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Aortic regurgitation therapy

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https://www.readbyqxmd.com/read/29334508/practical-valvular-issues-in-patients-requiring-ventricular-assist-devices
#1
Mitesh Badiwala, Terrence Yau
PURPOSE OF REVIEW: As ventricular assist device (VAD) therapy in patients with advanced heart failure continues to grow, experience with concomitant valvular diseases present either before or after VAD implantation continues to accrue. In this review, we discuss recent data and current practice as it pertains to the subject of concomitant valvular disease in patients requiring VADs. RECENT FINDINGS: Persistent aortic valve closure has been identified as a potential contributor to aortic valve 'disuse atrophy' resulting in valve degeneration...
January 13, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29260535/-application-of-echocardiography-to-support-transapical-transcatheter-aortic-valve-implantation-in-patients-with-aortic-regurgitation
#2
Ming-Dan Deng, Xin Wei, Hong Tang, Yu-Yan Cai, Gu-Yue Liu, Da Zhu, Ying-Qiang Guo
OBJECTIVE: To explore the role of echocardiography in pre-procedural,peri-procedural and post-procedural stages of transapical transcatheter aortic valve implantation (TAVI) in patients with aortic regurgitation (AR). METHODS: 31 patients with pure/dominant AR at a high risk on surgery were enrolled in this study. The degree of their aortic regurgitation was evaluated before TAVI,as well as the related diameters of aortic root and the left ventricular systolic function measured by transthoracic echocardiography (TTE)...
November 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29238882/the-presentation-and-management-of-hypertension-in-a-large-cohort-of-takayasu-arteritis
#3
Yu Qi, Lirui Yang, Huimin Zhang, Erpeng Liang, Lei Song, Jun Cai, Xiongjing Jiang, Yubao Zou, Haiyan Qian, Haiying Wu, Xianliang Zhou, Rutai Hui, Deyu Zheng
The objective of this study was to explore the presentation and management of hypertension secondary to Takayasu arteritis (TA) in a large cohort, single center in China. We retrospectively analyzed 381 TA patients with hypertension hospitalized in Fuwai hospital between Jan. 2004 and Feb. 2014. Diagnosis of hypertension was according to clinic blood pressure or the central blood pressure measured during angiography. Renal artery stenosis was the most common cause (264, 69.3%), followed by the thoracic descending aorta stenosis (98, 25...
December 14, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29234970/aortic-valve-reconstruction-using-autologous-pericardium-ozaki-procedure-for-active-infective-endocarditis-a-case-report
#4
Kimiaki Okada, Yoshito Inoue, Hirofumi Haida, Satoru Suzuki
Approximately one-third of patients with infective endocarditis require surgical treatment, but the ideal procedure that prevents infection ensures long durability and maintains quality of life remains unclear. A 21-year-old man who was diagnosed with aortic active infective endocarditis was referred to our hospital for surgical treatment. Echocardiography showed bicuspid aortic valve, severe aortic regurgitation, a large vegetation, and a paravalvular abscess. We planned to perform elective surgical treatment after antibiotic therapy; however, progression to heart failure required urgent operation...
December 12, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29233197/takayasu-arteritis-in-paediatrics
#5
Marisa Di Santo, Erica V Stelmaszewski, Alejandra Villa
Takayasu arteritis is an idiopathic chronic granulomatous panarteritis predominantly affecting the aorta and its main branches. Although idiopathic, genetic contribution to disease susceptibility is being increasingly recognised. Rare in children, Takayasu arteritis is a worldwide disease with significant morbidity and mortality. Its diagnosis is a challenge and requires awareness of the condition as clinical features at presentation are non-specific and assessing disease activity is difficult. In the inflammatory stage, treatment is essential to prevent the insidious course and vascular damage: stenotic, occlusive lesions, aneurysms, and aortic regurgitation...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29218014/acute-effects-of-positive-airway-pressure-on-functional-mitral-regurgitation-in-patients-with-systolic-heart-failure
#6
Takao Kato, Takatoshi Kasai, Shoichiro Yatsu, Azusa Murata, Hiroki Matsumoto, Shoko Suda, Masaru Hiki, Nanako Shiroshita, Mitsue Kato, Fusae Kawana, Sakiko Miyazaki, Hiroyuki Daida
Background: Acute effects of positive airway pressure (PAP) [including continuous PAP (CPAP) and adaptive servo-ventilation, an advanced form of bi-level PAP] on functional mitral regurgitation (fMR) in patients with heart failure (HF) with left ventricular (LV) systolic dysfunction remain unclear. Thus, whether PAP therapy reduces fMR in such patients with HF was investigated. Methods and Results: Twenty patients with HF and LV systolic dysfunction defined as LV ejection fraction (LVEF) <50% (14 men; mean LVEF, 35...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29181418/asymptomatic-cardiovascular-syphilis-with-aortic-regurgitation-requiring-surgical-repair-in-an-hiv-infected-patient
#7
Daniel S Graciaa, Marina B Mosunjac, Kimberly A Workowski, Russell R Kempker
A 47-year-old man with HIV infection presented 10 years after initial secondary syphilis diagnosis and treatment for routine follow-up. His HIV was well controlled on antiretroviral therapy. Rapid plasma reagin was 1:1, and TP-PA was reactive. Physical examination revealed a wide pulse pressure, a systolic murmur, and an early diastolic decrescendo murmur. Echocardiogram revealed moderate to severe aortic regurgitation, and subsequent computed tomography angiogram showed a 6.8-cm fusiform aneurysm of the proximal ascending aorta...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29176139/preoperative-evaluation-and-midterm-outcomes-after-the-surgical-correction-of-anomalous-origin-of-the-left-coronary-artery-from-the-pulmonary-artery-in-50-infants-and-children
#8
Hui-Li Zhang, Shou-Jun Li, Xu Wang, Jun Yan, Zhong-Dong Hua
BACKGROUND: Anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) is a rather rare congenital anomaly that has a profound effect on heart function. This study aimed to retrospectively illustrate the perioperative clinical features, therapy experience, and midterm outcomes after surgical correction, and to determine the value of left ventricular ejection fraction (LVEF) and myocardial viability in differentiating critically ill patients among infants and children with ALCAPA...
December 5, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#9
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29110304/beta-blockers-for-preventing-aortic-dissection-in-marfan-syndrome
#10
REVIEW
Hyun-Kyoung Koo, Kendra Ak Lawrence, Vijaya M Musini
BACKGROUND: Marfan syndrome is a hereditary disorder affecting the connective tissue and is caused by a mutation of the fibrillin-1 (FBN1) gene. It affects multiple systems of the body, most notably the cardiovascular, ocular, skeletal, dural and pulmonary systems. Aortic root dilatation is the most frequent cardiovascular manifestation and its complications, including aortic regurgitation, dissection and rupture are the main cause of morbidity and mortality. OBJECTIVES: To assess the long-term efficacy and safety of beta-blocker therapy as compared to placebo, no treatment or surveillance only in people with Marfan syndrome...
November 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29080191/computational-analysis-of-the-effect-of-mitral-and-aortic-regurgitation-on-the-function-of-ventricular-assist-devices-using-3d-cardiac-electromechanical-model
#11
Yoo Seok Kim, Ana R Yuniarti, Kwang-Soup Song, Natalia A Trayanova, Eun Bo Shim, Ki Moo Lim
Valvular insufficiency affects cardiac responses and the pumping efficacy of left ventricular assist devices (LVADs) when patients undergo LVAD therapy. Knowledge of the effect of valvular regurgitation on the function of LVADs is important when treating heart failure patients. The goal of this study was to examine the effect of valvular regurgitation on the ventricular mechanics of a heart under LVAD treatment and the pumping efficacy of an LVAD using a computational model of the cardiovascular system. For this purpose, a 3D electromechanical model of failing ventricles in a human heart was coupled with a lumped-parameter model of valvular regurgitation and an LVAD-implanted vascular system...
October 28, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29066079/diagnosis-of-aortic-dissection-presenting-as-st-elevation-myocardial-infarction-using-point-of-care-ultrasound
#12
Jordan Chenkin
BACKGROUND: Aortic dissections can present with a broad spectrum of signs and symptoms, making them difficult to diagnose in the emergency department (ED). Aortic dissections can cause occlusion of the coronary arteries, mimicking an acute ST-elevation myocardial infarction (STEMI). Emergency point-of-care ultrasound (POCUS) may be a useful diagnostic tool to help differentiate aortic dissection from a primary myocardial infarction. CASE REPORT: A 69-year-old man with no medical history presented to our ED complaining of chest pain...
October 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29058110/computational-prediction-of-the-effects-of-the-intra-aortic-balloon-pump-on-heart-failure-with-valvular-regurgitation-using-a-3d-cardiac-electromechanical-model
#13
Chang-Hyun Kim, Kwang-Soup Song, Natalia A Trayanova, Ki Moo Lim
Intra-aortic balloon pump (IABP) is normally contraindicated in significant aortic regurgitation (AR). It causes and aggravates pre-existing AR while performing well in the event of mitral regurgitation (MR). Indirect parameters, such as the mean systolic pressure, product of heart rate and peak systolic pressure, and pressure-volume are used to quantify the effect of IABP on ventricular workload. However, to date, no studies have directly quantified the reduction in workload with IABP. The goal of this study is to examine the effect of IABP therapy on ventricular mechanics under valvular insufficiency by using a computational model of the heart...
October 23, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29050627/outcomes-for-the-commercial-use-of%C3%A2-self-expanding-prostheses-in-transcatheter-aortic-valve-replacement-a-report-from-the-sts-acc-tvt-registry
#14
Paul Sorajja, Susheel Kodali, Michael J Reardon, Wilson Y Szeto, Stanley J Chetcuti, James Hermiller, Sharla Chenoweth, David H Adams, Jeffrey J Popma
OBJECTIVES: The authors sought to compare the outcomes of commercial transcatheter aortic valve replacement (TAVR) with the repositionable Evolut R platform to those observed with the CoreValve device in the Society of Thoracic Surgeons (STS)/American College of Cardiology (ACC) Transcatheter Valve Therapy (TVT) Registry. BACKGROUND: TAVR continues to evolve, with rapid adoption of iterative changes for commercial practice. Insight into the outcomes of this adoption is needed...
October 23, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29029058/inter-ethnic-differences-in-valve-morphology-valvular-dysfunction-and-aortopathy-between-asian-and-european-patients-with-bicuspid-aortic-valve
#15
William K F Kong, Madelien V Regeer, Kian K Poh, James W Yip, Philippe J van Rosendael, Tiong C Yeo, Edgar Tay, Vasileios Kamperidis, Enno T van der Velde, Bart Mertens, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Background: Transcatheter aortic valve replacement (TAVR) has been shown safe and feasible in patients with bicuspid aortic valve (BAV) morphology. Evaluation of inter-ethnic differences in valve morphology and function and aortic root dimensions in patients with BAV is important for the worldwide spread of this therapy in this subgroup of patients. Comparisons between large European and Asian cohorts of patients with BAV have not been performed, and potential differences between populations may have important implications for TAVR...
October 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28965619/transcatheter-aortic-valve-replacement-in-patients-with-aortic-stenosis-and-mitral-regurgitation
#16
Kreton Mavromatis, Vinod H Thourani, Amanda Stebbins, Sreekanth Vemulapalli, Chandan Devireddy, Robert A Guyton, Roland Matsouaka, Nima Ghasemzadeh, Peter C Block, Bradley G Leshnower, James P Stewart, John S Rumsfeld, Stamatios Lerakis, Vasilis Babaliaros
BACKGROUND: Many patients undergoing transcatheter aortic valve replacement (TAVR) for aortic stenosis also have significant mitral regurgitation (MR). We sought to understand the association of concomitant MR with TAVR clinical outcomes, as well changes in MR after TAVR. METHODS: Patients who underwent TAVR in the US Transcatheter Valve Therapy Registry from January 3, 2012, to December 31, 2013, were studied, with longer-term clinical outcomes from Center for Medicare Services data...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#17
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28929526/the-influence-of-marfans-and-bicuspid-valves-on-outcomes-following-aortic-valve-reimplantation
#18
Carlos E Martín, Carlos García Montero, Santiago-Fiz Serrano, Ana González, Susana Mingo, Vanessa Moñivas, Jorge Centeno, Alberto Forteza
BACKGROUND: We analyzed our early and midterm results with aortic valve reimplantation surgery to determine the influence of Marfan syndrome and bicuspid valves on outcomes with this technique. METHODS: Between March 2004 and December 2015, 267 patients underwent aortic valve reimplantation operations. The mean diameter of the sinuses of Valsalva was 50 ± 3 mm and moderate/severe aortic regurgitation was present in 34.4% of these patients. A bicuspid aortic valve was present in 21% and 40% had Marfan syndrome...
October 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28927697/aortic-regurgitation-in-acute-type-a-aortic-dissection-a-clinical-classification-for-the-perioperative-echocardiographer-in-the-era-of-the-functional-aortic-annulus
#19
REVIEW
Prakash A Patel, Joseph E Bavaria, Kamrouz Ghadimi, Jacob T Gutsche, Prashanth Vallabhajosyula, Hanjo A Ko, Nimesh D Desai, Emily Mackay, Stuart J Weiss, John G T Augoustides
The functional aortic annulus offers a clinical approach for the perioperative echocardiographer to classify the mechanisms of aortic regurgitation in acute type-A dissection. Comprehensive examination of the functional aortic annulus in this setting using transesophageal echocardiography can guide surgical therapy for the aortic root by considering the following important aspects: severity and mechanism of aortic regurgitation, extent of root dissection, and the pattern of coronary artery involvement. The final choice of surgical therapy also should take into account factors, such as patient presentation and surgical experience, to limit mortality and morbidity from this challenging acute aortic syndrome...
June 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28918529/anatomic-repair-of-congenitally-corrected-transposition-of-the-great-arteries-single-center-intermediate-term-experience
#20
Shagun Sachdeva, Roni M Jacobsen, Ronald K Woods, Michael E Mitchell, Joseph R Cava, Nancy S Ghanayem, Peter C Frommelt, Peter J Bartz, James S Tweddell
We present our experience for patients who have undergone an anatomic repair (AR) for congenitally corrected transposition of the great arteries (CCTGA) at the Children's Hospital of Wisconsin. A retrospective chart review of patients who underwent AR for CCTGA from 2001 to 2015 was performed. The cohort consisted of 15 patients (74% male). Median age of anatomic repair was 15 months (range 4.5-45.6 months). Four patients had a bidirectional Glenn (BDG) prior to AR. At the time of AR,-9 (60%) underwent Senning/Rastelli procedure, 4 (26...
December 2017: Pediatric Cardiology
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