAVR), discuss expansion of indications, and identify areas of future clinical applications. RECENT FINDINGS: Favorable clinical outcomes as well as continued refinement of transcatheter heart valve technology have prompted the continuous expansion of indications for TAVR. The results of randomized clinical trials comparing the safety and efficacy of TAVR relative to conventional surgical aortic valve replacement (SAVR) in lower- than high-risk patients have recently been published, and trials among lower-risk categories are ongoing...
September 14, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28894058/-ruptured-aneurysm-of-the-sinus-of-valsalva-accompanied-with-a-bicuspid-aortic-valve-in-an-elderly-man-report-of-a-case
#4
Toshifumi Murase, Susumu Tamura, Yasuhiro Ohzeki, Kunio Ebine
The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28854488/histological-and-biomechanical-characterization-of-decellularized-porcine-pericardium-as-a-potential-scaffold-for-tissue-engineering-applications
#5
Panagiotis Mallis, Efstathios Michalopoulos, Constantine Dimitriou, Nikolaos Kostomitsopoulos, Catherine Stavropoulos-Giokas
BACKGROUND: Each year, more than 800,000 vascular and cardiac surgeries are performed therefore, there is a great need for suitable material for bioprosthetic operations. Porcine pericardium is a double-walled sac that covers the heart and can be used in vascular and cardiac thoracic surgery. OBJECTIVE: The aim of the present study was to evaluate the decellularization process and biomechanical properties in porcine pericardial tissue after the decellularization treatment...
2017: Bio-medical Materials and Engineering
https://www.readbyqxmd.com/read/28844512/meta-analysis-of-usefulness-of-anticoagulation-after-transcatheter-aortic-valve-implantation
#6
REVIEW
Kinjal Banerjee, Kanhaiya Poddar, Stephanie Mick, Jonathon White, Amar Krishnaswamy, Douglas Johnston, Leonardo Rodriguez, E Murat Tuzcu, Samir Kapadia
Since the advent of bioprosthetic valves, the implications of long-term anticoagulation after valve replacement are unclear. There are very little data on outcomes of long-term anticoagulation after transcatheter aortic valve implantation (TAVI). Our aim was to conduct a systematic review of literature regarding anticoagulation after TAVI. The existing literature on anticoagulation after bioprosthetic valve replacement was thoroughly reviewed, including the most recent American College of Cardiology/American Heart Association 2017 guidelines for management of valvular disease, which is based on sparse, nonrandomized retrospective data...
August 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28838487/cardioscopically-guided-beating-heart-surgery-paravalvular-leak-repair
#7
Benoit Rosa, Zurab Machaidze, Margherita Mencattelli, Sunil Manjila, Borami Shin, Karl Price, Michael A Borger, Vinod Thourani, Pedro Del Nido, David W Brown, Christopher W Baird, John E Mayer, Pierre E Dupont
PURPOSE: There remains a paucity of direct visualization techniques for beating-heart intracardiac procedures. To address this need, we evaluated a novel cardioscope in the context of aortic paravalvular leaks (PVLs) localization and closure. DESCRIPTION: A porcine aortic PVL model was created using a custom-made bioprosthetic valve, and PVL presence was verified by epicardial echocardiography. Transapical delivery of occlusion devices guided solely by cardioscopy was attempted 13 times in a total of three pigs...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28820560/severe-valvular-aortic-stenosis-and-fixed-subvalvular-aortic-stenosis-a-rare-and-challenging-combination
#8
Ayman Elbadawi, Marwan Saad, Islam Y Elgendy, Basarat Baig, Farhad Abtahian
A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28797431/implantation-and-30-day-follow-up-on-all%C3%A2-4-valve-sizes-within-the-portico-transcatheter-aortic-bioprosthetic-family
#9
Helge Möllmann, Axel Linke, David M Holzhey, Thomas Walther, Ganesh Manoharan, Ulrich Schäfer, Karl Heinz-Kuck, Ad J Van Boven, Simon R Redwood, Jan Kovac, Christian Butter, Lars Søndergaard, Alexander Lauten, Gerhard Schymik, Stephen G Worthley
OBJECTIVES: The aim of this study was to evaluate the short-term safety and performance of the full range of valve sizes offered within the Portico transcatheter aortic valve replacement system. BACKGROUND: The Portico transcatheter aortic heart valve is a fully resheathable, repositionable, and self-expanding bioprosthesis designed to achieve optimal valve position and hemodynamic performance and limit conduction disturbances. METHODS: Patients (n = 222) with symptomatic (New York Heart Association functional class ≥II) severe aortic stenosis considered by a multidisciplinary heart team to be at high surgical risk were recruited between December 2011 and September 2015 in this prospective, nonrandomized, multicenter study...
August 14, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28780660/update-on-valvular-heart-disease-in-pregnancy
#10
REVIEW
Lucy M Safi, Sarah V Tsiaras
Valvular heart disease in women of childbearing age poses an increased risk of adverse maternal and fetal outcomes, and management in pregnancy can be challenging. Ideally, patients with suspected valvular disease should have preconception counseling by a multidisciplinary team including cardiologists with expertise in pregnancy and a maternal-fetal medicine specialist. Preconception planning should include a cardiac assessment of maternal risk, determination of frequency of surveillance, and a cardiovascular management plan during delivery...
September 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28780576/mechanical-and-surgical-bioprosthetic-valve-thrombosis
#11
REVIEW
Wei Yao Lim, Guy Lloyd, Sanjeev Bhattacharyya
Valve thrombosis can occur in mechanical prosthetic valves and is increasingly recognised in transcatheter and surgically implanted bioprosthetic valves. The risk of thrombosis of mechanical valves is higher in the mitral position compared with aortic position and in older generation valves (ball and cage valves). There is a wide spectrum of presentation from the asymptomatic patient to those with embolic complications or cardiogenic shock. A combination of transthoracic and transesophageal echocardiography is required to assess the haemodynamic effect of thrombosis (valve gradients and area), leaflet motion and thrombus size...
August 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28780254/modeling-the-response-of-exogenously-crosslinked-tissue-to-cyclic-loading-the-effects-of-permanent-set
#12
Will Zhang, Michael S Sacks
Bioprosthetic heart valves (BHVs), fabricated from exogenously crosslinked collagenous tissues, remain the most popular heart valve replacement design. However, the life span of BHVs remains limited to 10-15 years, in part because the mechanisms that underlie BHV failure remain poorly understood. Experimental evidence indicates that BHVs undergo significant changes in geometry with in vivo operation, which lead to stress concentrations that can have significant impact on structural damage. These changes do not appear to be due to plastic deformation, as the leaflets only deform in the elastic regime...
July 11, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28760466/outcomes-of-early-mitral-valve-reoperation-in-the-medicare-population
#13
Kathleen Kwedar, Christian McNeely, Alan Zajarias, Steve Markwell, Christina M Vassileva
BACKGROUND: Surgical series on mitral valve reoperation are limited by small numbers and lack of national representation. Large-scale outcomes of reoperation for mitral valve surgery remain uncertain. METHODS: This is a descriptive analysis of 1,627 Medicare beneficiaries who underwent mitral valve reoperation within a 3-year follow-up period after an initial mitral operation (repair or replacement) that took place between 2000 and 2006. The primary outcomes were hospital mortality and long-term survival...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28745279/paediatric-nanofibrous-bioprosthetic-heart-valve
#14
REVIEW
Mehrdad Namdari, Babak Negahdari, Ali Eatemadi
The search for an optimal aortic valve implant with durability, calcification resistance, excellent haemodynamic parameters and ability to withstand mechanical loading is yet to be met. Thus, there has been struggled to fabricate bio-prosthetics heart valve using bioengineering. The consequential product must be resilient with suitable mechanical features, biocompatible and possess the capacity to grow. Defective heart valves replacement by surgery is now common, this improves the value and survival of life for a lot of patients...
August 2017: IET Nanobiotechnology
https://www.readbyqxmd.com/read/28740625/pulmonary-valve-replacement-in-patients-with-corrected-tetralogy-of-fallot
#15
Fotios M Mitropoulos, Meletios A Kanakis, Christos Ntellos, Constantinos Loukas, Periklis Davlouros, Theophili Kousi, Andrew C Chatzis
Introduction: Development of pulmonary insufficiency in patients with surgically corrected tetralogy of Fallot (TOF) may lead to severe right heart failure with serious consequences. We herein present our experience with pulmonary valve replacement (PVR) in these patients. Methods: From 2005-2013, 99 consecutive patients (71 males/28 females, mean age 38±8 years), underwent PVR after 7 to 40 (mean 29 ± 8) years from the initial correction. Seventy nine of the symptomatic patients presented in NYHA II, 14 in III and 2 in IV...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#16
Julius I Ejiofor, Robert C Neely, Maroun Yammine, Siobhan McGurk, Tsuyoshi Kaneko, Marzia Leacche, Lawrence H Cohn, Prem S Shekar
BACKGROUND: Isolated tricuspid valve (ITV) operations are infrequent and the decision to operate is controversial. We report a series of ITV operations to outline the current disease status requiring this uncommon procedure with an emphasis on the results of tricuspid valve repair (TVr) versus replacement (TVR). METHODS: Using our prospective cardiac surgery database, 57 patients who underwent ITV operations between 01/02-03/14 were identified. Median follow up time was 3...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28691909/fracturing-mechanics-before-valve-in-valve-therapy-of-small-aortic-bioprosthetic-heart-valves
#17
Peter Johansen, Henrik Engholt, Mariann Tang, Rasmus F Nybo, Per D Rasmussen, Jens Erik Nielsen-Kudsk
AIMS: Patients with degraded bioprosthetic heart valves (BHV) who are not candidates for valve replacement may benefit from transcatheter valve-in-valve (VIV) therapy. However, at smaller sized surgical BHV the resultant orifice may become too narrow. To overcome this, the valve frame can be fractured by a high-pressure balloon prior to VIV. However, knowledge on fracture pressures and mechanics are prerequisites. The aim of this study is to identify the fracture pressures needed in BHV, and to describe the fracture mechanics...
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28671806/valvular-heart-disease-in-adults-management-of-prosthetic-heart-valves
#18
REVIEW
John F Trujillo, Steven M Hollenberg
Patients undergoing cardiac valve replacement may receive mechanical or bioprosthetic valves. Mechanical valves require lifelong anticoagulation but are durable and the need for a second surgery is up to eightfold times less than with bioprosthetic valves. Bioprosthetic valves do not require lifelong anticoagulation and thus are associated with fewer bleeding complications but they are less durable and associated with higher morbidity and mortality rates, particularly in younger patients. Anticoagulation with mechanical valves is achieved using warfarin; use of direct-acting oral anticoagulants is not indicated...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28633265/again-two-melodies-in-concert-transcatheter-double-valve-replacement-in-hedinger-syndrome
#19
Roberta De Rosa, Dietmar Schranz, Andreas M Zeiher, Stephan Fichtlscherer
Transcatheter pulmonary valve implantation is established as a valuable option to reconstruct failing right ventricular outflow tract function. Percutaneous tricuspid valve-in-valve or valve-in-ring reconstruction is even applied with increasing acceptance. A 46-year-old woman with a diagnosis of carcinoid-dependent right heart failure underwent surgical bioprosthetic tricuspid and pulmonary valve replacement. Almost 1 year later, she presented again with markedly dilatated and reduced right heart function caused by degeneration of both biologic valves...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28611348/early-detection-of-subclinical-aortic-valve-endocarditis-with-the-cardiomems-heart-failure-system
#20
Sinan Sarsam, Georgy Kaspar, Shukri David, Marcel Zughaib
BACKGROUND The CardioMEMS Heart Failure System is a well validated tool to optimize management of systolic and diastolic heart failure and has been shown to reduce the risk of hospitalization by 37%. We are reporting a unique case of acute aortic valve insufficiency as a first sign of endocarditis, detected early in a patient with the CardioMEMS device. CASE REPORT A 79-year-old man with dual bioprosthetic mitral and aortic valve replacement and non-ischemic cardiomyopathy had a CardioMEMS Heart Failure System implanted 2 months following valve replacement surgery...
June 14, 2017: American Journal of Case Reports
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