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https://www.readbyqxmd.com/read/27911025/effect-of-balloon-expandable-transcatheter-aortic-valve-replacement-positioning-a-patient-specific-numerical-model
#1
Matteo Bianchi, Gil Marom, Ram P Ghosh, Harold A Fernandez, James R Taylor, Marvin J Slepian, Danny Bluestein
Transcatheter aortic valve replacement (TAVR) has emerged as a life-saving and effective alternative to surgical valve replacement in high-risk, elderly patients with severe calcific aortic stenosis. Despite its early promise, certain limitations and adverse events, such as suboptimal placement and valve migration, have been reported. In the present study, it was aimed to evaluate the effect of various TAVR deployment locations on the procedural outcome by assessing the risk for valve migration. The deployment of a balloon-expandable Edwards SAPIEN valve was simulated via finite element analysis in a patient-specific calcified aortic root, which was reconstructed from CT scans of a retrospective case of valve migration...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27908608/a-hospital-based-survey-of-patients-with-severe-valvular-heart-disease-in-china
#2
Po Hu, Xian-Bao Liu, Jie Liang, Qi-Feng Zhu, Chao-Xia Pu, Meng-Yao Tang, Jian-An Wang
OBJECTIVES: Due to increasing aging, the epidemiology of VHD may have changed in China. This study aimed to provide contemporary information on the prevalence, distribution patterns, and etiology of severe VHD in China. METHODS: This was a retrospective survey at Second Affiliated Hospital of Zhejiang University, which included all consecutive patients between 2010 and 2015. RESULTS: In all, 139,496 patients were enrolled. Among severe valve diseases, MR was the most frequent (n=946, 0...
November 25, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27906615/polymorphism-in-exon-6-of-the-human-nt5e-gene-is-associated-with-aortic-valve-calcification
#3
Zdzislaw Kochan, Joanna Karbowska, Patrycja Gogga, Barbara Kutryb-Zajac, Ewa M Slominska, Ryszard T Smolenski
NT5E encodes ecto-5'-nucleotidase (e5NT, CD73) which hydrolyses extracellular AMP to adenosine. Adenosine has been shown to play a protective role against aortic valve calcification (AVC). We identified two nonsynonymous missense single nucleotide polymorphisms (c.1126A > G, p.T376A and c.1136T > C, p.M379T) in exon 6 of the human NT5E gene. Since both substitutions might affect e5NT activity and consequently alter extracellular adenosine levels, we evaluated the association between NT5E alleles and calcific aortic valve disease in 119 patients (95 patients with AVC and 24 controls)...
December 2016: Nucleosides, Nucleotides & Nucleic Acids
https://www.readbyqxmd.com/read/27889349/acquired-aseptic-intracardiac-shunts-following-transcatheter-aortic-valve%C3%A2-replacement-a%C3%A2-systematic-review
#4
Paol Rojas, Ignacio J Amat-Santos, Carlos Cortés, Javier Castrodeza, Javier Tobar, Rishi Puri, Teresa Sevilla, Silvio Vera, Luis H Varela-Falcón, Jose Luis Zunzunegui, Itziar Gómez, Josep Rodés-Cabau, José A San Román
OBJECTIVES: The aim of this study was to describe the incidence, mechanisms, features, and management of aseptic intracardiac shunts (AICS). BACKGROUND: AICS following transcatheter aortic valve replacement (TAVR) are an uncommon and barely described complication. METHODS: A systematic review was performed of all published cases of AICS following TAVR, and the incidence, predictors, main features, management, and related outcomes were analyzed...
November 17, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27887725/a-calcified-polymeric-valve-for-valve-in-valve-applications
#5
Ahmad Falahatpisheh, Daisuke Morisawa, Taraz T Toosky, Arash Kheradvar
The prevalence of aortic valve stenosis (AS) is increasing in the aging society. More recently, novel treatments and devices for AS, especially transcatheter aortic valve replacement (TAVR) have significantly changed the therapeutic approach to this disease. Research and development related to TAVR require testing these devices in the calcified heart valves that closely mimic a native calcific valve. However, no animal model of AS has yet been available. Alternatively, animals with normal aortic valve that are currently used for TAVR experiments do not closely replicate the aortic valve pathology required for proper testing of these devices...
November 16, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27881062/antihypertensive-treatments-in-patients-affected-by-aortic-valve-stenosis
#6
Paolo Poggio, Gianluca Folesani, Giuseppe M Raffa, Paola Songia, Vincenzo Valenti, Veronika Myasoedova, Alessandro Parolari
Systemic hypertension and aortic valve stenosis (AVS) are both age-related diseases. Severe aortic stenosis affects ≈2% to 5% of adults age > 65 years. Systemic hypertension (HTN) is a frequent comorbidity in patients with AVS and is coexistent for a longer period of time before AVS is treated. Essential systemic hypertension, per se, plays an important role in the creation of lesions on the aortic side of the valve, the region of higher exposure to tension stress. The subsequent endothelial defect represents the principal site of inflammatory process and oxidative stress, leading to aortic sclerosis and calcification...
November 23, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27879282/sex-related-discordance-between-aortic-valve-calcification-and-hemodynamic-severity-of-aortic-stenosis-is-valvular-fibrosis-the-explanation
#7
Louis Simard, Nancy Côté, François Dagenais, Patrick Mathieu, Christian Couture, Sylvain Trahan, Yohan Bossé, Siamak Mohammadi, Sylvain Pagé, Philippe Joubert, Marie-Annick Clavel
RATIONALE: Calcific aortic stenosis (AS) is characterized by calcium deposition in valve leaflets. However, women present lower aortic valve calcification (AVC) loads than men for the same AS hemodynamic severity. OBJECTIVE: We thus aimed to assess sex-differences in aortic valve fibro-calcific remodelling. METHODS AND RESULTS: One hundred and twenty-five patients underwent Doppler-echocardiography and multidetector-computed-tomography within 3 months prior to aortic valve replacement...
November 22, 2016: Circulation Research
https://www.readbyqxmd.com/read/27873060/reinforced-mitral-valve-replacement-using-a-xenopericardium-collared-prosthetic-valve-for-a-heavily-calcified-or-disrupted-mitral-annulus-a-simple-dumpling-technique
#8
Masaru Ishida, Koichi Toda, Teruya Nakamura, Shigeru Miyagawa, Yasushi Yoshikawa, Satsuki Fukushima, Shunsuke Saito, Takayoshi Ueno, Toru Kuratani, Yoshiki Sawa
Heavy mitral annular calcification or severe destruction of the mitral annulus in the setting of mitral valve replacement may result in fatal complications, such as atrioventricular disruption, ventricular rupture, valve dehiscence, and perivalvular leakage. Collar-reinforced mitral valve replacements with xenopericardium have been reported to prevent perivalvular leakage and valve detachment. We herein describe our experience with an easy method of handling the modified collar-reinforced prosthetic valve, which we call the "Dumpling technique", in six patients...
November 21, 2016: Surgery Today
https://www.readbyqxmd.com/read/27868419/-research-progress-on-pharmacotherapy-of-calcific-aortic-valve-disease
#9
Miaomiao DU, Gaigai Ma, Yuping Shi
With the population aging and declining incidence of rheumatic heart disease, calcific aortic valve disease (CAVD) has become the most frequent valve disease and the common cause of aortic valve replacement. Patients with CAVD need to cope with a deteriorating quality of life and valve replacement is the only effective clinical option for the patients. Therefore, early pharmacotherapy is of great significance in prevention or slow-down of the progression of CAVD. For years CAVD was considered to be a passive wear and tear process of valves, but now it is recognized as an active and multi-factorial process...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/27867942/quantification-of-calcified-particles-in-human-valve-tissue-reveals-asymmetry-of-calcific-aortic-valve-disease-development
#10
Katsumi Yabusaki, Joshua D Hutcheson, Payal Vyas, Sergio Bertazzo, Simon C Body, Masanori Aikawa, Elena Aikawa
Recent studies indicated that small calcified particles observable by scanning electron microscopy (SEM) may initiate calcification in cardiovascular tissues. We hypothesized that if the calcified particles precede gross calcification observed in calcific aortic valve disease (CAVD), they would exhibit a regional asymmetric distribution associated with CAVD development, which always initiates at the base of aortic valve leaflets adjacent to the aortic outflow in a region known as the fibrosa. Testing this hypothesis required counting the calcified particles in histological sections of aortic valve leaflets...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27866029/understanding-the-structural-features-of-symptomatic-calcific-aortic-valve-stenosis-a-broad-spectrum-clinico-pathologic-study-in-236-consecutive-surgical-cases
#11
Daniela Galli, Roberta Manuguerra, Rodolfo Monaco, Laura Manotti, Matteo Goldoni, Gabriella Becchi, Cecilia Carubbi, Giulia Vignali, Nicola Cucurachi, Tiziano Gherli, Francesco Nicolini, Roberto Lorusso, Marco Vitale, Domenico Corradi
BACKGROUND: With age, aortic valve cusps undergo varying degrees of sclerosis which, sometimes, can progress to calcific aortic valve stenosis (AVS). To perform a retrospective clinico-pathologic investigation in patients with calcific AVS. METHODS: We characterized and graded the structural remodeling in 236 aortic valves (200 tricuspid and 36 bicuspid) from patients with calcific AVS (148 males; average 72years); possible relationships between general/clinical/echocardiographic characteristics and the histopathologic changes were explored...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27863744/towards-the-improved-quantification-of-in-vivo-abnormal-wall-shear-stresses-in-bav-affected-patients-from-4d-flow-imaging-benchmarking-and-application-to-real-data
#12
F Piatti, S Pirola, M Bissell, I Nesteruk, F Sturla, A Della Corte, A Redaelli, E Votta
Bicuspid aortic valve (BAV), i.e. the fusion of two aortic valve cusps, is the most frequent congenital cardiac malformation. Its progression is often characterized by accelerated leaflet calcification and aortic wall dilation. These processes are likely enhanced by altered biomechanical stimuli, including fluid-dynamic wall shear stresses (WSS) acting on both the aortic wall and the aortic valve. Several studies have proposed the exploitation of 4D-flow magnetic resonance imaging sequences to characterize abnormal in vivo WSS in BAV-affected patients, to support prognosis and timing of intervention...
November 11, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27856308/dysregulation-of-hyaluronan-homeostasis-during-aortic-valve-disease
#13
Varun K Krishnamurthy, Andrew J Stout, Matthew C Sapp, Brittany Matuska, Mark E Lauer, K Jane Grande-Allen
Aortic valve disease (AVD) is one of the leading causes of cardiovascular mortality. Abnormal expression of hyaluronan (HA) and its synthesizing/degrading enzymes have been observed during latent AVD however, the mechanism of impaired hyaluronan homeostasis prior to and after the onset of AVD remains unexplored. Transforming growth factor beta (TGFβ) pathway defects and biomechanical dysfunction are hallmarks of AVD, however their association with altered hyaluronan regulation is understudied. Expression of HA homeostatic markers was evaluated in diseased human aortic valves and TGFβ1-cultured porcine aortic valve tissues using histology, immunohistochemistry and Western blotting...
November 14, 2016: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/27855469/right-sided-heart-failure-and-extracorporeal-life-support-in-patients-undergoing-pericardiectomy-for-constrictive-pericarditis-a-risk-factor-analysis-for-adverse-outcome
#14
Erik Beckmann, Issam Ismail, Serghei Cebotari, Alexander Busse, Andreas Martens, Malakh Shrestha, Christian Kühn, Axel Haverich, Christine Fegbeutel
Background Right ventricular failure is a life-threatening postoperative complication after pericardiectomy. We conducted a retrospective study with a special emphasis on right ventricular failure. Methods Between June 1997 and September 2011, 69 patients underwent surgical pericardiectomy at our center. Mean age was 59 ( ±  15.5) years, and 49 (71%) patients were male. Causes of constrictive pericarditis included idiopathic (52%, n = 36), tuberculosis (9%, n = 6), postcardiotomy (12%, n = 8), radiation (4%, n = 3), renal insufficiency (12%, n = 8), and autoimmune disease (12%, n = 8)...
November 17, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27847254/vascular-calcification-in-ckd-mbd-roles-for-phosphate-fgf23-and-klotho
#15
REVIEW
Shunsuke Yamada, Cecilia M Giachelli
Vascular calcification (VC) is highly prevalent in aging, diabetes mellitus, and chronic kidney disease (CKD). VC is a strong predictor of cardiovascular morbidity and mortality in the CKD population. Complex pathological mechanisms are involved in the development of VC, including osteochondrogenic differentiation and apoptosis of vascular smooth muscle cells, instability and release of extracellular vesicles loaded calcium and phosphate, and elastin degradation. Elevated serum phosphate is a late manifestation of CKD, and has been shown to accelerate mineral deposition in both the vessel wall and heart valves...
November 12, 2016: Bone
https://www.readbyqxmd.com/read/27836502/transcatheter-aortic-valves-produce-unphysiological-flows-which-may-contribute-to-thromboembolic-events-an-in-vitro-study
#16
Andrea Ducci, Francesco Pirisi, Spyridon Tzamtzis, Gaetano Burriesci
PURPOSE: Transcatheter aortic valve implantation (TAVI) has been associated with large incidence of ischemic events, whose sources are still unclear. In fact, sub-acute complications cannot be directly related to the severity of the calcification in the host tissues, nor with catheter manipulation during the implant. A potential cause could be local flow perturbations introduced by the implantation approach, resulting in thrombo-embolic consequences. In particular, contrary to the surgical approach, TAVI preserves the presence of the native leaflets, which are expanded in the paravalvular space inside the Valsalva sinuses...
November 3, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27832900/severe-mitral-annular-calcification-multimodality-imaging-for-therapeutic-strategies-and-interventions
#17
REVIEW
Mackram F Eleid, Thomas A Foley, Sameh M Said, Sorin V Pislaru, Charanjit S Rihal
Mitral annular calcification (MAC) is a chronic degenerative process associated with advanced age and conditions predisposing to left ventricular hypertrophy. Assessment of mitral valve disease in patients with severe MAC can be a challenge. When severe MAC results in mitral stenosis or regurgitation, multimodality imaging with 2-dimensional, 3-dimensional, and Doppler echocardiography and cardiac computed tomography angiography can delineate the severity and pathoanatomic features to help guide therapeutic strategies...
November 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27815266/role-for-galectin-3-in-calcific-aortic-valve-stenosis
#18
J Rafael Sádaba, Ernesto Martínez-Martínez, Vanessa Arrieta, Virginia Álvarez, Amaya Fernández-Celis, Jaime Ibarrola, Amaia Melero, Patrick Rossignol, Victoria Cachofeiro, Natalia López-Andrés
BACKGROUND: Aortic stenosis (AS) is a chronic inflammatory disease, and calcification plays an important role in the progression of the disease. Galectin-3 (Gal-3) is a proinflammatory molecule involved in vascular osteogenesis in atherosclerosis. Therefore, we hypothesized that Gal-3 could mediate valve calcification in AS. METHODS AND RESULTS: Blood samples and aortic valves (AVs) from 77 patients undergoing AV replacement were analyzed. As controls, noncalcified human AVs were obtained at autopsy (n=11)...
November 4, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27815101/cerebral-embolic-protection-during-transcatheter-aortic-valve-replacement
#19
Samir R Kapadia, Susheel Kodali, Raj Makkar, Roxana Mehran, Ronald M Lazar, Robert Zivadinov, Michael G Dwyer, Hasan Jilaihawi, Renu Virmani, Saif Anwaruddin, Vinod H Thourani, Tamim Nazif, Norman Mangner, Felix Woitek, Amar Krishnaswamy, Stephanie Mick, Tarun Chakravarty, Mamoo Nakamura, James M McCabe, Lowell Satler, Alan Zajarias, Wilson Y Szeto, Lars Svensson, Maria C Alu, Roseann M White, Carlye Kraemer, Azin Parhizgar, Martin B Leon, Axel Linke
BACKGROUND: Neurological events and brain infarction after transcatheter aortic valve replacement (TAVR) are concerns which may be reduced with transcatheter embolic protection (TEP). OBJECTIVE: Evaluate the safety and efficacy of TEP during TAVR. METHODS: Nineteen centers randomized 363 patients undergoing TAVR to safety (n=123), device imaging (n=121), and control imaging (n=119). The primary safety endpoint was major adverse cardiac and cerebrovascular events (MACCE) at 30 days and the primary efficacy endpoint was reduction in new lesion volume in protected brain territories on MRI scans at 2-7 days...
October 27, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27806099/plaque-vulnerability-as-assessed-by-radiofrequency-intravascular-ultrasound-in-patients-with-valvular-calcification
#20
Nagendra Boopathy Senguttuvan, Sharath Kumar, Wang-Soo Lee, Sundeep Mishra, Jun Hwan Cho, Jee Eun Kwon, Seong Hyeop Hyeon, Yun Sang Jeong, Hoyoun Won, Seung Yong Shin, Kwang Je Lee, Tae Ho Kim, Chee Jeong Kim, Sang-Wook Kim
BACKGROUND: Cardiac valvular calcification is associated with the overall coronary plaque burden and considered an independent cardiovascular risk and prognostic factor. The purpose of this study was to evaluate the relationship between the presence of valvular calcification and plaque morphology and/or vulnerability. METHODS: Transthoracic echocardiography was used to assess valvular calcification in 280 patients with coronary artery disease who underwent radiofrequency intravascular ultrasound (Virtual Histology IVUS, VH-IVUS)...
2016: PloS One
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