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Bioprosthetic heart valves

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https://www.readbyqxmd.com/read/28444168/mechanical-versus-bioprosthetic-aortic-valve-replacement
#1
Stuart J Head, Mevlüt Çelik, A Pieter Kappetein
Mechanical valves used for aortic valve replacement (AVR) continue to be associated with bleeding risks because of anticoagulation therapy, while bioprosthetic valves are at risk of structural valve deterioration requiring reoperation. This risk/benefit ratio of mechanical and bioprosthetic valves has led American and European guidelines on valvular heart disease to be consistent in recommending the use of mechanical prostheses in patients younger than 60 years of age. Despite these recommendations, the use of bioprosthetic valves has significantly increased over the last decades in all age groups...
April 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28442174/microstructural-alterations-owing-to-handling-of-bovine-pericardium-to-manufacture-bioprosthetic-heart-valves-a-potential-risk-for-cusp-dehiscence
#2
J Mao, Y Wang, E Philippe, T Cianciulli, I Vesely, D How, J-M Bourget, L Germain, Z Zhang, R Guidoin
INTRODUCTION: Cross-linking and anti-calcification of prosthetic heart valves have been continuously improved to prevent degeneration and calcification. However, non-calcific structural deteriorations such as cuspal dehiscences along the stent still require further analysis. MATERIAL AND METHOD: Based upon the previous analysis of an explanted valve after 7 years, a fresh commercial aortic valve was embedded in poly(methyl methacrylate) (PMMA) and cut into slices to ensure the detailed observation of the assembly and material structures...
April 22, 2017: Morphologie: Bulletin de L'Association des Anatomistes
https://www.readbyqxmd.com/read/28385406/clinical-bioprosthetic-heart-valve-thrombosis-after-transcatheter-aortic%C3%A2-valve-replacement-incidence-characteristics-and-treatment-outcomes
#3
John Jose, Dmitriy S Sulimov, Mohamed El-Mawardy, Takao Sato, Abdelhakim Allali, Erik W Holy, Björn Becker, Martin Landt, Julia Kebernik, Bettina Schwarz, Gert Richardt, Mohamed Abdel-Wahab
OBJECTIVES: The aim of this study was to determine the incidence, characteristics, and treatment outcomes of patients diagnosed with clinical transcatheter heart valve thrombosis. BACKGROUND: Limited data exists on clinical or manifest transcatheter heart valve thrombosis. Prior studies have focused on subclinical thrombosis. METHODS: A retrospective analysis was conducted of prospectively collected data from a single-center registry that included 642 consecutive patients who underwent transcatheter aortic valve replacement between 2007 and 2015 (305 patients had self-expanding valves; balloon-expandable, n = 281; mechanically expanding, n = 56)...
April 10, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28359556/valve-replacement-surgery-in-severe-chronic-kidney-disease
#4
Min Ho Ju, Sung-Ho Jung, Suk Jung Choo, Cheol Hyun Chung, Jae Won Lee, Joon Bum Kim
BACKGROUND: The impact of prosthetic choices in patients with severe chronic kidney disease (CKD) on long-term outcomes has not been well established. METHODS: The study involved 152 adult patients (61.6±14.1yrs.; 64 females) undergoing heart valve surgery who had stage 4 (n=87) or 5 CKD (end-stage; n=65) based on Kidney Disease Outcomes Quality Initiative Guidelines. To reduce the impact of selection bias between mechanical (n=92) and bio-prostheses groups (n=60), propensity score analyses were conducted...
March 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28353137/high-risk-trans-catheter-aortic-valve-replacement-in-a-failed-freestyle-valve-with-low-coronary-height-a-case-report
#5
Ashkan Karimi, Negiin Pourafshar, George Dibu, Thomas M Beaver, Anthony A Bavry
A 55-year-old male with a history of two prior cardiac surgeries presented with decompensated heart failure due to severe bioprosthetic aortic valve insufficiency. A third operation was viewed prohibitively high risk and valve-in-valve trans-catheter aortic valve replacement was considered. There were however several high-risk features and technically challenging aspects including low coronary ostia height, poor visualization of the aortic sinuses, and difficulty in identification of the coplanar view due to severe aortic insufficiency, and a highly mobile aortic valve mass...
March 28, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28347474/platelet-activation-of-mechanical-versus-bioprosthetic-heart-valves-during-systole
#6
Mohammadali Hedayat, Hafez Asgharzadeh, Iman Borazjani
Thrombus formation is a major concern for recipients of mechanical heart valves (MHVs), which requires them to take anticoagulant drugs for the rest of their lives. Bioprosthetic heart valves (BHVs) do not require life-long anticoagulant therapy but deteriorate after 10-15years. The thrombus formation is initiated by the platelet activation which is thought to be mainly generated in MHVs by the flow through the hinge and the leakage flow during the diastole. However, our results show that the activation in the bulk flow during the systole phase might play an essential role as well...
March 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28347328/a-rare-case-report-of-early-bioprosthetic-valve-thrombosis-presenting-with-acute-heart-failure-salvaged-by-thrombectomy
#7
Jingya Fan, Peng Teng, Yu Zou, Liang Ma
BACKGROUND: Bioprosthetic valve thrombosis is previously considered as an extremely rare complication which hasn't been systemically recognized and understood. CASE PRESENTATION: Herein, we present an unusual case of a patient manifesting with acute heart failure, secondary to thrombus formation in a porcine aortic bioprosthesis which was implanted 11 months prior to hospitalization. Due to the patient's poor heart function and intraoperative findings, thrombectomy was performed...
March 27, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28343443/lacosamide-induced-recurrent-ventricular-tachycardia-in-the-acute-care-setting
#8
Theodore J Berei, Matthew P Lillyblad, Adrian K Almquist
Lacosamide is a new-generation antiepileptic drug (AED) most commonly used adjunctively in the setting of partial-onset seizures refractory to traditional therapy. We describe the first case report, to our knowledge, of a patient who developed recurrent, sustained ventricular tachycardia with multiple administrations of lacosamide in an acute setting. A 70-year-old woman with a history significant for valvular heart disease was admitted to the inpatient cardiology service for worsening heart failure. On hospital day 7, she received a bioprosthetic aortic valve...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28335795/gemella-morbillorum-endocarditis-of-pulmonary-valve-a-case-report
#9
Dan Li, Zhicheng Zhu, Xiaomei Zheng, Weitie Wang, Rihao Xu, Kexiang Liu
BACKGROUND: Pulmonary valve infective endocarditis is a rare finding for endocarditis. Infective endocarditis caused by Gemella morbillorum remains a scanty occurrence. CASE PRESENTATION: This is a case reported of a 28-year-old Chinese male with endocarditis caused by pulmonary valve infection of Gemella morbillorum associated with congenital ventricular septal defect, atrial septal defect and double-chambered right ventricle. The patient presented with fever, shortness of breath, progressively worsening exertional fatigue, dyspnea and weight loss for 3 months...
March 23, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28330691/bioprosthetic-surgical-and-transcatheter-heart-valve-thrombosis
#10
Jeroen J Bax, Gregg W Stone
No abstract text is available yet for this article.
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28330690/subclinical-leaflet-thrombosis-in-surgical-and-transcatheter-bioprosthetic-aortic-valves-an-observational-study
#11
Tarun Chakravarty, Lars Søndergaard, John Friedman, Ole De Backer, Daniel Berman, Klaus F Kofoed, Hasan Jilaihawi, Takahiro Shiota, Yigal Abramowitz, Troels H Jørgensen, Tanya Rami, Sharjeel Israr, Gregory Fontana, Martina de Knegt, Andreas Fuchs, Patrick Lyden, Alfredo Trento, Deepak L Bhatt, Martin B Leon, Raj R Makkar
BACKGROUND: Subclinical leaflet thrombosis of bioprosthetic aortic valves after transcatheter valve replacement (TAVR) and surgical aortic valve replacement (SAVR) has been found with CT imaging. The objective of this study was to report the prevalence of subclinical leaflet thrombosis in surgical and transcatheter aortic valves and the effect of novel oral anticoagulants (NOACs) on the subclinical leaflet thrombosis and subsequent valve haemodynamics and clinical outcomes on the basis of two registries of patients who had CT imaging done after TAVR or SAVR...
March 19, 2017: Lancet
https://www.readbyqxmd.com/read/28328570/concomitant-valve-in-valve-transcatheter-aortic-valve-replacement-and-left-ventricular-assist-device-implantation
#12
Takashi Murashita, David L Joyce, Alberto Pochettino, John M Stulak, Lyle D Joyce
Redo aortic valve replacement (AVR) performed simultaneously with left ventricular assist device (LVAD) implantation carries potential for increased mortality rates. Although transcatheter AVR has been used for patients with previous LVAD placement, no literature reports concomitant valve-in-valve transcatheter AVR and LVAD implantation. Our patient had severe aortic prosthetic valve deterioration and advanced heart failure. Given the risks associated with reoperative aortic valve surgery, we chose transcatheter AVR at the time of LVAD implantation...
March 22, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28302715/late-thrombosis-of-a-mitral-bioprosthetic-valve-with-associated-massive-left-atrial-thrombus
#13
Preetham Muskula, Rigoberto Ramirez, A Michael Borkon, Michael L Main
An 84-year-old man presented 5 years following bioprosthetic mitral valve replacement with three months of worsening dyspnea on exertion. A new mitral stenosis murmur was noted on physical examination, and an electrocardiogram revealed newly recognized atrial fibrillation. Severe mitral stenosis (mean gradient = 13 mmHg) was confirmed by transthoracic echocardiography. Transesophageal echocardiography revealed markedly thickened mitral bioprosthetic leaflets with limited mobility, and a massive left atrial thrombus (> 4 cm in diameter) (see Figures 1A-D, and video files 1-4)...
March 16, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28267085/hemolytic-anemia-due-to-right-ventricular-to-pulmonary-artery-conduit-stenosis
#14
Sudha Rao, Julie A Creaden, Shunyou Gong, Cynthia Rigsby, John M Costello
Hemolytic anemia is a well-recognized complication in patients with left-sided mechanical heart valves. It is rare to see hemolysis with a bioprosthetic valve in the right ventricular outflow tract. We report a 4-year-old-girl with history of truncus arteriosus status-post repair who developed hemolytic anemia as a result of a calcified and obstructed bioprosthetic right ventricular to pulmonary artery-valved conduit. The hemolysis was alleviated by replacing the obstructed conduit with a larger valved conduit...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28213846/fixation-of-bovine-pericardium-based-tissue-biomaterial-with-irreversible-chemistry-improves-biochemical-and-biomechanical-properties
#15
H Tam, W Zhang, D Infante, N Parchment, M Sacks, N Vyavahare
Bioprosthetic heart valves (BHVs), derived from glutaraldehyde crosslinked (GLUT) porcine aortic valve leaflets or bovine pericardium (BP), are used to replace defective heart valves. However, valve failure can occur within 12-15 years due to calcification and/or progressive structural degeneration. We present a novel fabrication method that utilizes carbodiimide, neomycin trisulfate, and pentagalloyl glucose crosslinking chemistry (TRI) to better stabilize the extracellular matrix of BP. We demonstrate that TRI-treated BP is more compliant than GLUT-treated BP...
February 17, 2017: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#16
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28163423/mechanism-of-valve-failure-and-efficacy-of-reintervention-through-catheterization-in-patients-with-bioprosthetic-valves-in-the-pulmonary-position
#17
Ryan Callahan, Lisa Bergersen, Christopher W Baird, Diego Porras, Jesse J Esch, James E Lock, Audrey C Marshall
BACKGROUND: Surgical and transcatheter bioprosthetic valves (BPVs) in the pulmonary position in patients with congenital heart disease may ultimately fail and undergo transcatheter reintervention. Angiographic assessment of the mechanism of BPV failure has not been previously described. AIMS: The aim of this study was to determine the mode of BPV failure (stenosis/regurgitation) requiring transcatheter reintervention and to describe the angiographic characteristics of the failed BPVs and report the types and efficacy of reinterventions...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28157718/in-vitro-comparative-assessment-of-decellularized-bovine-pericardial-patches-and-commercial-bioprosthetic-heart-valves
#18
Paola Aguiari, Laura Iop, Francesca Favaretto, Cátia Marisa Lourenco Fidalgo, Filippo Naso, Gabriella Milan, Vincenzo Vindigni, Michel Spina, Franco Bassetto, Andrea Bagno, Roberto Vettor, Gino Gerosa
Notwithstanding their wide exploitation, biological prosthetic heart valves are characterized by limited durability (10-15 years). The treatment of biological tissues with chemical crosslinking agents such as glutaraldehyde accounts for the enhanced risk of structural deterioration associated with the early failure of bioprosthetic valves. To overcome the shortcomings of the currently available solutions, adoption of decellularized biological tissues of animal origin has emerged as a promising approach. The present study aims to assess in vitro cardiovascular scaffolds composed of bovine pericardium decellularized with the novel TRITDOC (TRIton-X100 and TauroDeOxyCholic acid) procedure...
February 3, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28151005/allograft-heart-valves-current-aspects-and-future-applications
#19
REVIEW
Milan Lisy, Guenay Kalender, Katja Schenke-Layland, Kelvin G M Brockbank, Anna Biermann, Ulrich Alfred Stock
Human heart valve allografts continue to represent almost perfect substitutes for heart valves. They have optimal hemodynamic characteristics and are highly resistant to infections. The first clinical use of allograft heart valves was as homovitals being transplanted after antibiotic incubation without any preservation. Since 1968, relatively standardized frozen cryopreservation (SFC) has been employed, including storage in vapor-phase liquid nitrogen. Disadvantages, particularly in pediatric patients, are limited availability due to organ scarcity, inability to grow, degeneration, immune response, and long-term failure...
April 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28104807/transcatheter-aortic-valve-implantation-new-hope-in-the-management-of-valvular-heart-disease
#20
REVIEW
Sofia Metaxa, Adam Ioannou, Constantinos G Missouris
Severe calcific aortic stenosis is relatively common, and unless treated with valve replacement it carries an adverse prognosis. A large number of patients, however, are denied surgery due to their advanced age or coexistent medical conditions that increase perioperative cardiovascular risks. Transcatheter aortic valve implantation (TAVI), a technique in which a bioprosthetic valve is inserted via a catheter and implanted within the diseased native aortic valve, is a new therapeutic modality for treatment of older patients with severe symptomatic aortic stenosis and other comorbidities, who have an inherently high surgical risk...
January 19, 2017: Postgraduate Medical Journal
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