Search results for "Aortic Valve"
showing 9 items of 179 documents
Determinants of elevated carbohydrate antigen 125 in patients with severe symptomatic aortic valve stenosis referred for transcatheter aortic valve i…
2018
Elevated carbohydrate antigen 125 (CA125) predicts adverse outcome after transcatheter aortic valve implantation (TAVI). While known underlying pathophysiological mechanisms of elevated CA125 include serosal effusions and inflammatory stimuli, clinical determinants associated with elevated CA125 in patients referred for TAVI remain unknown. Therefore, we investigated clinical, laboratory and echocardiographic determinants of elevated CA125 in patients with severe aortic valve stenosis referred for TAVI.This study includes 650 patients with severe aortic stenosis referred for TAVI. Baseline CA125 was determined by an immunoassay and dichotomized (elevated versus normal) based on the manufact…
Evidence, Lack of Evidence, Controversy, and Debate in the Provision and Performance of the Surgery of Acute Type A Aortic Dissection
2011
Acute type A aortic dissection is a lethal condition requiring emergency surgery. It has diverse presentations, and the diagnosis can be missed or delayed. Once diagnosed, decisions with regard to initial management, transfer, appropriateness of surgery, timing of operation, and intervention for malperfusion complications are necessary. The goals of surgery are to save life by prevention of pericardial tamponade or intra-pericardial aortic rupture, to resect the primary entry tear, to correct or prevent any malperfusion and aortic valve regurgitation, and if possible to prevent late dissection-related complications in the proximal and downstream aorta. No randomized trials of treatment or t…
“Unlucky punch”: unexpected annular rupture during TAVR and successful treatment
2021
Although rare, annular rupture in TAVR is a feared and often unpredictable complication with relevant impact on in-hospital prognosis. Severe annular calcification is a common risk factor for annular rupture. We report on a case of annular rupture during TAVR with a balloon-expanded prosthesis in the absence of any annular calcification in the planning CT scan and illustrate the proposed pathomechanism as well as its successful immediate surgical management.
Long-Term Outcome with New Generation Prostheses in Patients Undergoing Transcatheter Aortic Valve Replacement
2021
The aim of this study was to compare patients with transcatheter aortic valve replacement (TAVR) receiving new generation prostheses SAPIEN 3 (S3, Edwards Lifesc.) and Evolut R (ER, Medtronic Inc.) in terms of periprocedural and long-term outcome. Our retrospective, single-center analysis included 359 consecutive patients with severe aortic stenosis who underwent TAVR with S3 or ER from 2014–2016 (mean age 82 ± 7 years, 47% male, mean EuroSCORE II 8.0 ± 8%, mean follow-up 3.8 years). Device Success was equal (S3 93.0% vs. ER 92.4%, p = 0.812). We report a 30-day mortality of 2.8% in the S3 group, and 2.1% in the ER group (p = 0.674). There was no difference in stroke, conversion to open sur…
The progression rate of aortic stenosis: key to tailoring the management and potential target for treatment
2021
: Aortic stenosis is the most frequent valvular disease to require intervention in the western world and has always been featured as a progressive disease. The rate of progression can be assessed by carefully performed Doppler echocardiography and can vary greatly between individuals with a profound impact on prognosis. Unfortunately, the determinants of disease progression had been insufficiently studied and remain challenging to define, particularly in the outpatient setting. Multiple factors have been proposed and tested, but at present, there are no proven therapies to slow the course of the stenotic process. Heart valve clinics may be particularly important to define the progression ra…
Light on the molecular and cellular mechanisms of bicuspid aortic valve to unveil phenotypic heterogeneity
2019
Research on bicuspid aortic valve disease (BAV) and related complications has grown in an exponential manner in the last decades. However, the current knowledge of the mechanisms underlying the development of this disease is still limited, since all clinical and surgical studies on BAV mainly focused their objects on its major vascular complications, such as ascending aortic aneurysms and dissection. It is now clear that a better understanding of the pivotal molecular and cellular pathophysiological aspects of bicuspid valve aortopathy, including natural history, phenotypic expression, histology, cellular mechanisms and pathways, is critical for improving its clinical management. This chang…
Patient-specific computational evaluation of stiffness distribution in ascending thoracic aortic aneurysm
2021
Quantifying local aortic stiffness properties in vivo is acknowledged as essential to assess the severity of an ascending thoracic aortic aneurysm (ATAA). Recently, the LESI (local extensional stiffness identification) methodology has been established to quantify non-invasively local stiffness properties of ATAAs using electrocardiographic-gated computed tomography (ECG-gated CT) scans. The aim of the current study was to determine the most sensitive markers of local ATAA stiffness estimation with the hypothesis that direct measures of local ATAA stiffness could better detect the high-risk patients. A cohort of 30 patients (12 BAV and 18 TAV) referred for aortic size evaluation by ECG-gated…
RED BLOOD CELL DISTRIBUTION WIDTH PREDICTS MORBIDITY AND MORTALITY AFTER AORTIC VALVE REPLACEMENT
2014
Objective: Red blood cell distribution width (RDW), is a measurement of the size variation as well as an erythrocyte heterogeneity index (i.e., anysocytosis). used in combination with the mean corpuscular volume for anemia diagnosis. However, it is emerging as an useful predictor biomarker of mortality and morbidity of cardiovascular diseases. However, until now no literature data there are about the RDW role in predicting mortality after aortic valve replacement (AVR). Thus, in this pilot study biological significance of elevated RDW values in early outcome following AVR was evaluated Methods: We enrolled 75 patients (mean age 73.5 ±7.9 years) subjected to AVR and/ or not co temporally to …
Porównanie stopnia uszkodzenia mięśnia sercowego po zastosowaniu kardioplegii krwistej i krystaloidowej u pacjentów poddanych zabiegowi izolowanej wy…
2016
Wstęp: Kardioplegina jest środkiem używanym do tymczasowego zatrzymywania czynności elektromechanicznej serca w zabiegach kardiochirurgicznych. Jest to roztwór o wysokiej zawartości jonów potasu podawany do tętnic wieńcowych w postaci zmieszanej z krwią pacjenta z oksygenatora (kardioplegina krwista) lub w postaci roztworu krystaloidowego (kardioplegina krystaloidowa). W dotychczasowych badaniach w większości wykazano wyższość kardiopleginy krwistej nad krystaliczną w operacjach pomostowania aortalno-wieńcowego (CABG). Celem niniejszego badania było sprawdzenie, czy u pacjentów poddanych izolowanemu zabiegowi wymiany zastawki aortalnej (AVR), podobnie jak w przypadku pacjentów poddanych CAB…