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Epic heart valve

Anne-Sophie Zenses, Morgane A Evin, Viktória Stanová, Marie-Annick Clavel, Paul Barragan, Josep Rodés-Cabau, Jean-François Obadia, Philippe Pibarot, Régis Rieu
AIMS: Valve-in-Valve (ViV) procedure has become a valuable alternative for the treatment of failed surgical bioprostheses (BP) in high risk patients. However, in small BPs, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed at examining the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the hemodynamics of ViV within small BPs. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of 3 BP models: Trifecta, Mitroflow and Epic Supra...
March 13, 2018: EuroIntervention
Francesco Notaristefano, Matteo Rocco Reccia, Salvatore Notaristefano, Roberto Annunziata, Rocco Sclafani, Giuseppe Ambrosio, Claudio Cavallini
Trancatheter heart valve (THV) thrombosis is effectively treated with anticoagulation but alternative therapies are required when a faster gradient reduction is needed. Open heart surgery has been rarely performed due to the high perioperative mortality and only five cases have been described so far. Here we describe a case of emergent surgical explantation for THV thrombosis after a valve-in-valve. A 67years old man underwent transcatheter aortic valve implantation for a failed surgical bioprosthesis Epic 21mm (St...
December 13, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
A Boswood, S G Gordon, J Häggström, G Wess, R L Stepien, M A Oyama, B W Keene, J Bonagura, K A MacDonald, M Patteson, S Smith, P R Fox, K Sanderson, R Woolley, V Szatmári, P Menaut, W M Church, M L O'Sullivan, J-P Jaudon, J-G Kresken, J Rush, K A Barrett, S L Rosenthal, A B Saunders, I Ljungvall, M Deinert, E Bomassi, A H Estrada, M J Fernandez Del Palacio, N S Moise, J A Abbott, Y Fujii, A Spier, M W Luethy, R A Santilli, M Uechi, A Tidholm, C Schummer, P Watson
BACKGROUND: Changes in clinical variables associated with the administration of pimobendan to dogs with preclinical myxomatous mitral valve disease (MMVD) and cardiomegaly have not been described. OBJECTIVES: To investigate the effect of pimobendan on clinical variables and the relationship between a change in heart size and the time to congestive heart failure (CHF) or cardiac-related death (CRD) in dogs with MMVD and cardiomegaly. To determine whether pimobendan-treated dogs differ from dogs receiving placebo at onset of CHF...
January 2018: Journal of Veterinary Internal Medicine
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
Jagdish C Mohan, Vishwas Mohan, Madhu Shukla, Arvind Sethi
Doppler-derived trans-prosthetic gradients are higher and the estimated effective valve area is smaller than the catheter-derived and directly measured hemodynamic values, mostly due to pressure recovery phenomenon. Pressure recovery to a varying extent is common to all prosthetic heart valves including bioprostheses. Pressure recovery-related differences are usually small except in patients with bileaflet metallic prosthesis, wherein high-pressure local jets across central orifice have been documented since long back and also in patients with narrow aortic root...
January 2017: Indian Heart Journal
A Boswood, J Häggström, S G Gordon, G Wess, R L Stepien, M A Oyama, B W Keene, J Bonagura, K A MacDonald, M Patteson, S Smith, P R Fox, K Sanderson, R Woolley, V Szatmári, P Menaut, W M Church, M L O'Sullivan, J-P Jaudon, J-G Kresken, J Rush, K A Barrett, S L Rosenthal, A B Saunders, I Ljungvall, M Deinert, E Bomassi, A H Estrada, M J Fernandez Del Palacio, N S Moise, J A Abbott, Y Fujii, A Spier, M W Luethy, R A Santilli, M Uechi, A Tidholm, P Watson
BACKGROUND: Pimobendan is effective in treatment of dogs with congestive heart failure (CHF) secondary to myxomatous mitral valve disease (MMVD). Its effect on dogs before the onset of CHF is unknown. HYPOTHESIS/OBJECTIVES: Administration of pimobendan (0.4-0.6 mg/kg/d in divided doses) to dogs with increased heart size secondary to preclinical MMVD, not receiving other cardiovascular medications, will delay the onset of signs of CHF, cardiac-related death, or euthanasia...
November 2016: Journal of Veterinary Internal Medicine
Sean Guo-Dong Tan, Sangho Kim, Jimmy Kim Fatt Hon, Hwa Liang Leo
Prior studies have shown that in a healthy heart, there exist a large asymmetric vortex structure that aids in establishing a steady flow field in the left ventricle. However, the implantation of existing artificial heart valves at the mitral position is found to have a negative effect on this physiological flow pattern. In light of this, a novel D-shaped bileaflet porcine bioprosthesis (GD valve) has been designed based on the native geometry mitral valve, with the hypothesis that biomimicry in valve design can restore physiological left ventricle flow patterns after valve implantation...
2016: PloS One
Keisuke Kanda, Teruki Kotegawa, Satoshi Kawatsu, Goro Takahashi, Ichiro Yoshioka, Hidenori Fujiwara, Osamu Adachi, Masatoshi Akiyama, Kiichiro Kumagai, Shunsuke Kawamoto, Yoshikatsu Saiki
BACKGROUND: In Guideline for Surgical and Interventional Treatment of Valvular Heart Disease, revised by Japanese Circulation Society in 2012, mitral valve replacement (MVR) with bioprosthesis is class II b recommendation for patients aged 70 years or older who have no risk factors for thromboembolism. The aim of this study was to evaluate the early postoperative surgical outcomes and the hemodynamic performance with the Epic mitral bioprosthesis. METHODS: Twenty-six consecutive patients underwent MVR with Epic mitral bioprostesis at Tohoku University Hospital between April 2011 and July 2014...
November 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Koji Furukawa, Shuhei Sakaguchi, Eisaku Nakamura, Mitsuhiro Yano
An 83-year-old woman diagnosed with hypertrophic obstructive cardiomyopathy was referred to our hospital. Her echocardiogram revealed diffuse left ventricular hypertrophy, severe mitral valve regurgitation with systolic anterior motion of the mitral valve, and left ventricular obstruction with a peak outflow gradient of 142 mmHg. Cardiac catheterization revealed a peak pressure gradient of 60 mmHg across the left ventricular outflow tract. Because of the patient's advanced age, as well as uncertainty regarding our ability to resolve her mitral regurgitation, we performed mitral valve replacement with a St...
June 2015: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Nassir M Thalji, Rakesh M Suri, Hector I Michelena, Kevin L Greason, Joseph A Dearani, Richard C Daly, Lyle D Joyce, John M Stulak, Harold M Burkhart, Zhuo Li, Hartzell V Schaff
OBJECTIVE: Small early postoperative hemodynamic differences were noted in a randomized comparison of 3 current-generation bioprosthetic aortic valves. Whether these differences persist and influence clinical outcomes 1 year following implantation is unknown. METHODS: Three hundred adults with severe aortic stenosis undergoing valve replacement were randomized to receive the Epic (St Jude, St Paul, Minn) (n = 99), Magna (Edwards LifeSciences Inc, Irvine, Calif) (n = 100), or Mitroflow (Sorin Biomedica Spa, Saluggio, Italy) (n = 101) bioprostheses...
January 2015: Journal of Thoracic and Cardiovascular Surgery
Ajay Yadlapati, Jimmy Diep, MaryJo Barnes, Tristan Grogan, Daniel M Bethencourt, Gabriel Vorobiof
BACKGROUND: Patient-prosthesis mismatch (PPM) has been reported with a wide range of bioprosthetic valves after aortic valve replacement (AVR) and has been associated with multiple adverse outcomes. The aim of this study was to test the hypothesis that a novel low-profile stented pericardial tissue bioprosthesis for AVR, the Trifecta aortic valve, would have superior hemodynamics, a lower incidence of PPM, and an improvement in clinical outcomes. Its hemodynamic performance was evaluated, and a comparison was performed with a traditional stented pericardial bioprosthesis (Epic) with respect to hemodynamics, PPM, and clinical events...
June 2014: Journal of the American Society of Echocardiography
Filippo Naso, Alessandro Gandaglia, Tomaso Bottio, Vincenzo Tarzia, Mark B Nottle, Anthony J F d'Apice, Peter J Cowan, Emmanuele Cozzi, Cesare Galli, Irina Lagutina, Giovanna Lazzari, Laura Iop, Michele Spina, Gino Gerosa
BACKGROUND: Glutaraldehyde fixation does not guarantee complete tissue biocompatibility in current clinical bioprosthetic heart valves (BHVs). Particularly, circulating anti-αGal human antibodies increase significantly from just 10 days after a BHV implantation. The inactivation of such epitope should be mandatory to meet the requirements for a perspectively safe clinical application; nevertheless, its quantitative assessment in commercially available BHVs has never been carried out...
July 2013: Xenotransplantation
T Drosch, M Egle, L Zabel
HISTORY AND ADMISSION FINDINGS: A 77-year-old man suffered from recurrent peripheral cerebral embolisms five months after aortic valve replacement with a bioprosthesis (SJM Epic 25 mm). INVESTIGATIONS: MRT scanning of the brain revealed multiple ischemic areas in different vascular territories. Clinical signs of infective endocarditis were missing and markers of infection were only modestly increased. However, transthoracic echocardiography showed elevated pressure gradients across the bioprosthesis...
March 2013: Deutsche Medizinische Wochenschrift
Justo Rafael Sádaba, Marie-Christine Herregods, Jan Bogaert, Wolfgang Harringer, Gino Gerosa
BACKGROUND AND AIM OF THE STUDY: The question of whether left ventricular mass (LVM) regression following aortic valve replacement (AVR) is affected by the prosthesis indexed effective orifice area (IEOA) and transprosthetic gradient has not been fully elucidated. Data from a prospective, core-laboratory-reviewed echocardiography and magnetic resonance imaging (MRI) study was used to determine if the degree of LVM regression following AVR with two types of porcine bioprosthesis in patients suffering from predominant aortic valve stenosis (AS) was related to the prosthesis IEOA and transprosthetic gradient...
November 2012: Journal of Heart Valve Disease
Tomaso Bottio, Edward Buratto, Carlo Dal Lin, Alban Lika, Vincenzo Tarzia, Giulio Rizzoli, Gino Gerosa
BACKGROUND AND AIM OF THE STUDY: The study aim was to compare the hydrodynamics of the Carpentier-Edwards Magna 21 (CEM) and St. Jude Medical Biocor-Epic-Supra 21 (SJME) valves at increasing stroke volume and pulse rate in two different aortic conduits, namely straight and with sinuses of Valsalva present. METHODS: Both valve types were tested in the aortic chamber of the Sheffield pulse duplicator, at rates of 70, 80 and 90 beats/min, and stroke volumes of 50 and 60 ml...
November 2012: Journal of Heart Valve Disease
Rakesh M Suri, Hector I Michelena, Harold M Burkhart, Kevin L Greason, Richard C Daly, Joseph A Dearani, Soon J Park, Lyle D Joyce, John M Stulak, Thoralf M Sundt, Zhuo Li, Hartzell V Schaff
OBJECTIVE: Latest generation biologic aortic valve prostheses were designed to improve hemodynamic performance. We sought to determine whether there are clinically important early differences among these devices. METHODS: Three hundred adults with severe aortic valve stenosis undergoing aortic valve replacement were randomized to receive the Edwards Magna, Sorin Mitroflow, or St. Jude Epic bioprostheses (n = 100, n = 101, n = 99, respectively). Early hemodynamic performance was studied by echocardiography...
December 2012: Journal of Thoracic and Cardiovascular Surgery
Ronald K Binder, David Wood, John G Webb, Anson Cheung
An 86-year-old lady with recurrent admissions for heart failure due to a severely regurgitant aortic bioprosthesis (SJM Epic 19 mm) was not a candidate for re-operation due to age and frailty. Her small ilio-femoral arteries precluded a transfemoral transcatheter valve-in-valve (VIV) approach. The small internal diameter of her bioprosthesis (16 mm) forbids the implantation of the smallest available transapical transcatheter heart valve (THV). We, therefore, decided to perform a first-in-human transapical aortic VIV implantation using a 20 mm balloon expandable THV and a transfemoral delivery system...
December 1, 2013: Catheterization and Cardiovascular Interventions
Raffi Bekeredjian, Emmanuel Chorianopoulos, Hugo A Katus
Transfemoral aortic valve implantation has become an important interventional technique for patients with severe aortic stenosis and high surgical risks. The mitral valve has been a much greater challenge for interventional procedures, and no percutaneous mitral valve implantation system has yet been developed and approved. Here, we report the successful transfemoral, antegrade, valve-in-valve implantation of the SAPIEN XT valve (Edwards Lifesciences) into a degenerated mitral valve bioprosthesis. The patient was an 81-year-old woman with severe regurgitation of her 27 mm Epic mitral valve prosthesis (St...
April 2012: Journal of Invasive Cardiology
J Matthew Brennan, Karen P Alexander, Amelie Wallace, Audra B Hodges, John C Laschinger, Kent W Jones, Sean O'Brien, Laura E Webb, Rachel S Dokholyan, Eric D Peterson
BACKGROUND AND AIM OF THE STUDY: The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend a three-month administration of warfarin following bioprosthetic valve replacement (BVR). However, strong evidence supporting this recommendation is lacking, making process variation likely. METHODS: In the ANSWER Registry, a total of 386 patients who had received either Epic or Biocor BVRs between May 2007 and August 2008 at 40 centers was enrolled...
January 2012: Journal of Heart Valve Disease
Benyamin Rahmani, Spyridon Tzamtzis, Hossein Ghanbari, Gaetano Burriesci, Alexander M Seifalian
Synthetic leaflet heart valves have been widely studied as possible alternatives to the current mechanical and bioprosthetic valves. Assessing the in vitro hydrodynamic function of these prostheses is of great importance to predict their hemodynamic behaviour prior to implantation. This study introduces an innovative concept of a low-profile semi-stented surgical aortic valve (SSAV) made of a novel nanocomposite polyurethane with a polycarbonate soft segment (PCU) and polyhedral oligomeric silsesquioxane (POSS) nanoparticles covalently bonded as a pendant cage to the hard segment...
April 30, 2012: Journal of Biomechanics
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