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Aortic regurgitation therapy

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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 following 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...
September 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28903993/mitral-regurgitation-in-patients-with-severe-aortic-stenosis-diagnosis-and-management
#13
REVIEW
Anna Sannino, Paul A Grayburn
Severe aortic stenosis (AS) and mitral regurgitation (MR) frequently coexist. Although some observational studies have reported that moderate or severe MR is associated with higher mortality, the optimal management of such patients is still unclear. Simultaneous replacement of both aortic and mitral valves is linked to significantly higher morbidity and mortality. Recent advances in minimally invasive surgical or transcatheter therapies for MR allow for staged procedures in which surgical or transcatheter aortic valve replacement (SAVR/TAVR) is done first and MR severity re-evaluated afterwards...
September 13, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28895061/valvular-heart-disease-in-women-differential-remodeling-and-response-to-new-therapies
#14
REVIEW
Jaya Chandrasekhar, George Dangas, Roxana Mehran
In the United States, valvular heart disease (VHD) has a prevalence of 2.5%, most commonly presenting as aortic stenosis (AS) or mitral valve regurgitation (MR) and increasingly observed to be of a degenerative etiology. Women frequently have latent symptoms despite significant disease, and it is therefore pertinent to consider both clinical symptoms and imaging findings for decision-making on treatment. Indeed, significant advances have been made in noninvasive imaging allowing for more accurate diagnosis and disease prognostication...
September 11, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28885378/radial-force-an-underestimated-parameter-in-oversizing-transcatheter-aortic-valve-replacement-prostheses-in-vitro-analysis-with-five-commercialized-valves
#15
Sandrine Egron, Buntaro Fujita, Lucía Gullón, Pott Désirée, Thomas Schmitz-Rode, Stephan Ensminger, Ulrich Steinseifer
The goal is to inform in depth on transcatheter aortic valve replacement (TAVR) prosthesis mechanical behavior, depending on frame type, design, and size, and how it crucially impacts the oversizing issue in clinical use, and ultimately the procedure outcome. Transcatheter aortic valve replacement is an established therapy for high-risk patients suffering from aortic stenosis, and the indication for TAVR is progressively expanding to intermediate-risk patients. Choosing the optimal oversizing degree is crucial to safely anchor the TAVR valve-which involves limiting the risks for embolism, aortic regurgitation, conductance disturbance, or annulus rupture-and to increase the valve prosthesis performance...
September 5, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28863437/serotonin-and-catecholamines-in-the-development-and-progression-of-heart-valve-diseases
#16
Elliott Goldberg, Juan B Grau, Jacqueline H Fortier, Elisa Salvati, Robert J Levy, Giovanni Ferrari
Heart valve diseases (HVDs) arise from a number of different processes that affect both the structure and function of the valve apparatus. Despite diverse aetiologies, treatments for HVDs are limited to percutaneous or surgical interventions. The search for medical therapies to prevent or slow the progression of HVDs has been hampered by our poor understanding of the progression from subclinical to symptomatic phases, and our limited knowledge of the molecular signals that control the susceptibility of valve interstitial cells to pathological remodeling...
July 1, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28862762/quadricuspid-aortic-valve-infective-endocarditis
#17
Christopher Jackson, Tahira Sarwar, Inyong Hwang, Kiran Joglekar, Shadwan Alsafwah
Infective endocarditis complicating a quadricuspid aortic valve (QAV) is rare. Previous reports highlight the increased risk for complications, including progressive aortic regurgitation, decompensated heart failure, and valve perforation. Thus, cardiologists must be able to quickly identify QAVs to guide rapid evaluation and treatment. We report a case of infective endocarditis in a QAV identified on echocardiography and effectively managed with medical therapy alone without complications over an 8-year follow-up period...
May 8, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28832195/update-on-the-significance-of-postprocedural-aortic-regurgitation-after-transcatheter-aortic-valve-replacement-on-postprocedural-prognosis
#18
Maximilian Schmidt-Salzmann, Michael Schlüter, Karl-Heinz Kuck, Christian Frerker
Transcatheter aortic valve replacement (TAVR) is an established therapy for patients with aortic stenosis and a high surgical risk. Recent data on intermediate-risk patients will probably enlarge the indication for TAVR. In the beginning of the TAVR era, relevant (>mild) aortic regurgitation (AR) was a common finding after TAVR; it was associated with worse outcome compared with patients without significant AR. To date, several improvements in imaging, grading of severity and treatment have been done and will be discussed in this article...
August 23, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28775090/missed-aortic-valve-endocarditis-resulting-in-complete-atrioventricular-block-and-redo-mechanical-valve-replacement
#19
Amer Harky, Megan Garner, Miruna Popa, Alex Shipolini
Infective endocarditis is a rare disease associated with high morbidity and mortality. As a result, early diagnosis and prompt antibiotic treatment with or without surgical intervention is crucial in the management of such condition.We report a case of missed infective endocarditis of the aortic valve. The patient underwent mechanical aortic valve replacement, with the native valve being sent for histopathological examination. On re-admission 16 months later, he presented with syncope, shortness of breathing and complete heart block...
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28741245/the-last-frontier-transcatheter-devices-for-percutaneous-or-minimally-invasive-treatment-of-chronic-heart-failure
#20
REVIEW
V J Nijenhuis, L Sanchis, J A S van der Heyden, P Klein, B J W M Rensing, A Latib, F Maisano, J M Ten Berg, P Agostoni, M J Swaans
Heart failure has a high prevalence in the general population. Morbidity and mortality of heart failure patients remain high, despite improvements in drug therapy, implantable cardioverter-defibrillators and cardiac resynchronisation therapy. New transcatheter implantable devices have been developed to improve the treatment of heart failure. There has been a rapid development of minimally invasive or transcatheter devices used in the treatment of heart failure associated with aortic and mitral valve disease and these devices are being incorporated into routine clinical practice at a fast rate...
July 24, 2017: Netherlands Heart Journal
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