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Bioprosthetic heart valves

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https://www.readbyqxmd.com/read/28706864/surgical-outcomes-of-isolated-tricuspid-valve-procedures-repair-versus-replacement
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28605428/the-commence-trial-2-year-outcomes-with-an-aortic-bioprosthesis-with-resilia-tissue%C3%A2
#6
John D Puskas, Joseph E Bavaria, Lars G Svensson, Eugene H Blackstone, Bartley Griffith, James S Gammie, David A Heimansohn, Jerzy Sadowski, Krzysztof Bartus, Douglas R Johnston, Jacek Rozanski, Todd Rosengart, Leonard N Girardi, Charles T Klodell, Mubashir A Mumtaz, Hiroo Takayama, Michael Halkos, Vaughn Starnes, Percy Boateng, Tomasz A Timek, William Ryan, Shuab Omer, Craig R Smith
OBJECTIVES: The COMMENCE trial was conducted to evaluate the safety and effectiveness of a novel bioprosthetic tissue for surgical aortic valve replacement (AVR). METHODS: Patients underwent clinically indicated surgical AVR with the Carpentier-Edwards PERIMOUNT™ Magna Ease™ aortic valve with RESILIA™ tissue (Model 11000A) in a prospective, multinational, multicentre ( n  = 27), single-arm, FDA Investigational Device Exemption trial. Events were adjudicated by an independent Clinical Events Committee; echocardiograms were analysed by an independent Core Laboratory...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28559420/incremental-prognostic-use-of-left-ventricular-global-longitudinal-strain-in-asymptomatic-minimally-symptomatic-patients-with-severe-bioprosthetic-aortic-stenosis-undergoing-redo-aortic-valve-replacement
#7
Peyman Naji, Shailee Shah, Lars G Svensson, A Marc Gillinov, Douglas R Johnston, L Leonardo Rodriguez, Richard A Grimm, Brian P Griffin, Milind Y Desai
BACKGROUND: With improved survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. Timing of redo surgery in asymptomatic/minimally symptomatic patients remains controversial. Left ventricular (LV) global longitudinal strain (GLS) is a marker of subclinical LV dysfunction. In asymptomatic/minimally symptomatic patients with severe PAS undergoing redo AVR, we sought to determine whether LV-GLS provides incremental prognostic use...
June 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28555360/a-correlation-between-long-term-in-vitro-dynamic-calcification-and-abnormal-flow-patterns-past-bioprosthetic-heart-valves
#8
Oleksandr Barannyk, Robert Fraser, Peter Oshkai
In this paper, a long-term in vitro dynamic calcification of three porcine aortic heart valves was investigated using a combined approach that involved accelerated wear testing of the valves in the rapid calcification solution, hydrodynamic assessment of the progressive change of effective orifice area (EOA) along with the transaortic pressure gradient, and quantitative visualization of the flow. The motivation for this study was developing a standardized, economical, and feasible in vitro testing methodology for bioprosthetic heart valve calcification, which would address both the hydrodynamic performance of the valves as well as the subsequent changes in the flow field...
June 2017: Journal of Biological Physics
https://www.readbyqxmd.com/read/28521923/safety-and-efficacy-of-transcatheter-aortic-valve-replacement-in-the-treatment-of-pure-aortic-regurgitation-in-native-valves-and-failing-surgical-bioprostheses-results-from-an-international-registry-study
#9
Fadi J Sawaya, Marcus-André Deutsch, Moritz Seiffert, Sung-Han Yoon, Pablo Codner, Upul Wickramarachchi, Azeem Latib, A Sonia Petronio, Josep Rodés-Cabau, Maurizio Taramasso, Marco Spaziano, Johan Bosmans, Luigi Biasco, Darren Mylotte, Mikko Savontaus, Peter Gheeraert, Jason Chan, Troels H Jørgensen, Horst Sievert, Marco Mocetti, Thierry Lefèvre, Francesco Maisano, Antonio Mangieri, David Hildick-Smith, Ran Kornowski, Raj Makkar, Sabine Bleiziffer, Lars Søndergaard, Ole De Backer
OBJECTIVES: The aim of this study was to evaluate the use of transcatheter heart valves (THV) for the treatment of noncalcific pure native aortic valve regurgitation (NAVR) and failing bioprosthetic surgical heart valves (SHVs) with pure severe aortic regurgitation (AR). BACKGROUND: Limited data are available about the "off-label" use of transcatheter aortic valve replacement (TAVR) to treat pure severe AR. METHODS: The study population consisted of patients with pure severe AR treated by TAVR at 18 different centers...
May 22, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28488003/daily-transient-discontinuation-of-extracorporeal-lvad-to-prevent-thromboembolism-of-mechanical-aortic-valve-prosthesis
#10
Takamichi Inoue, Tadashi Kitamura, Shinzo Torii, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Kensuke Kobayashi, Mamika Motokawa, Miyuki Shibata, Takuya Matsushiro, Yuta Tsuchida, Yurie Miyata, Minoru Ono, Kagami Miyaji
Patients with mechanical aortic valves are generally contraindicated for left ventricular assist device (LVAD) insertion because the prosthetic valve often becomes fixed in closed position. A 41-year-old woman with mechanical aortic valve prosthesis experienced sudden chest pain and developed cardiogenic shock. A paracorporeal pulsatile LVAD and a monopivot centrifugal pump as a right VAD (RVAD) were implanted. The mechanical aortic valve was intentionally left in place. Soon after the operation, LVAD support was discontinued daily for few seconds to allow the mechanical aortic valve to open and to avoid thrombus formation...
May 9, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28483776/calcification-and-oxidative-modifications-are-associated-with-progressive-bioprosthetic-heart-valve-dysfunction
#11
Suengwon Lee, Robert J Levy, Abigail J Christian, Stanley L Hazen, Nathan E Frick, Eric K Lai, Juan B Grau, Joseph E Bavaria, Giovanni Ferrari
BACKGROUND: Bioprosthetic heart valves (BHVs), fabricated from glutaraldehyde-pretreated bovine pericardium or porcine aortic valves, are widely used for the surgical or interventional treatment of heart valve disease. Reoperation becomes increasingly necessary over time because of BHV dysfunction. METHODS AND RESULTS: Forty-seven explanted BHV aortic valve replacements were retrieved at reoperation for clinically severe BHV dysfunction over the period 2010-2016...
May 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28461800/bioprosthetic-aortic-valve-replacement-in-a-donor-heart-before-orthotopic-heart-transplantation
#12
Manish Patel, Khashayar K Vahdat, Sriram Nathan, Marija Petrovic, Pranav Loyalka, Biswajit Kar, Igor D Gregoric
Current criteria for donor hearts limit the number of hearts available for transplantation, despite an increasing number of recipients on waiting lists. We report the case of a patient with ischemic cardiomyopathy and refractory ventricular tachycardia who underwent successful orthotopic heart transplantation and concurrent aortic valve replacement with a donor heart that had displayed moderate aortic valve regurgitation. The patient was a 71-year-old man with a history of advanced heart failure, 5-vessel coronary artery bypass grafting, and paroxysmal ventricular tachycardia...
April 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28457092/transcatheter-tricuspid-valve-in-valve-implantation-in-patients-with-tricuspid-bioprosthetic-valve-degeneration-at-high-surgical-risk-a-multicenter-case-series
#13
Uri Landes, Arthur Kerner, Amit Segev, Haim Danenberg, Yaron Shapira, Ariel Finkelstein, Ran Kornowski
BACKGROUND: Transcatheter tricuspid valve-in-valve implantation (TVIV) is an attractive yet under-explored alternative to redo valve surgery. OBJECTIVES: To report the multicenter TVIV experience in Israel. METHODS: We approached multiple centers and collected data regarding seven TVIV cases. RESULTS: The study group comprised seven participants: five females and two males, with a mean age of 63 ± 12 years and EuroSCORE-II 13...
March 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28449781/bioprosthetic-valve-thrombosis
#14
REVIEW
Rishi Puri, Vincent Auffret, Josep Rodés-Cabau
Bioprosthetic valve (BPV) thrombosis is considered a relatively rare clinical entity. Yet a more recent analysis involving a more systematic echocardiographic follow-up, the advent of transcatheter heart valve (THV) technologies coupled with the highly sensitive nature of 4-dimensional computed tomographic imaging for detecting subclinical thrombi upon both surgically implanted and THVs, has generated enormous interest in this field, casting new light on both its true incidence and clinical relevance. Debate continues among clinicians as to both the clinical relevance of subclinical BPV thrombosis and the value of empirical oral anticoagulation following BPV implantation...
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28444168/mechanical-versus-bioprosthetic-aortic-valve-replacement
#15
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
#16
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...
June 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
#17
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
#18
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
#19
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...
June 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28347474/platelet-activation-of-mechanical-versus-bioprosthetic-heart-valves-during-systole
#20
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...
May 3, 2017: Journal of Biomechanics
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