Search results for "Valve replacement"
showing 8 items of 78 documents
Usefulness and limitations of contractile reserve evaluation in patients with low-flow, low-gradient aortic stenosis eligible for cardiac resynchroni…
2014
Aims In low-flow, low-gradient aortic stenosis (LF/LG AS), the assessment of contractile reserve (CR) by dobutamine stress echocardiography (DSE) is recommended for risk stratification and treatment strategy. However, DSE may show limitations in cases of left ventricular dyssynchrony (LVD). The impact of LVD in LF/LG AS, and the feasibility of CRT in this setting have never been evaluated. We aimed to assess: (i) the proportion of LF/LG AS patients with LVD; (ii) the influence of LVD on CR at DSE; and (iii) the effects of CRT in these patients. Methods and results Thirty consecutive patients with LF/LG AS underwent DSE with study of CR. The operative risk for aortic valve replacement (AVR) …
ACTIVATION (PercutAneous Coronary inTervention prIor to transcatheter aortic VAlve implantaTION)
2021
Abstract Objectives This study sought to determine if percutaneous coronary intervention (PCI) prior to transcatheter aortic valve replacement (TAVR) in patients with significant coronary artery disease would produce noninferior clinical results when compared with no PCI (control arm). Background PCI in patients undergoing TAVR is not without risk, and there are no randomized data to inform clinical practice. Methods Patients with severe symptomatic aortic stenosis and significant coronary artery disease with Canadian Cardiovascular Society class ≤2 angina were randomly assigned to receive PCI or no PCI prior to TAVR. The primary endpoint was a composite of all-cause death or rehospitalizat…
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…
“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…
Pre-Operative Modeling of Transcatheter Mitral Valve Replacement in a Surgical Heart Valve Bioprosthesis
2020
Obstruction of the left ventricular outflow tract (LVOT) is a common complication of transcatheter mitral valve replacement (TMVR). This procedure can determine an elongation of an LVOT (namely, the neo-LVOT), ultimately portending hemodynamic impairment and patient death. This study aimed to understand the biomechanical implications of LVOT obstruction in a patient who underwent TMVR using a transcatheter heart valve (THV) to repair a failed bioprosthetic heart valve. We first reconstructed the heart anatomy and the bioprosthetic heart valve to virtually implant a computer-aided-design (CAD) model of THV and evaluate the neo-LVOT area. A numerical simulation of THV deployment was then deve…
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…