Search results for "valve"

Transcatheter Heart Valve Implantation in Bicuspid Patients with Self-Expanding Device

2021

Bicuspid aortic valve (BAV) patients are conventionally not treated by transcathether aortic valve implantation (TAVI) because of anatomic constraint with unfavorable outcome. Patient-specific numerical simulation of TAVI in BAV may predict important clinical insights to assess the conformability of the transcathether heart valves (THV) implanted on the aortic root of members of this challenging patient population. We aimed to develop a computational approach and virtually simulate TAVI in a group of n.6 stenotic BAV patients using the self-expanding Evolut Pro THV. Specifically, the structural mechanics were evaluated by a finite-element model to estimate the deformed THV configuration in …

Diabetes and aortic root dimension: A controversial subject.

2018

TAVI imaging: over the echocardiography

2020

Aortic valve stenosis (AS) is a common valvular heart disease. Recently, transcatheter aortic valve implantation (TAVI) has changed the treatment of severe AS in elderly patients with contraindications to traditional surgical replacement. Echocardiography is conventionally used as the first imaging modality to assess the presence and severity of AS and to provide anatomical and functional information. Nowadays, imaging techniques play a crucial role in the planning of TAVI to define suitable candidates. Computed tomography (CT) is essential to display the anatomy of the aortic valve complex (including aortic annulus, Valsalva sinuses, coronary arteries ostia, sinotubular junction), thoracoa…

Bicuspid aortic valve and sports: From the echocardiographic evaluation to the eligibility for sports competition

2021

Bicuspid aortic valve (BAV) is the most common congenital heart defect in adults. Although a BAV may remain without clinical consequences for a lifetime, it can deteriorate in aortic valve stenosis and regurgitation and aortic dilatation. Unfortunately, the impact of regular training on patients with BAV and its natural course is not fully understood, although preliminary evidence suggests that the progression of valvular disease occurs primarily in an independent manner from sports practice. The current review aims to report how to perform a comprehensive echocardiographic examination in athletes with BAV and analyze the current literature on the influence of sports practice and how it imp…

Deep learning approach for the segmentation of aneurysmal ascending aorta.

2020

Diagnosis of ascending thoracic aortic aneurysm (ATAA) is based on the measurement of the maximum aortic diameter, but size is not a good predictor of the risk of adverse events. There is growing interest in the development of novel image-derived risk strategies to improve patient risk management towards a highly individualized level. In this study, the feasibility and efficacy of deep learning for the automatic segmentation of ATAAs was investigated using UNet, ENet, and ERFNet techniques. Specifically, CT angiography done on 72 patients with ATAAs and different valve morphology (i.e., tricuspid aortic valve, TAV, and bicuspid aortic valve, BAV) were semi-automatically segmented with Mimic…

Cost effectiveness of aortic valve therapies: a systematic review of the literature

2022

Background: Systematic review on the cost effectiveness of transcatheter aortic valve implantation (TAVI) to standard aortic valve replacement and medical management in high-risk elderly patients with severe aortic stenosis. Evidenced based systematic reviews are the core methodologies in health economics for evaluating cost effectiveness and medical effectiveness. Clarity and transparency of these reports can help to provide health care interventions accurately and reliably. Methods: In accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses, a systematic review on current literature for cost-effectiveness of TAVI, standard aortic valve replacement, and medical m…

On the severity of aortic stenosis in ascending aortic aneurysm: A computational tool to examine ventricular-arterial interaction and aortic wall str…

2020

Abstract An ascending thoracic aortic aneurysm (ATAA) is a life-threatening cardiovascular consequence of vessel dilatation that portends adverse events and death. From a clinical perspective, ATAA should not be treated as an isolated disease, and surgery is often carried out in the presence of AS, aortic insufficiency or a calcified valve leaflet. Aortic stenosis (AS) is common in ATAAs and leads to both vessel rigidity and left ventricular (LV) impairment. In this study, lumped-parameter modeling and computational analysis were used to assess the change in the wall shear stress (WSS) and intramural wall stress of patient-specific ATAA models with different degrees of AS (i.e., mild to sev…

Constitutive modeling of ascending thoracic aortic aneurysms using microstructural parameters.

2016

Ascending thoracic aortic aneurysm (ATAA) has been associated with diminished biomechanical strength and disruption in the collagen fiber microarchitecture. Additionally, the congenital bicuspid aortic valve (BAV) leads to a distinct extracellular matrix structure that may be related to ATAA development at an earlier age than degenerative aneurysms arising in patients with the morphological normal tricuspid aortic valve (TAV). The purpose of this study was to model the fiber-reinforced mechanical response of ATAA specimens from patients with either BAV or TAV. This was achieved by combining image-analysis derived parameters of collagen fiber dispersion and alignment with tensile testing dat…

Assessment of left ventricular function during aortic balloon valvuloplasty by transesophageal echocardiography

1989

Several reports have documented the feasability and utility of balloon aortic valvuloplasty as a palliative treatment for high-surgical-risk patients with critical aortic valve stenosis (1–3).

Valvular Heart Disease

2013

Valvular heart disease (VHD) refers to a wide spectrum of cardiac disorders that affect a large number of patients. Echocardiography is still considered the pivotal imaging method to evaluate the cardiac valves. However, echocardiography has some intrinsic limitations due to operator dependence and patient habitus. In the last two decades three-dimensional techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) have provided valuable assessment of VHD. MRI overcomes the limitation of the poor acoustic window of echocardiography without ionizing radiation. Nowadays, MRI aims to be considered as the reference standard for imaging cardiac valves because of the improved…