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Valve durability

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https://www.readbyqxmd.com/read/28728720/mitral-valve-repair-the-french-correction-versus-the-american-correction
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
July 10, 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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28683983/sutureless-sorin-perceval-aortic-valve-implantation
#11
Steffen Pfeiffer, Theodor Fischlein, Giuseppe Santarpino
The sutureless Perceval aortic valve (Sorin Group, Saluggia, Italy) is a device increasingly used in many European cardiac surgery centers. Since the first reports evaluating implantation feasibility and valve safety in humans in 2007, an increasing amount of data have become available, including premarketing clinical results and experience in particular conditions. Overall, excellent performances have been demonstrated in hemodynamic outcomes, safety, and versatility of use. However, several questions remain unanswered, especially regarding long-term durability, risk for endocarditis, and the need for postoperative pacemaker implantation...
April 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28673709/patient-tailored-aortic-root-repair-in-adult-marfanoid-patients-surgical-considerations-and-outcomes
#12
Paul P Urbanski, Atanas Jankulowski, Aleksandra Morka, Vadim Irimie, Xiaochun Zhan, Michael Zacher, Anno Diegeler
OBJECTIVE: The aim of the study was to evaluate the operative and functional results after individual, patient-tailored aortic root repair in marfanoid patients. METHODS: Among 518 patients who underwent operation between 2002 and January 2016, using patient-tailored aortic root repair with isolated sinus replacement, 42 patients fulfilled the original Ghent criteria. None/trivial, mild, moderate, and severe insufficiency grades were present in 5, 16, 10, and 11 patients, respectively...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28671806/valvular-heart-disease-in-adults-management-of-prosthetic-heart-valves
#13
John F Trujillo, Steven M Hollenberg
Patients undergoing cardiac valve replacement may receive mechanical or bioprosthetic valves. Mechanical valves require lifelong anticoagulation but are durable and the need for a second surgery is up to eightfold times less than with bioprosthetic valves. Bioprosthetic valves do not require lifelong anticoagulation and thus are associated with fewer bleeding complications but they are less durable and associated with higher morbidity and mortality rates, particularly in younger patients. Anticoagulation with mechanical valves is achieved using warfarin; use of direct-acting oral anticoagulants is not indicated...
June 2017: FP Essentials
https://www.readbyqxmd.com/read/28669506/risk-factors-for-late-aortic-valve-dysfunction-after-the-david-v-valve-sparing-root-replacement
#14
Jiro Esaki, Bradley G Leshnower, Jose N Binongo, Yi Lasanajak, LaRonica McPherson, Robert A Guyton, Edward P Chen
BACKGROUND: Valve-sparing root replacement (VSRR) is an established therapy for aortic root pathology. However, late aortic valve dysfunction requiring reoperation remains a primary concern of this procedure. This study examines risk factors for late aortic insufficiency (AI) and aortic stenosis (AS) after David V VSRR. METHODS: A retrospective review from 2005 to 2015 at a US academic center identified 282 patients who underwent VSRR. Cox proportional hazards regression analysis was used to identify risk factors for late AI and AS after VSRR...
June 29, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28669435/durability-of-tissue-valves-only-time-will-tell
#15
EDITORIAL
Torsten Doenst
No abstract text is available yet for this article.
June 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28658491/health-status-benefits-of-transcatheter-vs-surgical-aortic-valve-replacement-in-patients-with-severe-aortic-stenosis-at-intermediate-surgical-risk-results-from-the-partner-2-randomized-clinical-trial
#16
Suzanne J Baron, Suzanne V Arnold, Kaijun Wang, Elizabeth A Magnuson, Khaja Chinnakondepali, Raj Makkar, Howard C Herrmann, Susheel Kodali, Vinod H Thourani, Samir Kapadia, Lars Svensson, David L Brown, Michael J Mack, Craig R Smith, Martin B Leon, David J Cohen
Importance: In patients with severe aortic stenosis (AS) at intermediate surgical risk, treatment with transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in similar 2-year survival. The effect of TAVR vs SAVR on health status in patients at intermediate surgical risk is unknown. Objective: To compare health-related quality of life among intermediate-risk patients with severe AS treated with either TAVR or SAVR. Design, Setting, and Participants: Between December 2011 and November 2013, 2032 intermediate-risk patients with severe AS were randomized to TAVR with the Sapien XT valve or SAVR in the Placement of Aortic Transcatheter Valve 2 Trial and were followed up for 2 years...
June 28, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28656518/anatomy-of-the-aortic-root-implications-for-aortic-root-reconstruction
#17
REVIEW
Takashi Kunihara
Since the introduction of valve-preserving root replacement and aortic annuloplasty, precise understanding of the aortic root anatomy has emerged as a key to successful aortic valve-preservation surgery. Fundamentally, surgeons need to know the precise anatomical definition and structure of the aortic root, including its normal dimensions, know the anatomy of the coronary arteries, and understand the cardiac conduction system. Surgeons must be able to clearly distinguish normal and abnormal structures, and recognize the effects of aortic valve regurgitation or root expansion on dimensions and geometric relationships within the aortic root...
June 27, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28655532/surgical-relief-of-left-ventricular-outflow-tract-obstruction-in-adults-with-congenital-aortic-stenosis-and-associated-aortic-annulus-hypoplasia-and-or-subaortic-obstruction
#18
Tanveer Ahmad, Amalan Thuraisingam, Marco Larobina, Peter Skillington
BACKGROUND: In children and adolescents, a Ross/Konno operation is commonly done to both enlarge the aortic root and provide a competent aortic valve with relief of left ventricular outflow tract obstruction (LVOTO). Optimum management is not so straightforward in adults. METHODS: Between 1995 and 2014, 16 patients of mean age 39.4 years (18-57 years) with hypoplastic aortic annulus (AA) measuring 20mm and less, and mean aortic valve/LVOT gradient of 61mmHg (30-70mmHg) presented for surgery...
June 3, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28641394/reoperative-analysis-after-mitral-valve-repair-with-glutaraldehyde-treated-autologous-pericardium
#19
Naoto Fukunaga, Ryuzo Sakata, Tadaaki Koyama
OBJECTIVES: We reviewed reoperations following mitral valve repair (MVR) that used glutaraldehyde-treated autologous pericardium for mitral regurgitation (MR) to analyse the durability and risk factors for reoperation. METHODS: We retrospectively analysed 144 patients (mean age 57.9 years) who underwent MVR using glutaraldehyde-treated pericardium from March 1992 to December 2011. A total of 19 reoperations were necessary during the follow-up period (mean 6.9 years)...
June 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28633375/final-5-year-clinical-and-echocardiographic-results-for-treatment-of-severe-aortic-stenosis-with-a-self-expanding-bioprosthesis-from-the-advance-study
#20
Ulrich Gerckens, Corrado Tamburino, Sabine Bleiziffer, Johan Bosmans, Peter Wenaweser, Stephen Brecker, Jia Guo, Axel Linke
Aims: The ADVANCE study was designed to evaluate the safety and effectiveness of transcatheter aortic valve implantation (TAVI) with a self-expanding bioprosthesis in real-world patients with symptomatic, severe aortic stenosis at high surgical risk for valve replacement. Methods and results: Study participants were enrolled from 44 experienced centres in 12 countries. Patient eligibility, treatment approach, and choice of anaesthesia were determined by the local Heart Team...
June 13, 2017: European Heart Journal
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