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https://www.readbyqxmd.com/read/28730800/optimizing-the-role-of-transthoracic-echocardiography-to-improve-the-cardiovascular-risk-stratification-the-dream-of-subclinical-coronary-artery-disease-detection
#1
Giovanni Benfari, Andrea Rossi, Giulia Geremia, Giulia Vinco, Carlo Zivelonghi, Aldo D Milano, Leonardo Gottin, Flavio L Ribichini, Francesco Onorati, Giuseppe Faggian
Detecting coronary artery disease at a subclinical level has always been a challenging task for cardiologists. Various non-invasive echocardiographic approaches such as measurements of left ventricular hypertrophy, diastolic function, left atrial enlargement, valve sclerosis and calcification, epicardial fat thickness, and pulse wave velocity have been proposed to integrate the available risk-charts. The present review is a collection of evidence that supports the role of the above mentioned features in cardiac risk stratification, summarizing the state of the art in non-invasive echocardiographic coronary risk assessment...
July 21, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28729377/abundant-dystrophic-calcifications-mimicking-aortic-valve-abscess-in-a-patient-undergoing-elective-aortic-valve-replacement
#2
Adam L Booth, Christine Q Li, Ghannam Ayed Al-Dossari, Heather L Stevenson
Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation...
July 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28728867/finite-element-analysis-of-tavi-impact-of-native-aortic-root-computational-modeling-strategies-on-simulation-outcomes
#3
Alice Finotello, Simone Morganti, Ferdinando Auricchio
In the last few years, several studies, each with different aim and modeling detail, have been proposed to investigate transcatheter aortic valve implantation (TAVI) with finite elements. The present work focuses on the patient-specific finite element modeling of the aortic valve complex. In particular, we aim at investigating how different modeling strategies in terms of material models/properties and discretization procedures can impact analysis results. Four different choices both for the mesh size (from  20 k elements to  200 k elements) and for the material model (from rigid to hyperelastic anisotropic) are considered...
July 17, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28720119/calcified-amorphous-tumor-of-the-heart-with-mitral-annular-calcification-a-case-report
#4
Ryo Nakamaru, Hiroki Oe, Katsuomi Iwakura, Takafumi Masai, Kenshi Fujii
BACKGROUND: Calcified amorphous tumor of the heart is a rare, non-neoplastic cardiac mass characterized by nodular calcium in the background of amorphous degenerating fibrinous material. Clinical diagnosis of calcified amorphous tumor can be difficult, and current single imaging techniques do not specifically differentiate calcified amorphous tumor from other cardiac tumors such as calcified atrial myxoma, calcified thrombi, or vegetation. Complete surgical resection is the treatment of choice for both symptom improvement and prevention of embolization, as well as for pathological diagnosis...
July 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28716099/xenoantigenicity-of-porcine-decellularized-valves
#5
Meghana R K Helder, Nicholas J Stoyles, Brandon J Tefft, Ryan S Hennessy, Rebecca R C Hennessy, Roy Dyer, Tyra Witt, Robert D Simari, Amir Lerman
BACKGROUND: The xenoantigenicity of porcine bioprosthetic valves is implicated as an etiology leading to calcification and subsequent valve failure. Decellularization of porcine valves theoretically could erase the antigenicity of the tissue leading to more durable prosthetic valves, but the effectiveness of decellularization protocols in regard to completely removing antigens has yet to be verified. Our hypothesis was that decellularization would remove the more abundant α-gal antigens but not remove all the non α-gal antigens, which could mount a response...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28714498/chondrodysplasia-punctata-a-case-report-of-fetal-warfarin-syndrome
#6
S Songmen, O B Panta, S S Paudel, R K Ghimire
Chondrodysplasia punctata is abnormal calcification in the cartilage of developing bones and has been seen in association with deranged vitamin K metabolism. Warfarin, an oral anticoagulant acting on vitamin K dependent clotting factors is known to cause chondrodysplasia punctata. Despite the knowledge of the condition the management of patients with prosthetic heart valves might require use of the drug for anticoagulation. Here, we present a case of a fetal warfarin syndrome in a second born child of a 27 year lady under warfarin for prosthetic heart valve...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28712720/manual-aspiration-thrombectomy-in-patients-with-acute-stroke-related-calcified-cerebral-emboli
#7
Esther Koh, Hyo Sung Kwak, Gyung-Ho Chung
OBJECTIVE: The aim of this study was to evaluate the effectiveness of mechanical aspiration thrombectomy (MAT) in patients with acute ischemic stroke from calcified cerebral emboli. METHODS: Procedural results were reviewed for acute stroke patients with clinically neurological deficits who underwent recanalization from October 2012 through September 2015. Initial imaging studies and cerebral angiography were analyzed. RESULTS: Of the total number of patients with acute stroke, 5 patients were confirmed to have acute ischemic stroke by calcified cerebral emboli...
July 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28698423/-early-structural-valve-deterioration-of-trifecta-biological-prosthesis-report-of-a-case
#8
Atsushi Tamura, Takamichi Yoshizaki, Sho Kusadokoro
Trifecta valve is a 3rd-generation, stented bioprosthesis which is made from one bovine pericardial sheet. A 77-years-old male patient had undergone combine aortic valve replacement (AVR) using a 23-mm Trifecta valve and ascending aorta replacement for severe aortic valve regurgitation and ascending aorta aneurysm. The postoperative period was uneventful. However, he presented with dyspnea on effort and severe aortic valve regurgitation 31 months after operation. Re-do AVR with a new bioprosthetic valve was performed via 2nd sternotomy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28698175/echocardiographic-aortic-valve-calcification-and-outcomes-in-women-and-men-with-aortic-stenosis
#9
Henrik K Thomassen, Giovanni Cioffi, Eva Gerdts, Eigir Einarsen, Helga Bergljot Midtbø, Constantino Mancusi, Dana Cramariuc
OBJECTIVE: Sex differences in risk factors of aortic valve calcification (AVC) by echocardiography have not been reported from a large prospective study in aortic stenosis (AS). METHODS: AVC was assessed using a prognostically validated visual score and grouped into none/mild or moderate/severe AVC in 1725 men and women with asymptomatic AS in the Simvastatin Ezetimibe in Aortic Stenosis study. The severity of AS was assessed by the energy loss index (ELI) taking pressure recovery in the aortic root into account...
July 11, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28697033/ventricular-perforation-during-open-surgical-balloon-expandable-mitral-valve-replacement-a-case-report
#10
Yousef M Hamdeh, Jordan E Goldhammer, Nicholas J Ruggiero, John W Entwistle
A 79-year-old woman with severe mitral annular calcification was scheduled for mitral valve replacement. A SAPIEN 3 valve was implanted in mitral position using an open surgical approach. Immediately after cardiopulmonary bypass, bleeding from an unidentified source was encountered. Cardiopulmonary bypass was emergently resumed and a laceration of the left ventricular apex due to the valve delivery system was detected. Risk factors specific to the open surgical approach include a decompressed ventricle, decreased annulus to apical distance, and the absence of continuous fluoroscopic and echocardiographic imaging...
July 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28689947/a-novel-iliac-morphology-score-predicts-procedural-mortality-and-major-vascular-complications-in-transfemoral-aortic-valve-replacement
#11
Juliet Blakeslee-Carter, David Dexter, Paul Mahoney, Sadie Ahanchi, Samuel Steerman, Sebastian Larion, Brandon Cain, Jean Panneton
OBJECTIVES: Vascular complications remain a significant technical challenge for transfemoral TAVR (Transcatheter Aortic Valve Replacement). The goal of this study was to develop a pre-operative tool for prediction of major vascular complications of TAVR. METHODS: A retrospective review was performed of all patients who underwent transfemoral TAVR at a tertiary medical center from 2011-2015. Iliofemoral arterial measurements were obtained with CTA 3D reconstructions images and an Iliac Morphology Score (IMS) was created from these measurements...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689373/caseous-calcification-of-the-left-aortic-valve-cusp
#12
Elie Dan Schouver, Diane Lena, Gen Paul, Alain Mihoubi, Stephane Lopez
No abstract text is available yet for this article.
July 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28688892/vascular-ossification-pathology-mechanisms-and-clinical-implications
#13
Michael A Fuery, Lusha Liang, Frederick S Kaplan, Emile R Mohler
In recent years, the mechanisms and clinical significance of vascular calcification have been increasingly investigated. For over a century, however, pathologists have recognized that vascular calcification is a form of heterotopic ossification. In this review, we aim to describe the pathology and molecular processes of vascular ossification, to characterize its clinical significance and treatment options, and to elucidate areas that require further investigation. The molecular mechanisms of vascular ossification involve the activation of regulators including bone morphogenic proteins and chondrogenic transcription factors and the loss of mineralization inhibitors like fetuin-A and pyrophosphate...
July 5, 2017: Bone
https://www.readbyqxmd.com/read/28687561/impact-of-vascular-hemodynamics-on-aortic-stenosis-evaluation-new-insights-into-the-pathophysiology-of-normal-flow-small-aortic-valve-area-low-gradient-pattern
#14
Nancy Côté, Louis Simard, Anne-Sophie Zenses, Lionel Tastet, Mylène Shen, Marine Clisson, Marie-Annick Clavel
BACKGROUND: About 50% of normal-flow/low-gradient patients (ie, low mean gradient [MG] or peak aortic jet velocity and small aortic valve area) have severe aortic valve calcification as measured by computed tomography. However, they are considered to have moderate aortic stenosis (AS) in current American College of Cardiology/American Heart Association guidelines. The objective was thus to evaluate the effect of hypertension and reduced arterial compliance (rAC) on MG and Vpeak measurements...
July 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28684044/influence-of-metabolic-syndrome-and-diabetes-on-progression-of-calcific-aortic-valve-stenosis
#15
Ariane Testuz, Virginia Nguyen, Tiffany Mathieu, Caroline Kerneis, Dimitri Arangalage, Naozumi Kubota, Isabelle Codogno, Sarah Tubiana, Candice Estellat, Claire Cimadevilla, Alec Vahanian, David Messika-Zeitoun
BACKGROUND: Determinants of the progression of aortic stenosis (AS) remained unclear. Metabolic syndrome (MetS) and diabetes are suspected to play an active role but literature is scarce and results conflicting. We sought to assess their impact in an ongoing prospective cohort of asymptomatic patients with at least mild AS. METHODS: We enrolled 203 patients (73±9years, 75% men) with at least 2years of follow-up. Risk-factors assessment was performed at baseline...
June 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28683504/initial-experience-with-the-transapical-access-for-tevar
#16
Andreas H Mahnken, Marc Irqsusi, Walter Hundt, Rainer G Moosdorf
Background The endovascular approach has become a mainstay in the treatment of aortic aneurysms. While the transfemoral approach is most commonly used, it is often inaccessible due to a vascular pathology, such as occlusion, tortuosity or heavy calcifications. The transapical access provides an alternative approach. The goal of this study is to report the feasibility of the transapical approach for total endovascular repair of thoracic aortic aneurysms (TEVAR). Methods Three patients with thoracic aortic aneurysms with inaccessible femoral arteries underwent TEVAR via the transapical approach...
August 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28682324/matching-patients-with-the-ever-expanding-range-of-tavi-devices
#17
REVIEW
Brandon M Jones, Amar Krishnaswamy, E Murat Tuzcu, Stephanie Mick, Wael A Jaber, Lars G Svensson, Samir R Kapadia
Transcatheter aortic valve implantation (TAVI) has become a widely accepted strategy for the treatment of aortic stenosis in patients at intermediate, high, or prohibitive surgical risk. After >1 decade of innovation and clinical trial experience, the available technology for TAVI has grown enormously, and now includes a myriad of vascular access approaches and innovative valve designs. As a result, the range of patients who can benefit from these advances continues to grow rapidly. Furthermore, given the improved safety profile and clinical success of current-generation devices in randomized trials, the use of TAVI among even low-risk populations is justified in current trials...
July 6, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28673639/management-and-outcome-of-residual-aortic-regurgitation-after-transcatheter-aortic-valve-implantation
#18
Edward Koifman, Romain Didier, Hector Garcia-Garcia, Gaby Weissman, Andrew W Ertel, Sarkis Kiramijyan, Arie Steinvil, Toby Rogers, Nirav Patel, Sandeep Kumar, Arpi Tavil-Shatelyan, Itsik Ben-Dor, Augusto D Pichard, Rebecca Torguson, Jiaxiang Gai, Lowell F Satler, Ron Waksman
We aimed to evaluate the success rates of balloon valvuloplasty post-dilation (BVPD) and a second-valve deployment in reducing residual aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) and its impact on outcome. Residual AR immediately post-TAVI in patients with aortic stenosis is a common condition that adversely affects outcome. Patients who underwent TAVI who had more-than-mild residual AR were managed either with medical therapy, re-intervention with BVPD, or a second valve...
May 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28666146/intraleaflet-hemorrhages-are-a-common-finding-in-symptomatic-aortic-and-mitral-valves
#19
Olga C G Stam, Mat J A P Daemen, Jan Willem van Rijswijk, Bas A J M de Mol, Allard C van der Wal
INTRODUCTION: Intraleaflet hemorrhage (ILH) has been reported to occur in calcified degenerated aortic valves. At present, no such information is available for mitral valves or for other types of valvular disease. We examined the prevalence, age, and potential source of ILH in a consecutive series of surgically removed aortic and mitral valves, and related the findings to specific types of heart valve pathology. METHODS: A total of 105 aortic (n=85) and mitral (n=20) valves were retrieved from 100 symptomatic patients...
June 17, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28662835/ct-angiography-to-evaluate-coronary-artery-disease-and-revascularization-requirement-before-trans-catheter-aortic-valve-replacement
#20
Alexia Rossi, Carlo N De Cecco, Simon R O Kennon, Lu Zou, Felix G Meinel, William Toscano, Sabrina Segreto, Stephan Achenbach, Jörg Hausleiter, U Joseph Schoepf, Francesca Pugliese
BACKGROUND: Coronary artery disease (CAD) and aortic stenosis share pathophysiological mechanisms and risk factors. We evaluated the clinical utility of coronary computed tomography angiography (CTA) to identify CAD and revascularization requirement in patients with severe aortic stenosis considered for transcatheter aortic valve replacement (TAVR). METHODS: Consecutive patients without known CAD underwent calcium scoring, CTA and invasive coronary angiography (ICA)...
June 22, 2017: Journal of Cardiovascular Computed Tomography
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