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Valve durability

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https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#1
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28803350/comparison-of-mitral-competence-after-mitral-repair-with-papillary-muscle-approximation-versus-papillary-muscle-relocation-for-functional-mitral-regurgitation
#2
Koji Furukawa, Mitsuhiro Yano, Eisaku Nakamura, Masakazu Matsuyama, Masanori Nishimura, Katsuya Kawagoe, Kunihide Nakamura
The purpose of this study was to evaluate the surgical results of papillary muscle approximation (PMA) and papillary muscle relocation (PMR) for functional mitral regurgitation (FMR) and to compare the effects of both procedures on the change in mitral regurgitation (MR) and echocardiogram parameters associated with tethering. Eighteen patients with moderate-to-severe FMR (MR grade ≥2) who underwent PMA or PMR were retrospectively analyzed. Underlying diseases were ischemic cardiomyopathy, idiopathic dilated cardiomyopathy, and aortic valve disease for seven, six, and five patients, respectively...
August 12, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28795027/the-ross-procedure-in-pediatric-patients-a-20-year-experience-of-ross-procedure-in-a-single-institution
#3
Dong Woog Yoon, Ji-Hyuk Yang, Tae-Gook Jun, Pyo Won Park
BACKGROUND: The Ross/Ross-Konno procedure is considered a good option for irreparable aortic valve disease in pediatric patients because of its hemodynamic performance and potential for growth of the pulmonary autograft. This study is a review of the long-term results of our 20-year experience with the Ross and Ross-Konno operations in a single institution. METHODS: Between June 1995 and January 2016, 16 consecutive patients (mean age, 6.0±5.9 years; range, 16 days to 17...
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28782294/selective-patient-experience-with-the-blom-singer-dual-valve-voice-prosthesis
#4
Ben Brownlee, Saniya Ahmad, Tracy Grammer, Greg Krempl
OBJECTIVES/HYPOTHESIS: This study compares the overall durability, phonation effort, and speech quality achieved by the Blom-Singer Dual Valve prosthesis to the same characteristics achieved by the single-valve prosthesis used in a select population of total laryngectomy patients who have demonstrated single-valve prosthesis failure within 3 months of placement. STUDY DESIGN: Prospective phase IV study. METHODS: Fourteen patients who had previously experienced early valve failure using a single-valve prosthesis had a Dual Valve placed by a speech language pathologist...
August 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28780254/modeling-the-response-of-exogenously-crosslinked-tissue-to-cyclic-loading-the-effects-of-permanent-set
#5
Will Zhang, Michael S Sacks
Bioprosthetic heart valves (BHVs), fabricated from exogenously crosslinked collagenous tissues, remain the most popular heart valve replacement design. However, the life span of BHVs remains limited to 10-15 years, in part because the mechanisms that underlie BHV failure remain poorly understood. Experimental evidence indicates that BHVs undergo significant changes in geometry with in vivo operation, which lead to stress concentrations that can have significant impact on structural damage. These changes do not appear to be due to plastic deformation, as the leaflets only deform in the elastic regime...
July 11, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28776326/a-comprehensive-pipeline-for-multi-resolution-modeling-of-the-mitral-valve-validation-computational-efficiency-and-predictive-capability
#6
Andrew Drach, Amir H Khalighi, Michael S Sacks
Multiple studies have demonstrated that the pathological geometries unique to each patient can affect the durability of mitral valve (MV) repairs. While computational modeling of the MV is a promising approach to improve the surgical outcomes, the complex MV geometry precludes use of simplified models. Moreover, the lack of complete in-vivo geometric information presents significant challenges in the development of patient-specific computational models. There is thus a need to determine the level of detail necessary for predictive MV models...
August 3, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/28757798/mitral-valve-replacement-current-and-future-perspectives
#7
REVIEW
Johan van der Merwe, Filip Casselman
The favorable outcomes achieved with modern mitral valve repair techniques redefined the role of mitral valve replacement. Various international databases report a significant decrease in replacement procedures performed compared with repairs, and contemporary guidelines limit the application of surgical mitral valve replacement to pathology in which durable repair is unlikely to be achieved. The progressive paradigm shift toward endoscopic and robotic mitral valve surgery is also paralleled by rapid developments in transcatheter devices, which is progressively expanding from experimental approaches to becoming clinical reality...
2017: Open Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28745279/paediatric-nanofibrous-bioprosthetic-heart-valve
#8
REVIEW
Mehrdad Namdari, Babak Negahdari, Ali Eatemadi
The search for an optimal aortic valve implant with durability, calcification resistance, excellent haemodynamic parameters and ability to withstand mechanical loading is yet to be met. Thus, there has been struggled to fabricate bio-prosthetics heart valve using bioengineering. The consequential product must be resilient with suitable mechanical features, biocompatible and possess the capacity to grow. Defective heart valves replacement by surgery is now common, this improves the value and survival of life for a lot of patients...
August 2017: IET Nanobiotechnology
https://www.readbyqxmd.com/read/28740718/papillary-muscle-approximation-in-mitral-valve-repair-for-secondary-mr
#9
REVIEW
Francesco Nappi, Cristiano Spadaccio, Massimo Chello, Christos G Mihos
Ischemic mitral regurgitation (IMR) is a complex disorder occurring after a myocardial infarction and affecting both the mitral valvular and subvalvular apparati. Several abnormalities can be detected in IMR as annular dilatation, leaflet tethering with impaired coaptation and papillary muscle (PM) displacement along a posterior, apical or lateral vectors. Treatments available include, beside myocardial revascularization, mitral-valve repair or chordal-sparing replacement. Repair is normally achieved downsizing the mitral valve annulus with a rigid or semirigid ring...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740711/mitral-valve-repair-and-subvalvular-intervention-for-secondary-mitral-regurgitation-a-systematic-review-and-meta-analysis-of-randomized-controlled-and-propensity-matched-studies
#10
Christos G Mihos, Steve Xydas, Evin Yucel, Romain Capoulade, Roy F Williams, Maurice Mawad, Guillermo Garcia, Orlando Santana
BACKGROUND: Combining a ring annuloplasty (Ring) with a mitral subvalvular intervention (Ring + subvalvular) in patients with secondary mitral regurgitation (MR) may improve mitral valve (MV) repair durability. However, the outcomes of this strategy compared with a Ring only, have not been clearly defined. METHODS: A systematic review and meta-analysis was performed utilizing randomized controlled and propensity matched studies which compared a Ring + subvalvular versus Ring MV repair for the treatment of secondary MR...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28728720/mitral-valve-repair-the-french-correction-versus-the-american-correction
#11
REVIEW
Sarah A Schubert, James H Mehaffey, Eric J Charles, Irving L Kron
Degenerative mitral valve disease causing mitral regurgitation is the most common organic valve pathology and is classified based on leaflet motion. The "French correction" mitral valve repair method restores normal valvular anatomy with extensive leaflet resection, chordal manipulation, and rigid annuloplasty. The American correction attempts to restore normal valve function through minimal leaflet resection, flexible annuloplasty, and use of artificial chordae. These differing methods of mitral valve repair reflect an evolution in principles, but both require understanding of the valve pathology and correction of leaflet prolapse and annular dilatation...
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28724839/effect-of-recurrent-mitral-regurgitation-after-mitral-valve-repair-in-patients-with-degenerative-mitral-regurgitation
#12
Jung-Hwan Kim, Seung Hyun Lee, Hyun-Chel Joo, Young-Nam Youn, Kyung-Jong Yoo, Byung-Chul Chang, Sak Lee
BACKGROUND: This study investigated the consequences of recurrent mitral regurgitation (MR) after mitral valve (MV) repair in patients with degenerative MR and risk factors for recurrence.Methods and Results:From January 1990 to December 2015, 792 patients underwent MV repair due to degenerative MR. Recurrent MR was defined as moderate-to-severe MR on follow-up echocardiography. Mean follow-up duration was 8.71±5.58 years. During the follow-up period, MR recurred in 133 (16.8%) patients, and the MR recurrence-free rate at 20 years was 77...
July 20, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28716099/xenoantigenicity-of-porcine-decellularized-valves
#13
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/28706871/tricuspid-valve-regurgitation-after-heart-transplantation
#14
Murray H Kwon, Richard J Shemin
Tricuspid valve regurgitation (TVR) in the orthotopic heart transplant (OHT) recipient is quite common and has varied clinical sequelae. In its severest forms, it can lead to right-sided failure symptoms indistinguishable from that seen in native heart TVR disease. While certain implantation techniques are widely recognized to reduce the risk of TVR in the cardiac allograft, concomitant tricuspid annuloplasty, while having advocates, is not currently accepted as a routinely established adjunct. Decisions to surgically correct TVR in the OHT recipient must be made carefully, as certain clinical scenarios have high risk of failure...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28706867/tricuspid-leaflet-repair-innovative-solutions
#15
Jack H Boyd, J James B Edelman, David H Scoville, Y Joseph Woo
Tricuspid regurgitation (TR) represents a significant disease process and when severe, is associated with increased mortality. Recent guidelines support a more aggressive approach to tricuspid valve (TV) surgery, especially when encountered with left-sided valvular pathology. While annuloplasty has been the standard treatment for TR, it may not provide as effective or durable a repair compared to annuloplasty combined with TV repair techniques. Several of these approaches are discussed including bicuspidalization, anterior leaflet augmentation, edge to edge repair, neochords, leaflet resection and combined approaches...
May 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28697893/mechanical-valves-in-the-pulmonary-position-an-international-retrospective-analysis
#16
Hanna Pragt, Joost P van Melle, Hoda Javadikasgari, Dong Man Seo, John M Stulak, Igor Knez, Jürgen Hörer, Christian Muñoz-Guijosa, Mahyar G Dehaki, Hong Ju Shin, Joseph A Dearani, Maziar G Dehaki, Petronella G Pieper, Christine Eulenburg, Laura Dos, Tjark Ebels
OBJECTIVE: Life expectancy of patients with congenital heart disease has improved over the past decades, increasing the need for a durable pulmonary prosthetic valve. Biological valves in various forms have become the valve of choice for pulmonary valve replacement (PVR), but structural valve deterioration is unavoidable in the long term. Use of a mechanical valve could be an alternative, but data on long-term outcomes are sparse. METHODS: We retrospectively collected and analyzed data on 364 patients with mechanical valves implanted in the pulmonary position between 1965 and 2014...
May 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28697003/the-respect-rather-than-resect-principle-in-mitral-valve-repair-the-lateral-dislocation-of-the-p2-technique
#17
Marco Zanobini, Gabriella Ricciardi, Francesco Liborio Mammana, Samer Kassem, Paolo Poggio, Alessandro Di Minno, L Cavallotti, Matteo Saccocci
BACKGROUND: Leaflet resection represents the reference standard for surgical treatment of mitral valve (MV) regurgitation. New approaches recently proposed place emphasis on respecting, rather than resecting, the leaflet tissue to avoid the drawbacks of the 'resection' approach. OBJECTIVES: The lateral dislocation of mid portion of mitral posterior leaflet (P2) technique for MV repair is a nonresectional technique in which the prolapsed P2 segment is sutured to normal P1 segment...
September 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28688707/long-term-follow-up-of-bioprosthetic-aortic-valve-replacement-in-patients-aged-%C3%A2-60%C3%A2-years
#18
Amedeo Anselmi, Erwan Flecher, Celine Chabanne, Vito Giovanni Ruggieri, Thierry Langanay, Hervé Corbineau, Alain Leguerrier, Jean-Philippe Verhoye
OBJECTIVE: To address the long-term durability of bioprostheses used for aortic valve replacement (AVR) in adult patients aged ≤60 years at the time of surgery. METHODS: Through a retrospective review of a prospectively collected database, we identified 416 bioprosthetic AVRs performed between 1977 and 2013. A prospective follow-up of valve-related and non-valve-related events was performed. RESULTS: Follow-up was 98.5% complete (2423.1 patient-years; average, 6 ± 5...
June 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28684441/structural-valve-deterioration-after-transcatheter-aortic-valve-implantation
#19
Farid Foroutan, Gordon H Guyatt, Catherine M Otto, Reed A Siemieniuk, Stefan Schandelmaier, Thomas Agoritsas, Per O Vandvik, Sai Bhagra, Rodrigo Bagur
BACKGROUND: Transcatheter aortic valve implantation (TAVI), widely used to treat high-risk patients with severe symptomatic aortic stenosis, has recently been extended to younger patients at lower operative risk in whom long-term durability of TAVI devices is an important concern. Therefore, we conducted a systematic review and meta-analysis of observational studies addressing the frequency of structural valve deterioration (SVD) after TAVI. METHODS: We searched Medline, Embase, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL from 2002 to September 2016...
July 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28684004/tavr-vs-savr-rising-expectations-and-changing-indications-for-surgery-in-response-to-partner-ii
#20
Cristiano Spadaccio, Francesco Nappi, Jean-Louis Sablayrolles, Fraser W H Sutherland
Despite the criticisms and concerns raised on the data published in the PARTNER II trial and related analyses, we are undeniably witnessing a revolution in the management of aortic valve disease, in which conventional full sternotomy surgical aortic valve replacement (SAVR), with all related complications and clinical burden, will soon become a nonviable option. Several of the findings described in the PARTNER II trial, although considerable as points of incongruence and study biases in comparison with SAVR, could be taken as lessons to found a new course in SAVR and redesign the respective roles of surgery and interventional procedures in aortic disease...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
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