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https://www.readbyqxmd.com/read/28109383/portico-sheathless-transcatheter-aortic-valve-implantation-via-distal-axillary-artery
#1
Giuseppe Bruschi, Paola Colombo, Luca Botta, Stefano Nava, Bruno Merlanti, Oriana Belli, Francesco Musca, Francesco Soriano, Claudio F Russo, Fabrizio Oliva
Transcatheter aortic valve implantation has been designed to treat older patients affected by severe aortic stenosis who are considered high-risk surgical candidates because of multiple comorbidities. The least invasive approach for transcatheter aortic valves implantation should be considered the transfemoral retrograde route, because it is minimally invasive and is feasible with local anesthesia and mild sedation. Despite significant technical improvements in recent years, the transfemoral approach is contraindicated in cases of severe peripheral artery disease...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28108573/transcatheter-mitral-valve-implantation-a-percutaneous-transapical-system
#2
Huangdong Dai, Katharina Huenges, Saskia Pokorny, Gunther Fischer, Jochen Cremer, Anja Metzner, Derk Frank, Georg Lutter
OBJECTIVES: Despite recent achievements, implantation of a transcatheter mitral valved stent remains challenging. In this study, we present a different approach for implantation of a percutaneous mitral valved stent. METHODS: Percutaneous transapical access is combined with, respectively, a left-transatrial, right-transatrial/transseptal or transfemoral/transseptal approach for mitral valve stent implantation and secure fixation. The apical fixation and occlusion are ensured with an Amplatzer occluder...
January 19, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28106963/wire-skills-for-the-surgeon-femoral-access-safety-net-and-vascular-closure-devices-in-transfemoral-transcatheter-aortic-valve-implantation-procedures
#3
Simon Sndermann, Axel Unbehaun, Alexander Meyer, Volkmar Falk, Jrg Kempfert
Transfemoral transcatheter aortic valve implantation procedures are widely used to treat patients with aortic stenosis and high surgical risk. Major vascular complications are common and are associated with higher mortality rates. We describe the use of vascular access site closure systems and a safety net to prevent and handle these complications.
December 14, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28106026/successful-simultaneous-ipsilateral-stenting-of-common-iliac-artery-stenosis-and-transfemoral-aortic-valve-replacement
#4
Abdullah Nabi Aslan, Hacı Ahmet Kasapkara, Serkan Sivri, Murat Can Güney, Engin Bozkurt
Transcatheter aortic valve replacement (TAVR) was designed to treat elderly patients with severe aortic stenosis at high risk for surgery, and is most commonly performed with retrograde approach through femoral arteries. However, in up to 30% of cases, it is either not possible to use this access route or it is considered to have high risk of vascular injury. Alternative approaches have been described for patients with no suitable femoral access: trans-subclavian, transaortic, or direct aortic access; however, since the introduction of new valves deployed with low-profile delivery systems, another alternative transcatheter approach has been discovered...
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28106001/impact-of-femoral-artery-puncture-using-digital-subtraction-angiography-and-road-mapping-on-vascular-and-bleeding-complications-after-transfemoral-transcatheter-aortic-valve-implantation
#5
Mohamed El-Mawardy, Bettina Schwarz, Martin Landt, Dmitriy Sulimov, Julia Kebernik, Abdelhakim Allali, Bjoern Becker, Ralph Toelg, Gert Richardt, Mohamed Abdel-Wahab
AIMS: The use of large-diameter sheaths carries the risk of significant vascular and bleeding complications after transfemoral transcatheter aortic valve implantation (TAVI). In this analysis, we sought to assess the impact of a modified femoral artery puncture technique using digital subtraction angiography (DSA) and road mapping during transfemoral TAVI on periprocedural vascular and bleeding events. METHODS AND RESULTS: This is a retrospective analysis of transfemoral TAVI patients included in a prospective institutional database...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105998/simultaneous-transfemoral-aortic-and-transseptal-mitral-valve-replacement-utilising-sapien-3-valves-in-native-aortic-and-mitral-valves
#6
Mohammad Bashir, Gardar Sigurdsson, Phillip A Horwitz, Firas Zahr
AIMS: Concomitant severe calcific aortic and mitral stenosis is a relatively uncommon but very challenging valvular heart disease to manage. We sought to evaluate the feasibility of a fully percutaneous approach to replace both stenotic native mitral and aortic valves using SAPIEN 3 valves. METHODS AND RESULTS: An 87-year-old woman with chronic kidney disease stage 3, pul-monary hypertension, chronic obstructive pulmonary disease, a permanent pacemaker, and atrial fibrillation was referred with Class III heart failure symptoms...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105945/assessment-of-transfemoral-amputees-using-a-passive-microprocessor-controlled-knee-versus-an-active-powered-microprocessor-controlled-knee-for-level-walking
#7
Veerle Creylman, Ingrid Knippels, Paul Janssen, Evelyne Biesbrouck, Knut Lechler, Louis Peeraer
BACKGROUND: In transfemoral (TF) amputees, the forward propulsion of the prosthetic leg in swing has to be mainly carried out by hip muscles. With hip strength being the strongest predictor to ambulation ability, an active powered knee joint could have a positive influence, lowering hip loading and contributing to ambulation mobility. To assess this, gait of four TF amputees was measured for level walking, first while using a passive microprocessor-controlled prosthetic knee (P-MPK), subsequently while using an active powered microprocessor-controlled prosthetic knee (A-MPK)...
December 19, 2016: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28104716/source-3-registry-design-and-30-day-results-of-the-european-post-approval-registry-of-the-latest-generation-of-the-sapien-3tm-transcatheter-heart-valve
#8
Olaf Wendler, Gerhard Schymik, Hendrik Treede, Helmut Baumgartner, Nicolas Dumonteil, Leo Ihlberg, Franz-Josef Neumann, Giuseppe Tarantini, José L Zamorano, Alec Vahanian
BACKGROUND: -The SOURCE 3 Registry is a European multicentre, observational registry of the latest generation of transcatheter heart valve, the SAPIEN 3(TM) (Edwards Lifesciences, Irvine, CA/USA). Its purpose is to document outcomes of clinical safety and performance after European approval was given. METHODS: -In this manuscript we present the 30-day outcome of the SOURCE 3 Registry. All data is self-reported and all participating centres have committed to support their consecutive experience with the SAPIEN 3(TM) transcatheter heart valve, dependent on patients consent, before the start of the study...
January 19, 2017: Circulation
https://www.readbyqxmd.com/read/28103735/comparison-of-transtibial-amputations-in-diabetic-patients-with-and-without-end-stage-renal-disease
#9
Dane K Wukich, Junho Ahn, Katherine M Raspovic, Frank A Gottschalk, Javier La Fontaine, Larry A Lavery
BACKGROUND: The primary purpose of this retrospective study was to report on a consecutive series of 102 patients with diabetes mellitus (DM) who underwent transtibial amputation (TTA) for chronic infections and nonreconstructable lower extremity deformities. A secondary aim was to compare the outcomes of TTA patients with end-stage renal disease on dialysis (ESRD) to patients without ESRD, and to identify risk factors for mortality after TTA. METHODS: This cohort involved a consecutive series of patients who were treated by a single surgeon...
January 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28094689/quantification-of-rectifications-for-the-northwestern-university-flexible-sub-ischial-vacuum-socket
#10
Stefania Fatone, William Brett Johnson, Lilly Tran, Kerice Tucker, Christofer Mowrer, Ryan Caldwell
BACKGROUND: The fit and function of a prosthetic socket depend on the prosthetist's ability to design the socket's shape to distribute load comfortably over the residual limb. We recently developed a sub-ischial socket for persons with transfemoral amputation: the Northwestern University Flexible Sub-Ischial Vacuum Socket. OBJECTIVE: This study aimed to quantify the rectifications required to fit the Northwestern University Flexible Sub-Ischial Vacuum Socket to teach the technique to prosthetists as well as provide a computer-aided design-computer-aided manufacturing option...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28094686/northwestern-university-flexible-subischial-vacuum-socket-for-persons-with-transfemoral-amputation-part-1-description-of-technique
#11
Stefania Fatone, Ryan Caldwell
BACKGROUND: Current transfemoral prosthetic sockets restrict function, lack comfort, and cause residual limb problems. Lower proximal trim lines are an appealing way to address this problem. Development of a more comfortable and possibly functional subischial socket may contribute to improving quality of life of persons with transfemoral amputation. OBJECTIVES: The purpose of this study was to (1) describe the design and fabrication of a new subischial socket and (2) describe efforts to teach this technique...
January 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28093461/coil-embolization-of-left-ventricular-outflow-tract-pseudoaneurysms-techniques-and-5-year-results
#12
Hideki Ota, Yoshiaki Morita, Yoshikatsu Saiki, Kei Takase
We present 3 cases of percutaneous coil embolization of left ventricular outflow tract (LVOT) pseudoaneurysms. All patients had a history of repetitive aortic root surgery and/or inflammatory disease. Computed tomography showed pseudoaneurysms connecting the sacs to the LVOT lumen. In each case, a 6-Fr catheter was advanced to the sac by the transfemoral approach. A 0.052-in coil was placed across the tract. There was no significant complications associated with the procedure. No recurrence was evident in any case during the 5-year follow-up...
January 15, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28089778/image-noise-reduction-technology-reduces-radiation-in-a-radial-first-cardiac-catheterization-laboratory
#13
Ateka Gunja, Yagya Pandey, Hui Xie, Beata M Wolska, Adhir R Shroff, Amer K Ardati, Mladen I Vidovich
BACKGROUND: Transradial coronary angiography (TRA) has been associated with increased radiation doses. We hypothesized that contemporary image noise reduction technology would reduce radiation doses in the cardiac catheterization laboratory in a typical clinical setting. METHODS AND RESULTS: We performed a single-center, retrospective analysis of 400 consecutive patients who underwent diagnostic and interventional cardiac catheterizations in a predominantly TRA laboratory with traditional fluoroscopy (N=200) and a new image noise reduction fluoroscopy system (N=200)...
December 27, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28089455/comparison-of-transcatheter-aortic-valve-implantation-with-the-newest-generation-sapien-3-vs-direct-flow-medical-valve-in-a-single-center-cohort
#14
Eberhard Schulz, Alexander Jabs, Alexander Tamm, Patrick Herz, Andreas Schulz, Tommaso Gori, Stephan von Bardeleben, Walter Kasper-König, Ulrich Hink, Christian-Friedrich Vahl, Thomas Münzel
BACKGROUND: The latest generation transcatheter heart valves including Edwards Sapien 3 (ES3) and Direct Flow Medical (DFM) were designed to allow precise implantation at the intended position and to minimize prosthesis dysfunction as well as procedural complications. Our aim was to compare short-term functional and clinical outcomes of these 2 transcatheter aortic valve systems. METHODS: Of 174 patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) at our institution between August 2013 and June 2015, 113 were treated with ES3 and 61 with DFM...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088607/transcatheter-aortic-valve-implantation-leads-to-a-restoration-of-von-willebrand-factor-vwf-abnormalities-in-patients-with-severe-aortic-stenosis-incidence-and-relevance-of-clinical-and-subclinical-vwf-dysfunction-in-patients-undergoing-transfemoral-tavi
#15
Alexander Sedaghat, Hannah Kulka, Jan-Malte Sinning, Nora Falkenberg, Julia Driesen, Barbara Preisler, Christoph Hammerstingl, Georg Nickenig, Bernd Pötzsch, Johannes Oldenburg, Hans-Jörg Hertfelder, Nikos Werner
BACKGROUND: In this study, we sought to analyze the incidence and relevance of von Willebrand factor (VWF) abnormalities in patients undergoing transcatheter aortic valve implantation (TAVI), especially on perioperative bleeding. Furthermore, we hypothesized that, similar to aortic valve surgery, TAVI results in a restoration of VWF abnormalities. METHODS AND RESULTS: We performed a prospective analysis of periinterventional VWF parameters in 74 patients (80±7years, female in 37...
January 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28079554/latest-evidence-on-transcatheter-aortic-valve-implantation-vs-surgical-aortic-valve-replacement-for-the-treatment-of-aortic-stenosis-in-high-and-intermediate-risk-patients
#16
Fabien Praz, George C M Siontis, Subodh Verma, Stephan Windecker, Peter Jüni
PURPOSE OF REVIEW: The goal of this review is to summarize the current evidence supporting the use of transcatheter aortic valve implantation (TAVI) in high and intermediate-risk patients. The focus is on the five randomized controlled trials comparing TAVI with surgical aortic valve replacement (SAVR) published to date, as well as two recent meta-analyses. RECENT FINDINGS: TAVI has profoundly transformed the treatment of elderly patients presenting with symptomatic severe aortic stenosis...
January 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28077091/transradial-versus-transfemoral-approach-for-coronary-angiography-and-angioplasty-a-prospective-randomized-comparison
#17
Fayaz Ahmad Bhat, Khalid Hamid Changal, Hameed Raina, Nisar Ahmad Tramboo, Hilal Ahmad Rather
BACKGROUND: PCI has been done traditionally through transfemoral route. But now transradial and transbrachial routes are also coming up in practice. We compared transradial versus transfemoral routes for ease of operability, time for procedure, complications, and failure rates through a prospective study. METHODS: Four hundred Patients admitted in department of cardiology for percutaneous interventions were enrolled in the study. 200 patients were assigned to each group randomly...
January 11, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28075036/double-trouble-a-case-of-periprocedural-detection-of-intracardiac-thrombus-and-aortic-root-dissection-during-emergent-transfemoral-tavr
#18
Carlos Corredor, Eric Horlick, Wendy Tsang, Massimiliano Meineri
We report a case of emergency transcatheter aortic valve replacement (TAVR) in a 65-year-old patient presenting with decompensated severe aortic stenosis. Transesophageal echocardiography (TEE) was used effectively to obtain measurements of the aortic annulus and for intra-procedural guidance. At baseline, we detected a left atrial appendage thrombus and a localized aortic root dissection after balloon valvuloplasty. The case highlights the important role that TEE may play during TAVR procedures.
January 11, 2017: Echocardiography
https://www.readbyqxmd.com/read/28067197/comparison-of-procedural-and-clinical-outcomes-with-evolut-r-versus-medtronic-corevalve-a-swiss-tavi-registry-analysis
#19
Stephane Noble, Stefan Stortecky, Dik Heg, David Tuller, Raban Jeger, Stefan Toggweiler, Enrico Ferrari, Fabian Nietlispach, Maurizio Taramasso, Francesco Maisano, Jürg Grünenfelder, Peter Jüni, Christoph Huber, Thierry Carrel, Stephan Windecker, Peter Wenaweser, Marco Roffi
AIMS: Data on procedural and clinical outcomes after transcatheter aortic valve implantation (TAVI) with the new generation self-expanding Medtronic Evolut-R prosthesis in comparison with its predecessor, the Medtronic CoreValve, are scarce. METHODS AND RESULTS: In a nationwide, prospective, multi-center cohort study outcomes of consecutive transfemoral TAVI patients treated with the new- generation Medtronic Evolut-R (September 2014 - February 2016) and the Medtronic CoreValve (February 2011 - February 2016) were investigated...
January 10, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28066528/psychometric-evaluation-of-the-hill-assessment-index-hai-and-stair-assessment-index-sai-in-high-functioning-transfemoral-amputees
#20
M Jason Highsmith, Jason T Kahle, Brian Kaluf, Rebecca M Miro, Larry J Mengelkoch, Tyler D Klenow
The hill assessment index (HAI) and stair assessment index (SAI) were developed to objectively evaluate ramp and stair gait. This study's purpose was to determine the validity and reliability of these tests in a sample of persons with unilateral transfemoral amputation (TFA) using microprocessor prosthetic knee systems. All subjects were fit with a microprocessor knee system. After accommodation, subjects performed three trials ascending and descending a 5° ramp and a flight of stairs while being recorded on video...
September 2016: Technology and Innovation
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